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Hou W, Wu F, Wang Y, Li W, Cheng Y, Zhu Z, Liang S, Liu P, Yu Y, Wu J. Predicting slight freezing of gait in Parkinson's disease with anticipatory postural adjustments and limits of stability. Parkinsonism Relat Disord 2024; 123:106949. [PMID: 38564831 DOI: 10.1016/j.parkreldis.2024.106949] [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: 01/11/2024] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Gait initiation (GI) includes automatic and voluntary movements. However, research on their impact on the first step in patients with Parkinson's disease (PD) and their relationship to freezing of gait (FOG) is lacking. We examined the effects of automatic movements (anticipatory postural adjustments [APAs]) and voluntary movements (limits of stability [LOS]) on the first step (first-step duration and first-step range of motion), along with their early recognition and prediction of slight FOG. METHODS Twenty-three patients with PD and slight freezing (PD + FOG) and 25 non-freezing patients with PD (PD-FOG) were tested while off medications and compared with 24 healthy controls (HC). All participants completed a 7-m Stand and Walk Test (7 m SAW) and wore inertial sensors to quantify the APAs and first step. LOS was quantified by dynamic posturography in different directions using a pressure platform. We compared differences among all three groups, analysed correlations, and evaluated their predictive value for slight FOG. RESULTS In PD + FOG, APAs and LOS were worse than those in the PD-FOG and HC groups (p < 0.001), and the first step was worse than that in HC (p < 0.001). APAs were correlated mainly with the first-step duration. APAs and LOS were correlated with the first-step range of motion. APAs have been recognized as independent predictors of FOG, and their combination with LOS enhances predictive sensitivity. CONCLUSION APAs and LOS in patients with PD directly affect the first step during GI. In addition, the combination of APAs and LOS helped predict slight FOG.
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Affiliation(s)
- Weijia Hou
- Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, 300350, China
| | - Fan Wu
- Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, 300350, China
| | - Yue Wang
- Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, 300350, China
| | - Weihua Li
- Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, 300350, China
| | - Yuanyuan Cheng
- Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, 300350, China
| | - Zhizhong Zhu
- Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, 300350, China
| | - Siquan Liang
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, 300350, China
| | - Peipei Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgical Institute, Tianjin, 300350, China
| | - Yang Yu
- Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, 300350, China.
| | - Jialing Wu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgical Institute, Tianjin, 300350, China.
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Hardeman LES, Geerse DJ, Hoogendoorn EM, Nonnekes J, Roerdink M. Remotely prescribed, monitored, and tailored home-based gait-and-balance exergaming using augmented reality glasses: a clinical feasibility study in people with Parkinson's disease. Front Neurol 2024; 15:1373740. [PMID: 38872812 PMCID: PMC11172158 DOI: 10.3389/fneur.2024.1373740] [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: 01/20/2024] [Accepted: 03/04/2024] [Indexed: 06/15/2024] Open
Abstract
Background Exergaming has the potential to increase adherence to exercise through play, individually tailored training, and (online) remote monitoring. Reality Digital Therapeutics (Reality DTx®) is a digital therapeutic software platform for augmented reality (AR) glasses that enables a home-based gait-and-balance exergaming intervention specifically designed for people with Parkinson's disease (pwPD). Objective The primary objective was to evaluate the feasibility and potential efficacy of Reality DTx® AR exergaming intervention for improving gait, balance, and walking-adaptability fall-risk indicators. The secondary objective was to evaluate the potential superiority of AR glasses [Magic Leap 2 (ML2) vs. HoloLens 2 (HL2)]. Methods This waitlist-controlled clinical feasibility study comprised three laboratory visits (baseline; pre-intervention; and post-intervention), a home visit, and a 6-week AR exergaming intervention. Five complementary gait-and-balance exergames were remotely prescribed (default five sessions/week of 30 active minutes/session), monitored, and tailored. Feasibility was assessed in terms of safety, adherence, and user experience. During laboratory visits, gait-and-balance capacity was assessed using standard clinical gait-and-balance tests and advanced walking-adaptability fall-risk assessments. Results In total, 24 pwPD participated. No falls and four near falls were reported. Session adherence was 104%. The User Experience Questionnaire scores for Reality DTx® ranged from above average to excellent, with superior scores for HL2 over ML2 for Perspicuity and Dependability. Intervention effects were observed for the Timed Up and Go test (albeit small), the Five Times Sit to Stand test, and walking speed. Walking-adaptability fall-risk indicators all improved post-intervention. Conclusion Reality DTx® is a safe, adherable, usable, well-accepted, and potentially effective intervention in pwPD. These promising results warrant future randomized controlled trials on the (cost-)effectiveness of home-based AR exergaming interventions for improving gait, balance, and fall risk. Clinical trial registration ClinicalTrials.gov, identifier NCT05605249.
