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Bhardwaj K, Singh AA, Kumar H. Unveiling the Journey from the Gut to the Brain: Decoding Neurodegeneration-Gut Connection in Parkinson's Disease. ACS Chem Neurosci 2024. [PMID: 38896463 DOI: 10.1021/acschemneuro.4c00293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
Parkinson's disease, a classical motor disorder affecting the dopaminergic system of the brain, has been as a disease of the brain, but this classical notion has now been viewed differently as the pathology begins in the gut and then gradually moves up to the brain regions. The microorganisms in the gut play a critical role in maintaining the physiology of the gut from maintaining barrier integrity to secretion of microbial products that maintain a healthy gut state. The pathology subsequently alters the normal composition of gut microbes and causes deleterious effects that ultimately trigger strong neuroinflammation and nonmotor symptoms along with characteristic synucleopathy, a pathological hallmark of the disease. Understanding the complex pathomechanisms in distinct and established preclinical models is the primary goal of researchers to decipher how exactly gut pathology has a central effect; the quest has led to many answered and some open-ended questions for researchers. We summarize the popular opinions and some contrasting views, concise footsteps in the treatment strategies targeting the gastrointestinal system.
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Affiliation(s)
- Kritika Bhardwaj
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Ahmedabad (NIPER-A), Opposite Air force station, Palaj, Gandhinagar, 382355 Gujarat, India
| | - Aditya A Singh
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Ahmedabad (NIPER-A), Opposite Air force station, Palaj, Gandhinagar, 382355 Gujarat, India
| | - Hemant Kumar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Ahmedabad (NIPER-A), Opposite Air force station, Palaj, Gandhinagar, 382355 Gujarat, India
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Hodgson P, Jordan A, Sinani C, Charura D, Orange ST. The relationship between physical function and psychological symptoms in Parkinson's disease: A systematic review and meta-regression analysis. CNS Neurosci Ther 2024; 30:e14562. [PMID: 38334239 PMCID: PMC10853949 DOI: 10.1111/cns.14562] [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: 04/20/2023] [Revised: 08/21/2023] [Accepted: 12/01/2023] [Indexed: 02/10/2024] Open
Abstract
AIMS This systematic review and meta-regression aimed to examine available literature reporting measures of physical function, anxiety, and/or depression and whether any relationships exist between these measures in individuals with Parkinson's disease. METHODS MEDLINE, CINAHL, AMED, and APA PsychInfo databases were systematically searched. Screening, quality assessment, and data extraction were completed alongside meta-regression analysis. RESULTS Of 1175 studies retrieved, 40 were selected for analysis with only one study assessing the relationship between physical and psychological outcomes within their cohort. A total of 27 studies were also eligible for meta-regression analysis-a total sample of 1211 participants. Meta-regressions of five combinations of paired physical and psychological outcomes showed a significant moderating effect of symptoms of depression (Beck Depression Inventory) on mobility (Timed-Up-and-Go test; coefficient = 0.37, 95% CI 0.09 to 0.65, p = 0.012) and balance (Berg Balance Score) scores (coefficient = -1.25, 95% CI -1.77 to -0.73, p < 0.001). CONCLUSION Although physical and psychological outcomes of interest were used in all included studies, only one examined their relationship. Our analysis suggests that symptoms of depression may influence measures of mobility and balance. Specifically, as the severity of symptoms of depression increases, performance on measures of mobility and balance worsens.
