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Pal G, Bennett L, Roy J, Nyandege A, Mouradian MM, Gerhard T, Horton DB. Effects of antimicrobial exposure on the risk of Parkinson's disease. Parkinsonism Relat Disord 2024; 127:107081. [PMID: 39098264 DOI: 10.1016/j.parkreldis.2024.107081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 07/07/2024] [Accepted: 07/29/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND We aimed to assess how antimicrobial exposure affects Parkinson's disease (PD) risk. METHODS A nested case-control study was performed to examine the association between antimicrobial exposure and newly diagnosed PD using the Clinical Practice Research Datalink (CPRD). Each PD case was matched by age, sex, and year of diagnosis (index date) to up to 15 controls. Number of prescribed antimicrobial courses was assessed 1-5, 6-10, and 11-15 years prior to the index date. Logistic regression with generalized estimating equations (GEE) was used to estimate odds ratios (ORs) and false discovery rate-adjusted p-values between antimicrobial exposure and risk of PD. RESULTS We compared 12,557 PD cases with 80,804 matched controls. We found an inverse dose-response relationship between number of penicillin courses and PD risk across multiple time periods (5+ courses, 1-5 years prior: OR 0.85, 95 % CI 0.76-0.95, p = 0.043; 6-10 years prior: OR 0.84, 95 % CI: 0.73-0.95, p = 0.059; 11-15 years prior: OR 0.87, 95 % CI 0.74-1.02, p = 0.291). The number of macrolide courses was inversely but not significantly associated with PD risk 1-5 years prior to the index date (OR 0.89-0.91, 95 % CI: 0.79-0.99, adjusted p = 0.140-0.167). Exposure to ≥2 courses of antifungals 1-5 years prior was associated with an increased risk of PD (OR 1.16, 95 % CI: 1.06-1.27, p = 0.020). CONCLUSIONS In a large UK-representative population, the risk of PD was modestly lower among adults who had previously received multiple courses of penicillins in the last 15 years and modestly higher among those exposed to antifungal medicines in recent years.
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Affiliation(s)
- Gian Pal
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
| | - Laura Bennett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Jason Roy
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA; New Jersey Alliance for Clinical and Translational Science, New Brunswick, NJ, USA
| | - Abner Nyandege
- Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - M Maral Mouradian
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Robert Wood Johnson Medical School Institute for Neurological Therapeutics, Piscataway, NJ, USA
| | - Tobias Gerhard
- Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA; Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Piscataway, NJ, USA
| | - Daniel B Horton
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA; Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA; Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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2
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Pereira GM, Teixeira-Dos-Santos D, Soares NM, Marconi GA, Friedrich DC, Saffie Awad P, Santos-Lobato BL, Brandão PRP, Noyce AJ, Marras C, Mata IF, Rieder CRDM, Schuh AFS. A systematic review and meta-analysis of the prevalence of Parkinson's disease in lower to upper-middle-income countries. NPJ Parkinsons Dis 2024; 10:181. [PMID: 39349513 PMCID: PMC11442769 DOI: 10.1038/s41531-024-00779-y] [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: 12/18/2023] [Accepted: 08/13/2024] [Indexed: 10/02/2024] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disease that is a growing public health challenge. Estimates of the burden of PD have focused on data from high-income countries, with lower-income countries poorly described. We reviewed and examined the prevalence of PD reported by studies in low- to upper-middle-income countries. A systematic literature search was performed in the Medline/PubMed, Embase, LILACS, and Web of Science databases. Age group, sex, and geographic region were considered when analyzing the data. Of the 4327 assessed articles, 57 met the inclusion criteria for qualitative review, and 36 were included in the meta-analysis. Heterogeneity measures were high both as a whole and in each geographic region. Data analysis by geographic region showed that reported prevalence differed across regions, ranging from 49 per 100,000 (Sub-Saharan Africa) to 1081 per 100,000 (Latin America and the Caribbean). There was an increasing prevalence of PD with advancing age (per 100,000): 7 in 40-49 years, 158 in 50-59 years, 603 in 60-69 years, 1251 in 70-79 years, and 2181 in over the age of 80. The prevalence of PD in men and women was similar. There was a greater PD prevalence in populations with a higher 5-year GDP per capita and a higher life expectancy. Our findings suggest a higher prevalence of PD in lower and upper-middle-income countries than previously reported. Comparisons between regions are difficult, as the sociocultural differences and lack of methodological standardization hinder understanding key epidemiological data in varied populations.