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Affiliation(s)
- Lotte E. S. Hardeman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Daphne J. Geerse
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Eva M. Hoogendoorn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Jorik Nonnekes
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Centre of Expertise for Parkinson and Movement Disorders, Nijmegen, Netherlands
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, Netherlands
| | - Melvyn Roerdink
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
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Mendes D, Peixoto F, Oliveira MM, Andrade PB, Videira RA. Mitochondrial Dysfunction in Skeletal Muscle of Rotenone-Induced Rat Model of Parkinson's Disease: SC-Nanophytosomes as Therapeutic Approach. Int J Mol Sci 2023; 24:16787. [PMID: 38069110 PMCID: PMC10706108 DOI: 10.3390/ijms242316787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
The development of new therapeutic options for Parkinson's disease (PD) requires formulations able to mitigate both brain degeneration and motor dysfunctions. SC-Nanophytosomes, an oral mitochondria-targeted formulation developed with Codium tomentosum membrane polar lipids and elderberry anthocyanin-enriched extract, promote significant brain benefits on a rotenone-induced rat model of PD. In the present work, the effects of SC-Nanophytosome treatment on the skeletal muscle tissues are disclosed. It is unveiled that the rotenone-induced PD rat model exhibits motor disabilities and skeletal muscle tissues with deficient activity of mitochondrial complexes I and II along with small changes in antioxidant enzyme activity and skeletal muscle lipidome. SC-Nanophytosome treatment mitigates the impairment of complexes I and II activity, improving the mitochondrial respiratory chain performance at levels that surpass the control. Therefore, SC-Nanophytosome competence to overcome the PD-related motor disabilities should be also associated with its positive outcomes on skeletal muscle mitochondria. Providing a cellular environment with more reduced redox potential, SC-Nanophytosome treatment improves the skeletal muscle tissue's ability to deal with oxidative stress stimuli. The PD-related small changes on skeletal muscle lipidome were also counteracted by SC-Nanophytosome treatment. Thus, the present results reinforces the concept of SC-Nanophytosomes as a mitochondria-targeted therapy to address the neurodegeneration challenge.
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Affiliation(s)
- Daniela Mendes
- REQUIMTE/LAQV, Laboratory of Pharmacognosy, Department of Chemistry, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal; (D.M.); (P.B.A.)
| | - Francisco Peixoto
- Chemistry Center-Vila Real (CQ-VR), Biological and Environment Department, School of Life and Environmental Sciences, University of Trás-os-Montes e Alto Douro, UTAD, P.O. Box 1013, 5001-801 Vila Real, Portugal;
| | - Maria Manuel Oliveira
- Chemistry Center-Vila Real (CQ-VR), Chemistry Department, School of Life and Environmental Sciences, University of Trás-os-Montes e Alto Douro, UTAD, 5001-801 Vila Real, Portugal;
| | - Paula Branquinho Andrade
- REQUIMTE/LAQV, Laboratory of Pharmacognosy, Department of Chemistry, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal; (D.M.); (P.B.A.)
| | - Romeu António Videira
- REQUIMTE/LAQV, Laboratory of Pharmacognosy, Department of Chemistry, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal; (D.M.); (P.B.A.)
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Li T, Le W, Jankovic J. Linking the cerebellum to Parkinson disease: an update. Nat Rev Neurol 2023; 19:645-654. [PMID: 37752351 DOI: 10.1038/s41582-023-00874-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 09/28/2023]
Abstract
Parkinson disease (PD) is characterized by heterogeneous motor and non-motor symptoms, resulting from neurodegeneration involving various parts of the central nervous system. Although PD pathology predominantly involves the nigral-striatal system, growing evidence suggests that pathological changes extend beyond the basal ganglia into other parts of the brain, including the cerebellum. In addition to a primary involvement in motor control, the cerebellum is now known to also have an important role in cognitive, sleep and affective processes. Over the past decade, an accumulating body of research has provided clinical, pathological, neurophysiological, structural and functional neuroimaging findings that clearly establish a link between the cerebellum and PD. This Review presents an overview and update on the involvement of the cerebellum in the clinical features and pathogenesis of PD, which could provide a novel framework for a better understanding the heterogeneity of the disease.
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Affiliation(s)
- Tianbai Li
- Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Weidong Le
- Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China.
- Institute of Neurology, Sichuan Academy of Medical Sciences, Sichuan Provincial Hospital, Chengdu, China.
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
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Bologna M, Espay AJ, Fasano A, Paparella G, Hallett M, Berardelli A. Redefining Bradykinesia. Mov Disord 2023; 38:551-557. [PMID: 36847357 PMCID: PMC10387192 DOI: 10.1002/mds.29362] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 03/01/2023] Open
Affiliation(s)
- Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Alberto J. Espay
- Gardner Family Center for Parkinson’s Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson’s Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada
- Division of Neurology, University of Toronto, Toronto, Ontario, Canada
- Krembil Brain Institute, Toronto, Ontario, Canada
| | | | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
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Chung JW, Knight CA, Bower AE, Martello JP, Jeka JJ, Burciu RG. Rate control deficits during pinch grip and ankle dorsiflexion in early-stage Parkinson's disease. PLoS One 2023; 18:e0282203. [PMID: 36867628 PMCID: PMC9983837 DOI: 10.1371/journal.pone.0282203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 02/10/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Much of our understanding of the deficits in force control in Parkinson's disease (PD) relies on findings in the upper extremity. Currently, there is a paucity of data pertaining to the effect of PD on lower limb force control. OBJECTIVE The purpose of this study was to concurrently evaluate upper- and lower-limb force control in early-stage PD and a group of age- and gender-matched healthy controls. METHODS Twenty individuals with PD and twenty-one healthy older adults participated in this study. Participants performed two visually guided, submaximal (15% of maximum voluntary contractions) isometric force tasks: a pinch grip task and an ankle dorsiflexion task. PD were tested on their more affected side and after overnight withdrawal from antiparkinsonian medication. The tested side in controls was randomized. Differences in force control capacity were assessed by manipulating speed-based and variability-based task parameters. RESULTS Compared with controls, PD demonstrated slower rates of force development and force relaxation during the foot task, and a slower rate of relaxation during the hand task. Force variability was similar across groups but greater in the foot than in the hand in both PD and controls. Lower limb rate control deficits were greater in PD with more severe symptoms based on the Hoehn and Yahr stage. CONCLUSIONS Together, these results provide quantitative evidence of an impaired capacity in PD to produce submaximal and rapid force across multiple effectors. Moreover, results suggest that force control deficits in the lower limb may become more severe with disease progression.