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Affiliation(s)
- Philip Hodgson
- Tees, Esk and Wear Valleys NHS Foundation TrustYork St John UniversityYorkUK
- York St John UniversityYorkUK
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Sardar Z, Liaquat S, Yousaf Q, Bano S, Numan A. Non-Motor Symptoms Burden in Early Stages of Parkinson's Disease. Ann Indian Acad Neurol 2023; 26:39-43. [PMID: 37034035 PMCID: PMC10081544 DOI: 10.4103/aian.aian_483_22] [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: 05/31/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background Non-motor symptoms (NMSs) in Parkinson's disease (PD) are often overlooked and thus can impede clinical management and significantly reduce the patient's quality of life. Aims The study aimed to determine the burden of NMS in the early stages of PD. Material and Methods A 1-year observational cross-sectional study was conducted at Mayo Hospital, Lahore, in 2019. The MDS-PD criteria were used to diagnose PD patients. The study included patients with Hoehn and Yahr (HY) stages 1-3. The frequency of NMSs was assessed using a non-motor symptom questionnaire (NMSQ), and the non-motor symptom scale (NMSS) score was derived using the NMSS. Results A total of 100 PD patients were enrolled in the study. Sixty-three (63%) were males and 37 (37%) were females. Their age ranged between 45 and 75 years with a mean ± SD of 57.46 ± 8.46. At least one NMS was reported by 84% of patients, with neuropsychiatric symptoms (68%) preponderant, followed by a change in taste and smell (64%). The mean NMSS score is 46.22 ± 22.098 (median 44) with a range from 0 to 88, with the trend being increasing score with the advancing stage. Conclusion The use of the NMSQ and NMSS tools should be standard in clinical practice to identify the severity of the disease and commence appropriate care.
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Affiliation(s)
- Zomer Sardar
- Department of Neurology, District Hospital Nankana Sahib, Lahore, Pakistan
| | - Sumayyah Liaquat
- Department of Neurology, Hussain Lakhani Hospital, Karachi, Pakistan
| | - Qudsum Yousaf
- Department of Neurology, Central Park Teaching Hospital, Lahore, Pakistan
| | - Safia Bano
- Department of Neurology, King Edward Medical University, Lahore, Pakistan
| | - Ahsan Numan
- Department of Neurology, King Edward Medical University, Lahore, Pakistan
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Santos-García D, de Deus Fonticoba T, Bartolomé CC, Painceiras MJF, Castro ES, Canfield H, Miró CM, Jesús S, Aguilar M, Pastor P, Planellas L, Cosgaya M, Caldentey JG, Caballol N, Legarda I, Hernández-Vara J, Cabo I, Manzanares LL, Aramburu IG, Rivera MAÁ, Mayordomo VG, Nogueira V, Puente V, García-Soto JD, Borrué C, Vila BS, Sauco MÁ, Vela L, Escalante S, Cubo E, Padilla FC, Castrillo JCM, Alonso PS, Losada MGA, Ariztegui NL, Gastón I, Kulisevsky J, Estrada MB, Seijo M, Martínez JR, Valero C, Kurtis M, de Fábregues O, Ardura JG, Redondo RA, Ordás C, Díaz LML, McAfee D, Martinez-Martin P, Mir P. Motor Fluctuations Development Is Associated with Non-Mostor Symptoms Burden Progression in Parkinson’s Disease Patients: A 2-Year Follow-Up Study. Diagnostics (Basel) 2022; 12:diagnostics12051147. [PMID: 35626303 PMCID: PMC9140605 DOI: 10.3390/diagnostics12051147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 12/10/2022] Open
Abstract
Objective: The aim of the present study was to analyze the progression of non-motor symptoms (NMS) burden in Parkinson’s disease (PD) patients regarding the development of motor fluctuations (MF). Methods: PD patients without MF at baseline, who were recruited from January 2016 to November 2017 (V0) and evaluated again at a 2-year follow-up (V2) from 35 centers of Spain from the COPPADIS cohort, were included in this analysis. MF development at V2 was defined as a score ≥ 1 in the item-39 of the UPDRS-Part IV, whereas NMS burden was defined according to the Non-motor Symptoms Scale (NMSS) total score. Results: Three hundred and thirty PD patients (62.67 ± 8.7 years old; 58.8% males) were included. From V0 to V2, 27.6% of the patients developed MF. The mean NMSS total score at baseline was higher in those patients who developed MF after the 2-year follow-up (46.34 ± 36.48 vs. 34.3 ± 29.07; p = 0.001). A greater increase in the NMSS total score from V0 to V2 was observed in patients who developed MF (+16.07 ± 37.37) compared to those who did not develop MF (+6.2 ± 25.8) (p = 0.021). Development of MF after a 2-year follow-up was associated with an increase in the NMSS total score (β = 0.128; p = 0.046) after adjustment to age, gender, years from symptoms onset, levodopa equivalent daily dose (LEDD) and the NMSS total score at baseline, and the change in LEDD from V0 to V2. Conclusions: In PD patients, the development of MF is associated with a greater increase in the NMS burden after a 2-year follow-up.