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Affiliation(s)
- Gabriela Magalhães Pereira
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | | | - Nayron Medeiros Soares
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Gabriel Alves Marconi
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Deise Cristine Friedrich
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica de Porto Alegre, Porto Alegre, RS, Brazil
| | - Paula Saffie Awad
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Alastair J Noyce
- Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Connie Marras
- The Edmond J Safra Program in Parkinson's disease, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Ignacio F Mata
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Artur Francisco Schumacher Schuh
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
- Departamento de Farmacologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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3
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Chen YS, Kuo CY, Lu CH, Wang YW, Chou KH, Lin WC. Multiscale brain age prediction reveals region-specific accelerated brain aging in Parkinson's disease. Neurobiol Aging 2024; 140:122-129. [PMID: 38776615 DOI: 10.1016/j.neurobiolaging.2024.05.003] [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: 10/26/2023] [Revised: 04/20/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
Brain biological age, which measures the aging process in the brain using neuroimaging data, has been used to assess advanced brain aging in neurodegenerative diseases, including Parkinson disease (PD). However, assuming that whole brain degeneration is uniform may not be sufficient for assessing the complex neurodegenerative processes in PD. In this study we constructed a multiscale brain age prediction models based on structural MRI of 1240 healthy participants. To assess the brain aging patterns using the brain age prediction model, 93 PD patients and 91 healthy controls matching for sex and age were included. We found increased global and regional brain age in PD patients. The advanced aging regions were predominantly noted in the frontal and temporal cortices, limbic system, basal ganglia, thalamus, and cerebellum. Furthermore, region-level rather than global brain age in PD patients was associated with disease severity. Our multiscale brain age prediction model could aid in the development of objective image-based biomarkers to detect advanced brain aging in neurodegenerative diseases.
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Affiliation(s)
- Yueh-Sheng Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chen-Yuan Kuo
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yuan-Wei Wang
- The Science & Technology Policy Research and Information Center, National Applied Research Laboratories(NARLabs), Taipei, Taiwan
| | - Kun-Hsien Chou
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Wattenbach C, Ellrichmann G, Feinkohl I, Voß S, Brinks R. Incidence of Parkinson's disease in Germany based on prevalence data from 70 million patients of the statutory health insurance. BMC Neurol 2024; 24:221. [PMID: 38937689 PMCID: PMC11210077 DOI: 10.1186/s12883-024-03739-4] [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: 03/27/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and nonmotor system manifestations and psychiatric symptoms. The aim of this study was to estimate the age- and sex-specific incidence of PD in Germany using an illness-death model and a corresponding partial differential equation (PDE) based on prevalence and mortality data. METHODS Based on a PDE that describes the dynamics in an illness-death model, the age- and sex-specific incidence of PD in Germany was estimated using published prevalence and mortality rates. Prevalence rates were provided by the Central Institute for Statutory Health Insurance (Zi) for the period from 2010 to 2019. Parkinson's related mortality was estimated based on comparable population data from Norway. Bootstrapping was used for incidence estimation (median of 5000 samples) and to obtain 95% confidence intervals to interpret the accuracy of the incidence estimation. RESULTS Men had higher incidences of PD than women at all ages. The highest incidences (median of 5000 bootstrap samples) for both groups were estimated for the age of 85 years with an incidence of 538.49 per 100,000 person-years (py) in men and 284.09 per 100,000 py in women, with an increasing width of bootstrapping 95% CIs showing greater uncertainty in the estimation at older ages. CONCLUSION The illness-death model and the corresponding PDE, which describes changes in prevalence as a function of mortality and incidence, can be used to estimate the incidence of PD as a chronic disease. As overestimation of incidence is less likely with this method, we found incidence rates of Parkinson's disease that are suitable for further analyses with a lower risk of bias.
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Affiliation(s)
- Claudius Wattenbach
- Faculty of Health/School of Medicine, Chair of Medical Biometry and Epidemiology, Witten/Herdecke University, Witten, 58448, Germany.
| | - Gisa Ellrichmann
- Faculty of Health/School of Medicine, Chair of Neurology II, Witten/Herdecke University, Witten, 58448, Germany
- Department of Neurology, Klinikum Dortmund gGmbH, Dortmund, 44137, Germany
| | - Insa Feinkohl
- Faculty of Health/School of Medicine, Chair of Medical Biometry and Epidemiology, Witten/Herdecke University, Witten, 58448, Germany
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, 13092, Germany
| | - Sabrina Voß
- Faculty of Health/School of Medicine, Chair of Medical Biometry and Epidemiology, Witten/Herdecke University, Witten, 58448, Germany
| | - Ralph Brinks
- Faculty of Health/School of Medicine, Chair of Medical Biometry and Epidemiology, Witten/Herdecke University, Witten, 58448, Germany
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Varden R, Walker R, O'Callaghan A. No trend to rising rates: A review of Parkinson's prevalence studies in the United Kingdom. Parkinsonism Relat Disord 2024:107015. [PMID: 38876845 DOI: 10.1016/j.parkreldis.2024.107015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/15/2024] [Accepted: 05/19/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Of the neurodegenerative diseases, Parkinson's disease is recognised to have the fastest growing prevalence. It is unclear whether this is due to the ageing global population alone, with several environmental factors increasingly implicated in changing prevalence rates. Large data sets have been used nationally and globally to help predict future disease burden. However, the reliability of such sources is yet unknown for Parkinson's disease. SUMMARY This review discusses the methods used in all published UK prevalence studies conducted to date. Direct comparison between prevalence figures obtained from the 10 to discussed prevalence studies is precluded due to differences in methodology for case ascertainment and diagnosis. Age adjusted estimates vary from 105/100,000 to 168/100,000. KEY MESSAGES These studies demonstrate no overall trend in changing prevalence figures between 1961 and 2007. No difference in prevalence trends were seen for those living in rural or urban areas. Differences between ethnic groups, for example, remains an under explored area.