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Affiliation(s)
- Jae Woo Chung
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - Christopher A. Knight
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States of America
| | - Abigail E. Bower
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - Justin P. Martello
- Department of Neurosciences, Christiana Care Health System, Newark, DE, United States of America
| | - John J. Jeka
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States of America
| | - Roxana G. Burciu
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States of America
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Sreedharan S, Zouganelis G, Drake SJ, Tripathi G, Kermanizadeh A. Nanomaterial-induced toxicity in pathophysiological models representative of individuals with pre-existing medical conditions. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2023; 26:1-27. [PMID: 36474307 DOI: 10.1080/10937404.2022.2153456] [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: 06/17/2023]
Abstract
The integration of nanomaterials (NMs) into an ever-expanding number of daily used products has proven to be highly desirable in numerous industries and applications. Unfortunately, the same "nano" specific physicochemical properties, which make these materials attractive, may also contribute to hazards for individuals exposed to these materials. In 2021, it was estimated that 7 out of 10 deaths globally were accredited to chronic diseases, such as chronic liver disease, asthma, and cardiovascular-related illnesses. Crucially, it is also understood that a significant proportion of global populace numbering in the billions are currently living with a range of chronic undiagnosed health conditions. Due to the significant number of individuals affected, it is important that people suffering from chronic disease also be considered and incorporated in NM hazard assessment strategies. This review examined and analyzed the literature that focused on NM-induced adverse health effects in models which are representative of individuals exhibiting pre-existing medical conditions with focus on the pulmonary, cardiovascular, hepatic, gastrointestinal, and central nervous systems. The overall objective of this review was to outline available data, highlighting the important role of pre-existing disease in NM-induced toxicity with the aim of establishing a weight of evidence approach to inform the public on the potential hazards posed by NMs in both healthy and compromised persons in general population.
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Masaki M, Kasahara M, Inagaki Y, Yokota M, Takeuchi M. Association of sagittal spinal alignment in the standing position with the masses and amounts of intramuscular non-contractile tissue of the trunk and lower extremity muscles in patients with Parkinson's disease. Clin Biomech (Bristol, Avon) 2023; 101:105868. [PMID: 36580828 DOI: 10.1016/j.clinbiomech.2022.105868] [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: 09/21/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND We examined the association of sagittal spinal alignment in the standing position with the masses and amounts of intramuscular non-contractile tissue of multiple trunk and lower extremity muscles, such as the hip joint muscles, measured using an ultrasound imaging device in patients with Parkinson's disease (PD). METHODS The participants were 10 patients with PD. Sagittal spinal alignment (thoracic kyphosis, lumbar lordosis, and sacral anterior inclination angles) in the standing position was measured using a Spinal Mouse. Muscle thicknesses and echo intensities of the trunk and lower extremity muscles, including the hip joint muscles, were also measured in the prone or supine position using an ultrasound imaging device. FINDINGS Partial correlation analysis with body height and weight as control variables showed that a low lumbar lordosis angle in the standing position was significantly associated with low thicknesses of the trunk extensor muscles (lumbar erector spinae and multifidus). Partial correlation analysis also revealed that a high sacral anterior inclination angle in the standing position was significantly associated with low lumbar multifidus muscle thickness. However, the thicknesses and echo intensities of the trunk flexor and hip joint muscles were not significantly related to thoracic kyphosis, lumbar lordosis, or sacral anterior inclination angles. INTERPRETATION The results of this study suggested the association between a low lumbar lordosis angle in the standing position and low lumbar erector spinae and multifidus muscle thicknesses and between a high sacral anterior inclination angle in the standing position and low lumbar multifidus muscle thickness in patients with PD.
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Affiliation(s)
- Mitsuhiro Masaki
- Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma 501 Nakaorui-machi, Takasaki 370-0033, Japan.
| | - Maki Kasahara
- Department of Rehabilitation, Tsunoda Hospital, Gunma 675-4 Kamishinden, Tamamura-machi, Sawagun 370-1133, Japan.
| | - Yukika Inagaki
- Department of Rehabilitation, Sawarabi Medical Welfare Center, Gunma 168-1 Oyagi-machi, Takasaki 370-0072, Japan.
| | - Minori Yokota
- Department of Rehabilitation, Takeda General Hospital, Fukushima 3-27 Yamaga-machi, Aizuwakamatsu 965-8585, Japan.
| | - Moeka Takeuchi
- Department of Rehabilitation, Iwamuro Rehabilitation Hospital, Niigata 772-1 Iwamuronsen, Nishikan-ku, Niigata 953-0104, Japan.