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Affiliation(s)
- Diego Santos-García
- Department of Neurology, Hospital Universitario de A Coruña (HUAC), Complejo Hospitalario Universitario de A Coruña (CHUAC), C/As Xubias 84, 15006 A Coruña, Spain
- Correspondence: ; Tel.: +34-646173341
| | | | - Carlos Cores Bartolomé
- Department of Neurology, Hospital Universitario de A Coruña (HUAC), Complejo Hospitalario Universitario de A Coruña (CHUAC), C/As Xubias 84, 15006 A Coruña, Spain
| | - Maria J. Feal Painceiras
- Department of Neurology, Hospital Universitario de A Coruña (HUAC), Complejo Hospitalario Universitario de A Coruña (CHUAC), C/As Xubias 84, 15006 A Coruña, Spain
| | | | - Héctor Canfield
- CHUF, Complejo Hospitalario Universitario de Ferrol, 15006 A Coruña, Spain
| | - Cristina Martínez Miró
- Department of Neurology, Hospital Universitario de A Coruña (HUAC), Complejo Hospitalario Universitario de A Coruña (CHUAC), C/As Xubias 84, 15006 A Coruña, Spain
| | - Silvia Jesús
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain
| | - Miquel Aguilar
- Hospital Universitari Mutua de Terrassa, 08221 Terrassa, Barcelona, Spain
| | - Pau Pastor
- Hospital Universitari Mutua de Terrassa, 08221 Terrassa, Barcelona, Spain
| | | | | | | | - Nuria Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, 08970 Sant Joan Despí, Barcelona, Spain
| | - Ines Legarda
- Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
| | - Jorge Hernández-Vara
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain
- Hospital Universitario Vall d’Hebron, 08035 Barcelona, Spain
| | - Iria Cabo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), 36071 Pontevedra, Spain
| | | | - Isabel González Aramburu
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain
- Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
| | - Maria A. Ávila Rivera
- Consorci Sanitari Integral, Hospital General de L’Hospitalet, L’Hospitalet de Llobregat, 08906 Barcelona, Spain
| | | | | | | | | | | | - Berta Solano Vila
- Institut d’Assistència Sanitària (IAS)—Institut Català de la Salut, 17190 Girona, Spain
| | | | - Lydia Vela
- Fundación Hospital de Alcorcón, 28922 Madrid, Spain
| | - Sonia Escalante
- Hospital de Tortosa Verge de la Cinta (HTVC), Tortosa, 43500 Tarragona, Spain
| | - Esther Cubo
- Complejo Asistencial Universitario de Burgos, 09006 Burgos, Spain
| | | | | | | | - Maria G. Alonso Losada
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), 36213 Vigo, Spain
| | | | - Itziar Gastón
- Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
| | - Jaime Kulisevsky
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain
- Hospital de Sant Pau, 08041 Barcelona, Spain
| | | | - Manuel Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), 36071 Pontevedra, Spain
| | | | | | | | | | | | | | | | - Luis M. López Díaz
- Complejo Hospitalario Universitario de Orense (CHUO), 32005 Orense, Spain
| | - Darrian McAfee
- University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Pablo Martinez-Martin
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain
| | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain
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Neuroprotection against Aminochrome Neurotoxicity: Glutathione Transferase M2-2 and DT-Diaphorase. Antioxidants (Basel) 2022; 11:antiox11020296. [PMID: 35204179 PMCID: PMC8868244 DOI: 10.3390/antiox11020296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
Glutathione is an important antioxidant that plays a crucial role in the cellular protection against oxidative stress and detoxification of electrophilic mutagens, and carcinogens. Glutathione transferases are enzymes catalyzing glutathione-dependent reactions that lead to inactivation and conjugation of toxic compounds, processes followed by subsequent excretion of the detoxified products. Degeneration and loss of neuromelanin-containing dopaminergic neurons in the nigrostriatal neurons generally involves oxidative stress, neuroinflammation, alpha-synuclein aggregation to neurotoxic oligomers, mitochondrial dysfunction, protein degradation dysfunction, and endoplasmic reticulum stress. However, it is still unclear what triggers these neurodegenerative processes. It has been reported that aminochrome may elicit all of these mechanisms and, interestingly, aminochrome is formed inside neuromelanin-containing dopaminergic neurons during neuromelanin synthesis. Aminochrome is a neurotoxic ortho-quinone formed in neuromelanin synthesis. However, it seems paradoxical that the neurotoxin aminochrome is generated during neuromelanin synthesis, even though healthy seniors have these neurons intact when they die. The explanation of this paradox is the existence of protective tools against aminochrome neurotoxicity composed of the enzymes DT-diaphorase, expressed in these neurons, and glutathione transferase M2-2, expressed in astrocytes. Recently, it has been reported that dopaminergic neurons can be protected by glutathione transferase M2-2 from astrocytes, which secrete exosomes containing the protective enzyme.