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Affiliation(s)
- Rosanna Varden
- North Cumbria Integrated Care NHS Foundation Trust, Carlisle, United Kingdom; Newcastle University, Newcastle-upon-Tyne, United Kingdom.
| | - Richard Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside, United Kingdom; Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Ailish O'Callaghan
- North Cumbria Integrated Care NHS Foundation Trust, Carlisle, United Kingdom
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Collett J, Lawrie S, Bromley S, Harling P, Reed A, Brusco N, Coe S, Coebergh J, Carroll C, Roberts HC, Hu MT, Dawes H. A programme evaluation of 'First Steps': A peer-conceived, developed and led self-management intervention for people after a Parkinson's diagnosis. Clin Rehabil 2024; 38:403-413. [PMID: 37941369 PMCID: PMC10829422 DOI: 10.1177/02692155231210969] [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: 04/20/2023] [Accepted: 10/13/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE A diagnosis of Parkinson's often leads to uncertainty about the future and loss of perceived control. Peer support may offer a means to address these concerns and promote self-management. DESIGN A programme evaluation of the feasibility and potential effects of 'First Steps', utilising a pragmatic step wedge approach. Comparing First Steps (intervention) to (control) conditions.Setting: In the community at four sites in southern England.Participants: Newly diagnosed (≤ 12months) people with Parkinson's.Intervention: First Steps was a 2-day peer-conceived, developed and led intervention to support self-management.Main measures: At 0, 12 and 24 weeks anxiety and depression (Hospital, Anxiety and Depression Scale, HADS), daily functioning (World Health Organisation Disability Assessment Schedule, WHODAS), physical activity, quality of life (EQ5D), carer strain and service utilisation were assessed. RESULTS Between February 2018 and July 2019, 36 participants were enrolled into intervention and 21 to control conditions, all were included in statistical analysis. Lost to follow up was n = 1 (intervention) and n = 1 adverse event was reported (control, unrelated). Of the 36 allocated to the intervention n = 22 participants completed both days of First Steps during the study period. Completion of outcome measures was >95% at 24 weeks. Small effects favouring the intervention were found for HADS (odds ratio (OR) = 2.06, 95% confidence interval (CI) 0.24:17.84), Carer Strain Index (OR = 2.22, 95% CI 0.5:9.76) and vigorous (d = 0.42, 95% CI -0.12:0.97) and total physical activity (d = 0.41, 95% CI -0.13:0.95). EQ5D, WHOSDAS and service utilisation, was similar between groups. CONCLUSIONS First Steps was feasible and safe and we found potential to benefit physical activity, mental health and carer strain. Further research with longer-term follow up is warranted.
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Affiliation(s)
- Johnny Collett
- Centre for Movement, Occupational and Rehabilitation Sciences, OxINMAHR Oxford Brookes University, Oxfordshire, UK
| | - Sophie Lawrie
- Centre for Movement, Occupational and Rehabilitation Sciences, OxINMAHR Oxford Brookes University, Oxfordshire, UK
| | | | | | - Alex Reed
- European Parkinson's Therapy Centre, Brescia, Italy
| | - Natasha Brusco
- School of Primary and Allied Health Care, Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Australia
| | - Shelly Coe
- Centre for Movement, Occupational and Rehabilitation Sciences, OxINMAHR Oxford Brookes University, Oxfordshire, UK
- Centre for Nutrition and Health, OxINMAHR Oxford Brookes University, Oxfordshire, UK
| | - Jan Coebergh
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
- Department of Neurology, Ashford St Peter's NHS Foundation Trust, Chertsey, UK
| | - Camille Carroll
- Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Helen C Roberts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Hampshire, UK
| | - Michele T Hu
- Oxford Parkinson's Disease Centre, Division of Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxfordshire, UK
| | - Helen Dawes
- NIHR Exeter BRC, Medical School, University of Exeter, Devon, UK
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Grotewold N, Albin RL. Update: Descriptive epidemiology of Parkinson disease. Parkinsonism Relat Disord 2024; 120:106000. [PMID: 38233324 PMCID: PMC10922566 DOI: 10.1016/j.parkreldis.2024.106000] [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: 11/08/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/19/2024]
Abstract
We review the descriptive epidemiology of Parkinson disease (PD). PD is a prevalent neurologic disorder in high Socio-Demographic Index (SDI) nations with rising prevalence in low and middle SDI nations. PD became a prevalent disorder in high SDI nations during the 20th century. Population growth, population aging, and increased disease duration are major drivers of rising PD prevalence. Exposure to industrial toxicants may also be a contributor to rising PD prevalence. PD is an age-related disorder with incidence likely peaking in the 8th decade of life and prevalence in the 9th decade of life. PD is notable for significant sex difference in PD risk with greater risk in men. There may be ancestral differences in PD prevalence and risk. PD is associated with moderately increased mortality though this may be underestimated. Despite significant research, there is considerable uncertainty about basic features of PD epidemiology.