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Liu X, Yu H, Chen B, Friedman V, Mu L, Kelly TJ, Ruiz-Pérez G, Zhao L, Bai X, Hillard CJ, Liu QS. CB2 Agonist GW842166x Protected against 6-OHDA-Induced Anxiogenic- and Depressive-Related Behaviors in Mice. Biomedicines 2022; 10:1776. [PMID: 35892676 PMCID: PMC9329798 DOI: 10.3390/biomedicines10081776] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 11/19/2022] Open
Abstract
In addition to motor dysfunction, patients with Parkinson's disease (PD) are often affected by neuropsychiatric disorders, such as anxiety and depression. In animal models, activation of the endocannabinoid (eCB) system produces anxiolytic and antidepressant-like behavioral effects. CB2 agonists have demonstrated neuroprotective effects against neurotoxin-induced dopamine neuron loss and deficits in motor function. However, it remains unknown whether CB2 agonism ameliorates anxiogenic- and depressive-like behaviors in PD models. Here, we report that the selective CB2 agonist GW842166x exerted neuroprotective effects against 6-hydroxydopamine (6-OHDA)-induced loss of dopaminergic terminals and dopamine release in the striatum, which were blocked by the CB2 antagonist AM630. We found that 6-OHDA-treated mice exhibited anxiogenic- and depressive-like behaviors in the open-field, sucrose preference, novelty-suppressed feeding, marble burying, and forced swim tests but did not show significant changes in the elevated plus-maze and light-dark box test. GW842166x treatments ameliorated 6-OHDA-induced anxiogenic- and depressive-like behaviors, but the effects were blocked by CB2 antagonism, suggesting a CB2-dependent mechanism. These results suggest that the CB2 agonist GW842166x not only reduces 6-OHDA-induced motor function deficits but also anxiogenic- and depressive-like behaviors in 6-OHDA mouse models of PD.
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Affiliation(s)
- Xiaojie Liu
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; (X.L.); (H.Y.); (B.C.); (V.F.); (L.M.); (T.J.K.); (G.R.-P.); (C.J.H.)
| | - Hao Yu
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; (X.L.); (H.Y.); (B.C.); (V.F.); (L.M.); (T.J.K.); (G.R.-P.); (C.J.H.)
- Department of Exercise Physiology, Beijing Sport University, Beijing 100084, China;
| | - Bixuan Chen
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; (X.L.); (H.Y.); (B.C.); (V.F.); (L.M.); (T.J.K.); (G.R.-P.); (C.J.H.)
| | - Vladislav Friedman
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; (X.L.); (H.Y.); (B.C.); (V.F.); (L.M.); (T.J.K.); (G.R.-P.); (C.J.H.)
| | - Lianwei Mu
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; (X.L.); (H.Y.); (B.C.); (V.F.); (L.M.); (T.J.K.); (G.R.-P.); (C.J.H.)
| | - Thomas J. Kelly
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; (X.L.); (H.Y.); (B.C.); (V.F.); (L.M.); (T.J.K.); (G.R.-P.); (C.J.H.)
| | - Gonzalo Ruiz-Pérez
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; (X.L.); (H.Y.); (B.C.); (V.F.); (L.M.); (T.J.K.); (G.R.-P.); (C.J.H.)
| | - Li Zhao
- Department of Exercise Physiology, Beijing Sport University, Beijing 100084, China;
| | - Xiaowen Bai
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA;
| | - Cecilia J. Hillard
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; (X.L.); (H.Y.); (B.C.); (V.F.); (L.M.); (T.J.K.); (G.R.-P.); (C.J.H.)
| | - Qing-song Liu
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; (X.L.); (H.Y.); (B.C.); (V.F.); (L.M.); (T.J.K.); (G.R.-P.); (C.J.H.)
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Berger AA, Winnick A, Izygon J, Jacob BM, Kaye JS, Kaye RJ, Neuchat EE, Kaye AM, Alpaugh ES, Cornett EM, Han AH, Kaye AD. Opicapone, a Novel Catechol-O-methyl Transferase Inhibitor, for Treatment of Parkinson's Disease "Off" Episodes. Health Psychol Res 2022; 10:36074. [PMID: 35774903 DOI: 10.52965/001c.36074] [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: 12/18/2021] [Accepted: 01/04/2022] [Indexed: 11/06/2022] Open
Abstract
Parkinson's Disease (PD) is a common neurodegenerative disorder and the leading cause of disability. It causes significant morbidity and disability through a plethora of symptoms, including movement disorders, sleep disturbances, and cognitive and psychiatric symptoms. The traditional pathogenesis theory of PD involves the loss of dopaminergic neurons in the substantia nigra (SN). Classically, treatment is pursued with an assortment of medications that are directed at overcoming this deficiency with levodopa being central to most treatment plans. Patients taking levodopa tend to experience "off episodes" with decreasing medication levels, causing large fluctuations in their symptoms. These off episodes are disturbing and a source of morbidity for these patients. Opicapone is a novel, peripherally acting Catechol-O-methyl transferase (COMT) inhibitor that is used as adjunctive therapy to carbidopa/levodopa for treatment and prevention of "off episodes." It has been approved for use as an adjunct to levodopa since 2016 in Europe and has recently (April 2020) gained FDA approval for use in the USA. By inhibiting COMT, opicapone slows levodopa metabolism and increases its availability. Several clinical studies demonstrated significant improvement in treatment efficacy and reduction in duration of "off episodes." The main side effect demonstrated was dyskinesia, mostly with the 100mg dose, which is higher than the approved, effective dose of 50mg. Post-marketing surveillance and analysis are required to further elucidate its safety profile and contribute to patient selection. This paper reviews the seminal and latest evidence in the treatment of PD "off episodes" with the novel drug Opicapone, including efficacy, safety, and clinical indications.