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Hermanowicz N, Ospina MC, Torres-Yaghi Y, Gould S, Papesh K, Rivera JA, Miller S, Jones S, Musick K, May D. Impact of Isolation During the COVID-19 Pandemic on the Patient Burden of Parkinson's Disease: A PMD Alliance Survey. Neuropsychiatr Dis Treat 2022; 18:633-643. [PMID: 35355505 PMCID: PMC8958201 DOI: 10.2147/ndt.s351691] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/22/2022] [Indexed: 01/10/2023] Open
Abstract
PURPOSE As the COVID-19 pandemic resulted in social restrictions around the globe, this cross-sectional survey aimed to assess the impact of social isolation on self- or proxy-reported symptoms of Parkinson's disease (PD) during the pandemic. PATIENTS AND METHODS The survey was distributed among 7109 subscribers of the Parkinson and Movement Disorders Alliance (PMD Alliance) News and Information list and was open only to people with PD (PwP) and care partners (CP, defined as main caregivers of PwP and serving as proxy respondents). No attempt was made to identify PwP and CP pairs. The survey was distributed online using Survey Monkey between 01/06/2021 and 02/27/2021. Respondents were grouped by level of social support from outside of their household during the pandemic (decreased or maintained [ie, the same as pre-pandemic or increased]). RESULTS Of 7109 invited participants, 718 responded to the survey (response rate 10.1%). PwP (self-reports) accounted for 70.6% of respondents and CP (proxy reports) for 29.4%. Decreased social support from outside of the household during the COVID-19 pandemic (58.5% of all responses) was significantly associated with increases in sadness/depression and anxiety, compared with maintained levels of social support (p < 0.0001 for both comparisons). It was also associated with increased burden of several non-motor (decline in memory, problem solving, or communication, p = 0.0009; new or worsening confusion, p < 0.0001; new or worsening delusions, p = 0.018) and motor PD symptoms. CONCLUSION Decline in social support from outside of the household during the COVID-19 pandemic showed a statistically significant and negative association with the burden of mood and non-motor symptoms of PD. These results call for increased vigilance towards non-motor symptoms in PwP experiencing social isolation and highlight the need for stronger provider focus on encouraging PwP and their CPs to build and maintain social connections and engagements.
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Affiliation(s)
| | | | | | - Sherrie Gould
- Scripps Clinic Movement Disorder Center, La Jolla, CA, USA
| | - Kelly Papesh
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Jason A Rivera
- Parkinson and Movement Disorder Alliance (PMD Alliance), Tucson, AZ, USA
| | - Susan Miller
- Parkinson and Movement Disorder Alliance (PMD Alliance), Tucson, AZ, USA
| | - Sarah Jones
- Parkinson and Movement Disorder Alliance (PMD Alliance), Tucson, AZ, USA
| | | | - Damian May
- ACADIA Pharmaceuticals Inc, San Diego, CA, USA
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