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Affiliation(s)
- Nikolas Grotewold
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Roger L Albin
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA; GRECC, VAAAHS, Ann Arbor, MI, 48105, USA; University of Michigan Morris K. Udall Center of Excellence for Parkinson's Disease Research, Ann Arbor, MI, 48109, USA; University of Michigan Parkinson's Foundation Research Center of Excellence, USA.
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Cardoso VSL, Valente-Amaral A, Monteiro RFM, Meira CLS, de Meira NS, da Silva MN, Pinheiro JDJV, Bastos GDNT, Felício JS, Yamada ES. Aqueous extract of Swietenia macrophylla leaf exerts an anti-inflammatory effect in a murine model of Parkinson's disease induced by 6-OHDA. Front Neurosci 2024; 18:1351718. [PMID: 38449740 PMCID: PMC10914943 DOI: 10.3389/fnins.2024.1351718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Parkinson's disease affects 2% of the population aged over 65 years and is the second most common neurodegenerative disorder in the general population. The appearance of motor symptoms is associated with the degeneration of dopaminergic neurons in the nigrostriatal pathway. Clinically significant nonmotor symptoms are also important for severe disability with disease progression. Pharmacological treatment with levodopa, which involves dopamine restitution, results in a temporary improvement in motor symptoms. Among the mechanisms underlying the pathogenesis of the disease are exacerbated oxidative stress, mitochondrial dysfunction, and neuroinflammation. A phytochemical prospecting study showed that the aqueous extract of the leaves from Swietenia macrophylla (Melineaceae), known as mahogany, has polyphenols with antioxidant and anti-inflammatory capacity in a significantly higher percentage than leaf extracts from other Amazonian plants. Furthermore, the antioxidant and anti-inflammatory capacity of aqueous extract of mahogany leaf has already been demonstrated in an in vitro model. In this study, we hypothesized that the aqueous extract of mahogany leaf (AEML) has a neuroprotective effect in a murine model of Parkinson's disease induced by 6-hydroxidopamine (6-OHDA), due to antioxidant and anti-inflammatory properties of its phenolic compounds. Methods Mice were treated daily with the mahogany extract at a dose of 50 mg/kg, starting 7 days before 6-OHDA infusion until post-surgery day 7. Results and discussion The animals from the 6-OHDA/mahogany group, which corresponds to animals injected with the toxin and treated with aqueous extract of the mahogany leaf, presented distinct behavioral phenotypes after apomorphine challenge and were therefore subdivided into 2 groups, 6-OHDA/mahogany F1 and 6-OHDA/mahogany F2. The F1 group showed a significant increase in contralateral rotations, whereas the F2 group did not show rotations after the apomorphine stimulus. In the F1 group, there was an increase, although not significant, in motor performance in the open field and elevated plus maze tests, whereas in the F2 group, there was significant improvement, which may be related to the lesser degree of injury to the nigrostriatal dopaminergic pathway. The TH+ histopathological analysis, a dopaminergic neuron marker, confirmed that the lesion to the nigrostriatal dopaminergic pathway was more pronounced in 6-OHDA/mahogany F1 than in 6-OHDA/mahogany F2. Our main result consisted of signs of improvement in the inflammatory profile in both the F1 and F2 6-OHDA/mahogany groups, such as a lower number of IBA-1+ microglial cells in the ventral striatum and substantia nigra pars compacta and a reduction in GFAP+ expression, an astrocyte marker, in the dorsal striatum. In this study, several bioactive compounds in the aqueous extract of mahogany leaf may have contributed to the observed beneficial effects. Further studies are necessary to better characterize their applicability for treating chronic degenerative diseases with inflammatory and oxidative bases, such as Parkinson's disease.