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Affiliation(s)
- Amnon A Berger
- Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center
| | - Ariel Winnick
- Soroka University Medical Center and Faculty of Health Sciences; School of Optometry, University of California
| | - Jonathan Izygon
- Soroka University Medical Center and Faculty of Health Sciences
| | - Binil M Jacob
- Soroka University Medical Center and Faculty of Health Sciences
| | - Jessica S Kaye
- Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific
| | | | | | - Adam M Kaye
- Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific
| | - Edward S Alpaugh
- Department of Anesthesiology, Louisiana State University Health Sciences Center
| | - Elyse M Cornett
- Department of Anesthesiology, Louisiana State University Health Sciences Center
| | - Andrew H Han
- Georgetown University School of Medicine, Georgetown University School of Medicine
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center
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Chen WN, Shaikh MF, Bhuvanendran S, Date A, Ansari MT, Radhakrishnan AK, Othman I. Poloxamer 188 (P188), A Potential Polymeric Protective Agent for Central Nervous System Disorders: A Systematic Review. Curr Neuropharmacol 2022; 20:799-808. [PMID: 34077349 PMCID: PMC9878954 DOI: 10.2174/1570159x19666210528155801] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 11/22/2022] Open
Abstract
Poloxamer 188 (P188) is an FDA-approved biocompatible block copolymer composed of repeating units of Poly(Ethylene Oxide) (PEO) and poly(propylene oxide) (PPO). Due to its amphiphilic nature and high Hydrophile-Lipophile Balance (HLB) value of 29, P188 is used as a stabilizer/emulsifier in many cosmetics and pharmaceutical preparations. While the applications of P188 as an excipient are widely explored, the data on the pharmacological activity of P188 are scarce. Notably, the neuroprotective potential of P188 has gained a lot of interest. Therefore, this systematic review is aimed at summarizing evidence of neuroprotective potential of P188 in CNS disorders. The PRISMA model was used, and five databases (Google Scholar, Scopus, Wiley Online Library, ScienceDirect, and PubMed) were searched with relevant keywords. The search resulted in 11 articles, which met the inclusion criteria. These articles described the protective effects of P188 on traumatic brain injury or mechanical injury in cells, neurotoxicity, Parkinson's disease, Amyotrophic lateral sclerosis (ALS), and ischemia/ reperfusion injury from stroke. All the articles were original research in experimental or pre-clinical stages using animal models or in vitro systems. The reported activities demonstrated the potential of P188 as a neuroprotective agent in improving CNS conditions such as neurodegeneration.
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Affiliation(s)
- Win Ning Chen
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor, Malaysia
| | - Mohd Farooq Shaikh
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor, Malaysia;,Address correspondence to this author at the Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor, Malaysia; Tel: +603 5514 4483; E-mail:
| | - Saatheeyavaane Bhuvanendran
- Brain Research Institute of Monash Sunway (BRIMS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor, Malaysia
| | - Abhijit Date
- Department of Pharmaceutical Sciences, The Daniel K. Inouye College of Pharmacy, University of Hawaii Hilo, Hilo, HI96720, USA
| | - Mohammad Tahir Ansari
- School of Pharmacy, University of Nottingham Malaysia, Semenyih43500, Selangor, Malaysia
| | - Ammu Kutty Radhakrishnan
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor, Malaysia
| | - Iekhsan Othman
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor, Malaysia
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12
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de Oliveira PCA, de Araújo TAB, Machado DGDS, Rodrigues AC, Bikson M, Andrade SM, Okano AH, Simplicio H, Pegado R, Morya E. Transcranial Direct Current Stimulation on Parkinson's Disease: Systematic Review and Meta-Analysis. Front Neurol 2022; 12:794784. [PMID: 35082749 PMCID: PMC8785799 DOI: 10.3389/fneur.2021.794784] [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] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/30/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Clinical impact of transcranial direct current stimulation (tDCS) alone for Parkinson's disease (PD) is still a challenge. Thus, there is a need to synthesize available results, analyze methodologically and statistically, and provide evidence to guide tDCS in PD. Objective: Investigate isolated tDCS effect in different brain areas and number of stimulated targets on PD motor symptoms. Methods: A systematic review was carried out up to February 2021, in databases: Cochrane Library, EMBASE, PubMed/MEDLINE, Scopus, and Web of science. Full text articles evaluating effect of active tDCS (anodic or cathodic) vs. sham or control on motor symptoms of PD were included. Results: Ten studies (n = 236) were included in meta-analysis and 25 studies (n = 405) in qualitative synthesis. The most frequently stimulated targets were dorsolateral prefrontal cortex and primary motor cortex. No significant effect was found among single targets on motor outcomes: Unified Parkinson's Disease Rating Scale (UPDRS) III – motor aspects (MD = −0.98%, 95% CI = −10.03 to 8.07, p = 0.83, I2 = 0%), UPDRS IV – dyskinesias (MD = −0.89%, CI 95% = −3.82 to 2.03, p = 0.55, I2 = 0%) and motor fluctuations (MD = −0.67%, CI 95% = −2.45 to 1.11, p = 0.46, I2 = 0%), timed up and go – gait (MD = 0.14%, CI 95% = −0.72 to 0.99, p = 0.75, I2 = 0%), Berg Balance Scale – balance (MD = 0.73%, CI 95% = −1.01 to 2.47, p = 0.41, I2 = 0%). There was no significant effect of single vs. multiple targets in: UPDRS III – motor aspects (MD = 2.05%, CI 95% = −1.96 to 6.06, p = 0.32, I2 = 0%) and gait (SMD = −0.05%, 95% CI = −0.28 to 0.17, p = 0.64, I2 = 0%). Simple univariate meta-regression analysis between treatment dosage and effect size revealed that number of sessions (estimate = −1.7, SE = 1.51, z-score = −1.18, p = 0.2, IC = −4.75 to 1.17) and cumulative time (estimate = −0.07, SE = 0.07, z-score = −0.99, p = 0.31, IC = −0.21 to 0.07) had no significant association. Conclusion: There was no significant tDCS alone short-term effect on motor function, balance, gait, dyskinesias or motor fluctuations in Parkinson's disease, regardless of brain area or targets stimulated.
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Affiliation(s)
- Paloma Cristina Alves de Oliveira
- Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Brazil
| | - Thiago Anderson Brito de Araújo
- Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Brazil
| | | | - Abner Cardoso Rodrigues
- Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Brazil
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
| | | | - Alexandre Hideki Okano
- Center for Mathematics, Computing and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Hougelle Simplicio
- Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Brazil.,Rehabilitation Center, Anita Garibaldi Center for Education and Health, Santos Dumont Institute, Macaíba, Brazil.,Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, Brazil.,Neuron-Care Unit in Neurosurgery, Hospital Rio Grande, Natal, Brazil
| | - Rodrigo Pegado
- Program in Rehabilitation Science, Program in Health Science, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Edgard Morya
- Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Brazil
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13
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Aras B, Seyyar GK, Fidan O, Colak E. The effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease: A systematic review and meta-analysis of systematic reviews. Explore (NY) 2021; 18:402-410. [PMID: 34952799 DOI: 10.1016/j.explore.2021.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 11/10/2021] [Accepted: 12/04/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND The aim of the study was to evaluate the effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease. MATERIALS AND METHODS A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses up to the end of October 2021. 601 studies were identified, and 16 of them were included in our study. RESULTS According to our meta-analysis; there was a significant effect of Tai Chi on balance (SMD, -0.777 95% CI -0.921 to -0.633; p = 0.000), functional mobility (SMD, -0.719 95% CI -0.944 to -0.494; p = 0.000), and falls (SMD, -0.456 95% CI -0.668 to -0.245; p = 0.000) in PD. CONCLUSION Our systematic review and meta-analysis found significant effects of Tai Chi on functional mobility, balance and falls in patients with PD.
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Affiliation(s)
- Bahar Aras
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kutahya Health Sciences University, Kutahya, Turkey.
| | - Gulce Kallem Seyyar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kutahya Health Sciences University, Kutahya, Turkey
| | - Oznur Fidan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Osmangazi University, Eskisehir, Turkey
| | - Ertugrul Colak
- Faculty of Medicine, Department of Biostatistics, Osmangazi University, Eskisehir, Turkey
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14
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Tekriwal A, Lintz MJ, Thompson JA, Felsen G. Disrupted basal ganglia output during movement preparation in hemiparkinsonian mice is consistent with behavioral deficits. J Neurophysiol 2021; 126:1248-1264. [PMID: 34406873 DOI: 10.1152/jn.00001.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Parkinsonian motor deficits are associated with elevated inhibitory output from the basal ganglia (BG). However, several features of Parkinson's disease (PD) have not been accounted for by this simple "classical rate model" framework, including the observation in patients with PD that movements guided by external stimuli are less impaired than otherwise identical movements generated based on internal goals. Is this difference due to divergent processing within the BG itself or due to the recruitment of extra-BG pathways by sensory processing? In addition, surprisingly little is known about precisely when, in the sequence from selecting to executing movements, BG output is altered by PD. Here, we address these questions by recording activity in the substantia nigra pars reticulata (SNr), a key BG output nucleus, in hemiparkinsonian mice performing a well-controlled behavioral task requiring stimulus-guided and internally specified directional movements. We found that hemiparkinsonian mice exhibited a bias ipsilateral to the side of dopaminergic cell loss that was stronger when movements were internally specified rather than stimulus guided, consistent with clinical observations in patients with Parkinson's disease. We further found that changes in parkinsonian SNr activity during movement preparation were consistent with the ipsilateral behavioral bias, as well as its greater magnitude for internally specified movements. Although these findings are inconsistent with some aspects of the classical rate model, they are accounted for by a related "directional rate model" positing that SNr output phasically overinhibits motor output in a direction-specific manner. These results suggest that parkinsonian changes in BG output underlying movement preparation contribute to the greater deficit in internally specified than stimulus-guided movements.NEW & NOTEWORTHY Movements of patients with Parkinson's disease are often less impaired when guided by external stimuli than when generated based on internal goals. Whether this effect is due to distinct processing in the basal ganglia (BG) or due to compensation from other motor pathways is an open question with therapeutic implications. We recorded BG output in behaving parkinsonian mice and found that BG activity during movement preparation was consistent with the differences between these forms of movement.