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Affiliation(s)
- Váldina Solimar Lopes Cardoso
- Experimental Neuropathology Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Oncology Research Center and Graduate Program in Oncology and Medical Sciences, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Anderson Valente-Amaral
- Experimental Neuropathology Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Graduate Program in Neuroscience and Cellular Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Rayan Fidel Martins Monteiro
- Graduate Program in Neuroscience and Cellular Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Neuroinflammation Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Clarina Loius Silva Meira
- Experimental Neuropathology Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Natália Silva de Meira
- Experimental Neuropathology Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Milton Nascimento da Silva
- Liquid Chromatography Laboratory, Institute of Exact and Natural Science, Federal University of Pará, Belém, Brazil
| | - João de Jesus Viana Pinheiro
- Oncology Research Center and Graduate Program in Oncology and Medical Sciences, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Laboratory of Pathological Anatomy and Immunohistochemistry, School of Dentistry, Federal University of Pará, Belém, Brazil
| | - Gilmara de Nazareth Tavares Bastos
- Graduate Program in Neuroscience and Cellular Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Neuroinflammation Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - João Soares Felício
- Oncology Research Center and Graduate Program in Oncology and Medical Sciences, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | - Elizabeth Sumi Yamada
- Experimental Neuropathology Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Oncology Research Center and Graduate Program in Oncology and Medical Sciences, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Graduate Program in Neuroscience and Cellular Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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Alushaj E, Handfield-Jones N, Kuurstra A, Morava A, Menon RS, Owen AM, Sharma M, Khan AR, MacDonald PA. Increased iron in the substantia nigra pars compacta identifies patients with early Parkinson'sdisease: A 3T and 7T MRI study. Neuroimage Clin 2024; 41:103577. [PMID: 38377722 PMCID: PMC10944193 DOI: 10.1016/j.nicl.2024.103577] [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: 08/07/2023] [Revised: 12/19/2023] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
Degeneration in the substantia nigra (SN) pars compacta (SNc) underlies motor symptoms in Parkinson's disease (PD). Currently, there are no neuroimaging biomarkers that are sufficiently sensitive, specific, reproducible, and accessible for routine diagnosis or staging of PD. Although iron is essential for cellular processes, it also mediates neurodegeneration. MRI can localize and quantify brain iron using magnetic susceptibility, which could potentially provide biomarkers of PD. We measured iron in the SNc, SN pars reticulata (SNr), total SN, and ventral tegmental area (VTA), using quantitative susceptibility mapping (QSM) and R2* relaxometry, in PD patients and age-matched healthy controls (HCs). PD patients, diagnosed within five years of participation and HCs were scanned at 3T (22 PD and 23 HCs) and 7T (17 PD and 21 HCs) MRI. Midbrain nuclei were segmented using a probabilistic subcortical atlas. QSM and R2* values were measured in midbrain subregions. For each measure, groups were contrasted, with Age and Sex as covariates, and receiver operating characteristic (ROC) curve analyses were performed with repeated k-fold cross-validation to test the potential of our measures to classify PD patients and HCs. Statistical differences of area under the curves (AUCs) were compared using the Hanley-MacNeil method (QSM versus R2*; 3T versus 7T MRI). PD patients had higher QSM values in the SNc at both 3T (padj = 0.001) and 7T (padj = 0.01), but not in SNr, total SN, or VTA, at either field strength. No significant group differences were revealed using R2* in any midbrain region at 3T, though increased R2* values in SNc at 7T MRI were marginally significant in PDs compared to HCs (padj = 0.052). ROC curve analyses showed that SNc iron measured with QSM, distinguished early PD patients from HCs at the single-subject level with good diagnostic accuracy, using 3T (mean AUC = 0.83, 95 % CI = 0.82-0.84) and 7T (mean AUC = 0.80, 95 % CI = 0.79-0.81) MRI. Mean AUCs reported here are from averages of tests in the hold-out fold of cross-validated samples. The Hanley-MacNeil method demonstrated that QSM outperforms R2* in discriminating PD patients from HCs at 3T, but not 7T. There were no significant differences between 3T and 7T in diagnostic accuracy of QSM values in SNc. This study highlights the importance of segmenting midbrain subregions, performed here using a standardized atlas, and demonstrates high accuracy of SNc iron measured with QSM at 3T MRI in identifying early PD patients. QSM measures of SNc show potential for inclusion in neuroimaging diagnostic biomarkers of early PD. An MRI diagnostic biomarker of PD would represent a significant clinical advance.
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Affiliation(s)
- Erind Alushaj
- Department of Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Ontario N6A 3K7, Canada; Western Institute for Neuroscience, Western University, London, Ontario N6A 3K7, Canada
| | - Nicholas Handfield-Jones
- Department of Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Ontario N6A 3K7, Canada; Western Institute for Neuroscience, Western University, London, Ontario N6A 3K7, Canada
| | - Alan Kuurstra
- Robarts Research Institute, Western University, London, Ontario N6A 3K7, Canada; Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada
| | - Anisa Morava
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario N6A 3K7, Canada
| | - Ravi S Menon
- Robarts Research Institute, Western University, London, Ontario N6A 3K7, Canada; Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada
| | - Adrian M Owen
- Western Institute for Neuroscience, Western University, London, Ontario N6A 3K7, Canada; Department of Physiology and Pharmacology, Western University, London, Ontario N6A 3K7, Canada
| | - Manas Sharma
- Department of Radiology, Western University, London, Ontario N6A 3K7, Canada; Department of Clinical Neurological Sciences, Western University, London, Ontario N6A 3K7, Canada
| | - Ali R Khan
- Robarts Research Institute, Western University, London, Ontario N6A 3K7, Canada; Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada
| | - Penny A MacDonald
- Western Institute for Neuroscience, Western University, London, Ontario N6A 3K7, Canada; Department of Clinical Neurological Sciences, Western University, London, Ontario N6A 3K7, Canada.
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Copeland S, Anderson T, Carter G, Brown Wilson C, Stark P, Doumas M, Rodger M, O'Shea E, Creighton L, Craig S, McMahon J, Gillis A, Crooks S, Mitchell G. Experiences of People Living with Parkinson's Disease in Care Homes: A Qualitative Systematic Review. NURSING REPORTS 2024; 14:428-443. [PMID: 38391078 PMCID: PMC10885076 DOI: 10.3390/nursrep14010033] [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: 12/23/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Incidence of disability secondary to Parkinson's disease is increasing faster globally than any other neurological condition. The diverse appearance of symptomatology associated with Parkinson's, and the degenerative nature and subsequent functional decline, often increase dependence on caregivers for assistance with daily living, most commonly within a care home setting. Yet, primary literature and evidence synthesis surrounding these unique and complex care needs, challenges and the lived experiences of this population living in long-term nursing or residential facilities remains sparce. The aim of this review is to synthesize qualitative literature about the lived experience of people with Parkinson's disease living in care home settings. METHODS A systematic search of the literature was conducted in October 2023 across six different databases (CINAHL, Medline, EMBASE, PsycINFO, Scopus and Cochrane Library). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to guide this review. RESULTS Five articles met the inclusion criteria. Four themes were identified following evidence synthesis: (1) Unique pharmacological challenges. (2) Transitioning and adapting to care home life and routines. (3) Dignified care within care homes. (4) Multidisciplinary care vacuum in care homes. CONCLUSION This review revealed the significant and unique challenges for people with Parkinson's disease when transitioning into care homes. These are exacerbated by wider social care challenges such as staffing levels, skill mixes and attitudes as well as a lack of disease-specific knowledge surrounding symptomatology and pharmacology. The lack of multi-disciplinary working and risk-adverse practice inhibited person-centred care and autonomy and reduced the quality of life of people living with Parkinson's disease in care homes. Recommendations for practice highlight training gaps, the need for consistent and improved interdisciplinary working and better person-centred assessment and care delivery.
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Affiliation(s)
- Shannon Copeland
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Tara Anderson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Gillian Carter
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | | | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Mihalis Doumas
- School of Psychology, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Matthew Rodger
- School of Psychology, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Emma O'Shea
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, T12 YN60 Cork, Ireland
| | - Laura Creighton
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Stephanie Craig
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - James McMahon
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Arnelle Gillis
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Sophie Crooks
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
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11
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Yuan XY, Chen YS, Liu Z. Relationship among Parkinson's disease, constipation, microbes, and microbiological therapy. World J Gastroenterol 2024; 30:225-237. [PMID: 38314132 PMCID: PMC10835526 DOI: 10.3748/wjg.v30.i3.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/16/2023] [Accepted: 12/26/2023] [Indexed: 01/18/2024] Open
Abstract
This comprehensive review elucidates the complex interplay between gut microbiota and constipation in Parkinson's disease (PD), a prevalent non-motor symptom contributing significantly to patients' morbidity. A marked alteration in the gut microbiota, predominantly an increase in the abundance of Proteobacteria and Bacteroidetes, is observed in PD-related constipation. Conventional treatments, although safe, have failed to effectively alleviate symptoms, thereby necessitating the development of novel therapeutic strategies. Microbiological interventions such as prebiotics, probiotics, and fecal microbiota transplantation (FMT) hold therapeutic potential. While prebiotics improve bowel movements, probiotics are effective in enhancing stool consistency and alleviating abdominal discomfort. FMT shows potential for significantly alleviating constipation symptoms by restoring gut microbiota balance in patients with PD. Despite promising developments, the causal relationship between changes in gut microbiota and PD-related constipation remains elusive, highlighting the need for further research in this expanding field.