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Affiliation(s)
- Anand Tekriwal
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, Colorado.,Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado.,Neuroscience Program, University of Colorado School of Medicine, Aurora, Colorado.,Medical Scientist Training Program, University of Colorado School of Medicine, Aurora, Colorado
| | - Mario J Lintz
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, Colorado.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado.,Neuroscience Program, University of Colorado School of Medicine, Aurora, Colorado.,Medical Scientist Training Program, University of Colorado School of Medicine, Aurora, Colorado
| | - John A Thompson
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado.,Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado.,Neuroscience Program, University of Colorado School of Medicine, Aurora, Colorado.,Medical Scientist Training Program, University of Colorado School of Medicine, Aurora, Colorado
| | - Gidon Felsen
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, Colorado.,Neuroscience Program, University of Colorado School of Medicine, Aurora, Colorado.,Medical Scientist Training Program, University of Colorado School of Medicine, Aurora, Colorado
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15
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Rossi T, Trevisol MB, Oliveira DSD, Schütz DM, Lima MP, Irigaray TQ, Oliveira CRD, Paloski LH. Executive Functions in Parkinson’s Disease. PSICO-USF 2021. [DOI: 10.1590/1413-82712021260304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract The objective of this study was to investigate executive functions (EFs) in older adults with Parkinson’s disease (PD). It was a cross-sectional and comparative study, composed of 62 participants divided into PD group (n = 31; M age = 75.26; SD age = 7.26) and control group (n = 31; M age = 74.03; SD age = 6.95), aged 61 to 93 years, recruited for convenience in 5 cities in the state of Rio Grande do Sul. The instruments used were a sociodemographic data questionnaire; MMSE; GDS-15; BIS-11; verbal fluency tasks (FAS and animals), DEX; WCST-64 and FDT. Descriptive analyzes and Student’s t and Chi-square tests were used. The PD group had a lower performance in the WCST-64 and FDT tests compared to controls, indicating worse performance in tasks that required reasoning, cognitive flexibility and processing speed, in addition, showed difficulties in performing tasks that require EF (DEX).
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16
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Ding W, Qi M, Ma L, Xu X, Chen Y, Zhang W. ADP/ATP translocase 1 protects against an α-synuclein-associated neuronal cell damage in Parkinson's disease model. Cell Biosci 2021; 11:130. [PMID: 34246309 PMCID: PMC8272299 DOI: 10.1186/s13578-021-00645-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/02/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND ADP/ATP translocase 1 (ANT1) is involved in the exchange of cytosolic ADP and mitochondrial ATP, and its defection plays an important role in mitochondrial pathogenesis. To reveal an etiological implication of ANT1 for Parkinson's disease (PD), a neurodegenerative disorder, a mouse model treated with 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine and neuroblastoma cell model induced by 1-methyl-4-pehny1-pyridine were utilized in this study. RESULTS The tissue-specific abundance in ANT1 in mouse brains was accessed using the analysis of Western blot and immunohistochemistry. Down-regulated soluble ANT1 was found to be correlated with PD, and ANT1 was associated with PD pathogenesis via forming protein aggregates with α-synuclein. This finding was confirmed at cellular level using neuroblastoma cell models. ANT1 supplement in neuronal cells revealed the protective roles of ANT1 against cytotoxicity caused by MPP+. Protein interaction assay, coupled with the analysis of LC-MS/MS, silver-stained SDS-PAGE and Western blot against anti-ANT1 antibody respectively, illustrated the interaction of ANT1 with α-synuclein using the expressed α-synuclein as a bite. Additionally, a significant increasing ROSs was detected in the MPP+-treated cells. CONCLUSIONS This study indicated that ANT1 was a potentially causative factor of PD, and led to neuropathogenic injury via promoting the formation of protein aggregates with α-synuclein. This investigation potentially promotes an innovative understanding of ANT1 on the etiology of PD and provides valuable information on developing potential drug targets in PD treatment or reliable biomarkers in PD prognostication.
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Affiliation(s)
- Wenyong Ding
- Biochemistry and Molecular Biology Department of College of Basic Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Minghua Qi
- Biochemistry and Molecular Biology Department of College of Basic Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Li Ma
- Department of Epidemiology, Dalian Medical University, Dalian, 116044, China
| | - Xuefei Xu
- Biochemistry and Molecular Biology Department of College of Basic Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Yingfei Chen
- Grade 2020, Capital Medical University, Beijing, 100069, China
| | - Wenli Zhang
- Biochemistry and Molecular Biology Department of College of Basic Medical Sciences, Dalian Medical University, Dalian, 116044, China.