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Affiliation(s)
- Xin-Yang Yuan
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
- Institute of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Zhanjiang 524000, Guangdong Province, China
| | - Yu-Sen Chen
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
- Institute of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Zhanjiang 524000, Guangdong Province, China
| | - Zhou Liu
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
- Institute of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Zhanjiang 524000, Guangdong Province, China
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12
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Albin RL, Grotewold N. What is the Parkinson Pandemic? Mov Disord 2023; 38:2141-2144. [PMID: 37859586 PMCID: PMC10843050 DOI: 10.1002/mds.29637] [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: 08/18/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Affiliation(s)
- Roger L. Albin
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, USA
- Neurology Service & GRECC, VAAAHS, Ann Arbor, MI, USA
- University of Michigan Morris K. Udall Center of Excellence for Parkinson;s Disease Reseach
- Parkinson’s Foundation Research Center of Excellence
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13
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Dammertz L, Schrag A, Bohlken J, Heuer J, Kohring C, Schorlemmer J, Akmatov MK, Bätzing J, Holstiege J. Falling incidence of Parkinson's disease in Germany. Eur J Neurol 2023; 30:3124-3131. [PMID: 37498553 DOI: 10.1111/ene.16000] [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: 06/28/2023] [Accepted: 07/22/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND AND PURPOSE Idiopathic Parkinson's disease (IPD) is a progressive neurodegenerative disorder that is strongly associated with age. The aim of the present study was to describe current sex- and age-specific trends and regional differences in the incidence of IPD diagnosed in older people in Germany. METHODS This study was based on nationwide outpatient claims and drug prescription data from the German Statutory Health Insurance, covering approximately 87% of the general population. We conducted a cohort study in patients aged 50 years or older with observation time of at least 4 years. To assess the robustness of nationwide annual IPD incidence trends from 2013 to 2019, three case definitions with varying levels of stringency regarding coded outpatient diagnoses and drug prescriptions were applied. RESULTS In 2019, the population at risk comprised 30,575,726 persons. Using the primary and most specific case definition, annual age- and sex-standardized cumulative IPD incidence decreased stepwise from 137 (2013) to 106 (2019) new cases per 100,000 persons. The decline in incidence was seen in both sexes, in all age groups and in the majority of German regions. The relative decrease (2013-2019) in the annual age- and sex-standardized IPD incidence varied from 23% to 28% among case definitions. CONCLUSION Our findings indicate a nationwide decline in the age- and sex-standardized incidence of IPD from 2013 to 2019 in Germany. This trend was consistent using different case definitions. Further research is needed to elucidate the factors underlying this trend.
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Affiliation(s)
- Lotte Dammertz
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Jens Bohlken
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP) der Medizinischen Fakultät der Universität Leipzig, Leipzig, Germany
| | - Joachim Heuer
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Claudia Kohring
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | | | - Manas K Akmatov
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Jörg Bätzing
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Jakob Holstiege
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
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14
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Chen Y, Gao Y, Sun X, Wang BH, Qin L, Wu IX, Li G. Association between Sleep Factors and Parkinson's Disease: A Prospective Study Based on 409,923 UK Biobank Participants. Neuroepidemiology 2023; 57:293-303. [PMID: 37231899 DOI: 10.1159/000530982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Limited evidence indicates an association between sleep factors and the risk of Parkinson's disease (PD). However, large prospective cohort studies including both sexes are needed to verify the association between daytime sleepiness, sleep duration, and PD risk. Furthermore, other sleep factors like chronotype and snoring and their impact on increased PD risk should be explored by simultaneously considering daytime sleepiness and snoring. METHODS This study included 409,923 participants from the UK Biobank. Data on five sleep factors (chronotype, sleep duration, sleeplessness/insomnia, snoring, and daytime sleepiness) were collected using a standard self-administered questionnaire. PD occurrence was identified using linkages with primary care, hospital admission, death register, or self-report. Cox proportional hazard models were used to investigate the association between sleep factors and PD risk. Subgroup (age and sex) and sensitivity analyses were performed. RESULTS During a median follow-up of 11.89 years, 2,158 incident PD cases were documented. The main association analysis showed that prolonged sleep duration (hazard ratio [HR]: 1.20, 95% confidence interval [CI]: 1.05, 1.37) and occasional daytime sleepiness (HR: 1.15, 95% CI: 1.04, 1.26) increased the PD risk. Compared to those who self-reported never or rarely having sleeplessness/insomnia, participants who reported usually having sleeplessness/insomnia had a decreased risk of PD (HR: 0.85, 95% CI: 0.75, 0.96). Subgroup analysis revealed that women who self-reported no snoring had a decreased PD risk (HR: 0.85; 95% CI: 0.73, 0.99). Sensitivity analyses indicated that the robustness of the results was affected by potential reverse causation and data completeness. CONCLUSION Long sleep duration increased the PD risk, especially among men and participants ≥60 years, while snoring increased the risk of PD in women. Additional studies are needed to (i) further consider other sleep traits (e.g., rapid eye movement sleep behavior disorder and sleep apnea) that might be related to PD, (ii) objectively measure sleep-related exposure, and (iii) confirm the effects of snoring on PD risk by considering the impact of obstructive sleep apnea and investigating its underlying mechanisms.
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Affiliation(s)
- Yancong Chen
- Changsha Center for Disease Control and Prevention, Changsha, China,
- Xiangya School of Public Health, Central South University, Changsha, China,
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Xuemei Sun
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Betty Huan Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Lang Qin
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Irene Xy Wu
- Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Central South University, Changsha, China
| | - Guowei Li
- MMed, MBBS, CCEM, Guangdong Second Provincial General Hospital, Guangzhou, China
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15
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Newby D, Linden AB, Fernandes M, Molero Y, Winchester L, Sproviero W, Ghose U, Li QS, Launer LJ, Duijn CMV, Nevado-Holgado AJ. Comparative effect of metformin versus sulfonylureas with dementia and Parkinson's disease risk in US patients over 50 with type 2 diabetes mellitus. BMJ Open Diabetes Res Care 2022; 10:10/5/e003036. [PMID: 36109050 PMCID: PMC9478804 DOI: 10.1136/bmjdrc-2022-003036] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/28/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Type 2 diabetes is a risk factor for dementia and Parkinson's disease (PD). Drug treatments for diabetes, such as metformin, could be used as novel treatments for these neurological conditions. Using electronic health records from the USA (OPTUM EHR) we aimed to assess the association of metformin with all-cause dementia, dementia subtypes and PD compared with sulfonylureas. RESEARCH DESIGN AND METHODS A new user comparator study design was conducted in patients ≥50 years old with diabetes who were new users of metformin or sulfonylureas between 2006 and 2018. Primary outcomes were all-cause dementia and PD. Secondary outcomes were Alzheimer's disease (AD), vascular dementia (VD) and mild cognitive impairment (MCI). Cox proportional hazards models with inverse probability of treatment weighting (IPTW) were used to estimate the HRs. Subanalyses included stratification by age, race, renal function, and glycemic control. RESULTS We identified 96 140 and 16 451 new users of metformin and sulfonylureas, respectively. Mean age was 66.4±8.2 years (48% male, 83% Caucasian). Over the 5-year follow-up, 3207 patients developed all-cause dementia (2256 (2.3%) metformin, 951 (5.8%) sulfonylurea users) and 760 patients developed PD (625 (0.7%) metformin, 135 (0.8%) sulfonylurea users). After IPTW, HRs for all-cause dementia and PD were 0.80 (95% CI 0.73 to 0.88) and 1.00 (95% CI 0.79 to 1.28). HRs for AD, VD and MCI were 0.81 (0.70-0.94), 0.79 (0.63-1.00) and 0.91 (0.79-1.04). Stronger associations were observed in patients who were younger (<75 years old), Caucasian, and with moderate renal function. CONCLUSIONS Metformin users compared with sulfonylurea users were associated with a lower risk of all-cause dementia, AD and VD but not with PD or MCI. Age and renal function modified risk reduction. Our findings support the hypothesis that metformin provides more neuroprotection for dementia than sulfonylureas but not for PD, but further work is required to assess causality.
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Affiliation(s)
- Danielle Newby
- Psychiatry, University of Oxford, Oxford, UK
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | | | - Yasmina Molero
- Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm, Sweden
- Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | | | | | | | - Qingqin S Li
- Neuroscience, Janssen Research and Development, Titusville, New Jersey, USA
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland, USA
| | - Cornelia M van Duijn
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands
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16
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Zhu M, Liu X, Ye Y, Yan X, Cheng Y, Zhao L, Chen F, Ling Z. Gut Microbiota: A Novel Therapeutic Target for Parkinson’s Disease. Front Immunol 2022; 13:937555. [PMID: 35812394 PMCID: PMC9263276 DOI: 10.3389/fimmu.2022.937555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/26/2022] [Indexed: 12/16/2022] Open
Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disease characterized by motor dysfunction. Growing evidence has demonstrated that gut dysbiosis is involved in the occurrence, development and progression of PD. Numerous clinical trials have identified the characteristics of the changed gut microbiota profiles, and preclinical studies in PD animal models have indicated that gut dysbiosis can influence the progression and onset of PD via increasing intestinal permeability, aggravating neuroinflammation, aggregating abnormal levels of α-synuclein fibrils, increasing oxidative stress, and decreasing neurotransmitter production. The gut microbiota can be considered promising diagnostic and therapeutic targets for PD, which can be regulated by probiotics, psychobiotics, prebiotics, synbiotics, postbiotics, fecal microbiota transplantation, diet modifications, and Chinese medicine. This review summarizes the recent studies in PD-associated gut microbiota profiles and functions, the potential roles, and mechanisms of gut microbiota in PD, and gut microbiota-targeted interventions for PD. Deciphering the underlying roles and mechanisms of the PD-associated gut microbiota will help interpret the pathogenesis of PD from new perspectives and elucidate novel therapeutic strategies for PD.
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Affiliation(s)
- Manlian Zhu
- Department of Geriatrics, Lishui Second People’s Hospital, Lishui, China
| | - Xia Liu
- Department of Intensive Care Unit, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yiru Ye
- Department of Respiratory Medicine, Lishui Central Hospital, Lishui, China
| | - Xiumei Yan
- Department of Laboratory Medicine, Lishui Second People’s Hospital, Lishui, China
| | - Yiwen Cheng
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Longyou Zhao
- Department of Laboratory Medicine, Lishui Second People’s Hospital, Lishui, China
| | - Feng Chen
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Zongxin Ling, ; ; Feng Chen,
| | - Zongxin Ling
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Zongxin Ling, ; ; Feng Chen,
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