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17
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The relation between falls risk and movement variability in Parkinson's disease. Exp Brain Res 2021; 239:2077-2087. [PMID: 33914138 DOI: 10.1007/s00221-021-06113-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
Falls are a major health concern for older adults with Parkinson's disease (PD). This study was designed to examine differences in falls risk and its relation to changes in the average and variability (i.e. intra-individual variability) of reaction time (RT), finger tapping, standing balance and walking between healthy older adults and persons with PD. Thirty-nine adults with PD (70.0 ± 8.1 years) and 29 healthy older adults (66.8 ± 10.4 years) participated in this study. Falls risk (using the physiological profile assessment), gait, RT, balance and tapping responses were assessed for all persons. Results demonstrated that individuals with PD exhibited a greater risk of falling coupled with a general slowing of motor function covering declines in walking, RT and finger tapping. In addition, the movement responses of the PD group were more variable than the healthy older adults. Correlation results revealed group differences with regards to the neuromotor measures which were significantly correlated with falls risk. For the PD group, gait measures were highly correlated with their falls risk while, for the healthy older adults, falls risk was linked to balance measures even though PD persons had increased sway. Overall, persons with PD were at greater falls risk, moved slower and with increased variability compared to the healthy older adults. Further, while there are some similarities between the two groups in terms of those measures related to falls risk, there were also several differences which highlight that persons with PD can have different risk factors for falling compared to healthy adults of similar age.
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18
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LeWitt PA, Chaudhuri KR. Unmet needs in Parkinson disease: Motor and non-motor. Parkinsonism Relat Disord 2020; 80 Suppl 1:S7-S12. [PMID: 33349582 DOI: 10.1016/j.parkreldis.2020.09.024] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/25/2020] [Accepted: 09/15/2020] [Indexed: 12/28/2022]
Abstract
Compared to other neurodegenerative diseases, Parkinson's disease (PD) is distinctive in terms of marked symptomatic variability and prognosis, as well as for the wide variety of symptomatic treatment options. Despite several decades of advances in medications and neurosurgical approaches, there remains an unmet need for symptomatic motor control. Better control of tremor, gait and balance, posture, dexterity, and communication skills are major challenges for better therapeutics of the PD movement disorder. Non-motor symptoms (NMS), which often precede motor impairments, add complexity to the burden of PD and its management. Recognized by James Parkinson MD two centuries ago, and despite 21st century neurological advances, a range of NMS plague the patient's journey, from prodromal to palliative stages. Characterizing the clinical phenotype of the entire non-motor profile of PD is challenging. Further research and understanding are needed for discovering biomarkers of certain NMS, such as dementia, fatigue, pain, sleep, and apathy. More work is needed to gather a robust evidence base for guiding treatment of troubling NMS, which exert a major impact on quality of life for people with PD and their caregivers.
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Affiliation(s)
- Peter A LeWitt
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Neurology, Henry Ford Hospital, Detroit, MI, USA.
| | - K Ray Chaudhuri
- King's College London and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
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19
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Dos Santos EUD, da Silva IIFG, Asano AGC, Asano NMJ, De Mascena Diniz Maia M, de Souza PRE. Pharmacogenetic profile and the development of the dyskinesia induced by levodopa-therapy in Parkinson's disease patients: a population-based cohort study. Mol Biol Rep 2020; 47:8997-9004. [PMID: 33151475 DOI: 10.1007/s11033-020-05956-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/28/2020] [Indexed: 12/21/2022]
Abstract
Levodopa-induced dyskinesia (LID) is an adverse effect that negatively impacts the quality of life of patients with Parkinson's disease (PD). Studies report that genetic variations in the genes of the pharmacogenetic pathway of the levodopa (L-DOPA) might be associated with LID development. The goal of the present study was to investigate a possible influence of functional genetic variants in the DRD1 (rs4532), DRD2 (rs1800497), DAT1 (rs28363170), and COMT (rs4680) genes with LID development. A total of 220 patients with idiopathic PD were enrolled. The genotyping for DRD1 (rs4532), DRD2 (rs1800497), DAT1 (rs28363170), and COMT (rs4680) polymorphisms were performed using Restriction Fragment Length Polymorphism (PCR-RFLP). Univariate and multivariate analyses were performed to assess the association of these polymorphisms and risk factors with LID development. Multivariate Cox regression analysis showed increased risk to LID development for both Levodopa Dose Equivalency (LED) (Hazard ratios (HR) = 1.001; 95% CI 1.00-1.01; p = 0.009) and individuals carrying the COMT L/L genotype (HR = 2.974; 95% CI 1.12-7.83; p = 0.010). Furthermore, when performed a Cox regression analysis adjusted for a total LED, we observed that the genotype COMT L/L had a 3.84-fold increased risk for LID development (HR = 3.841; 95% CI 1.29-11.37; p = 0.012). Our results suggest that before treating LID in PD patients, it is important to take into consideration genetic variant in the COMT gene, since COMT LL genotype may increase the risk for LID development.
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Affiliation(s)
- Erinaldo Ubirajara Damasceno Dos Santos
- Graduate Program in Applied Cellular and Molecular Biology, University of Pernambuco (UPE), Rua Dom Manuel de Medeiros, S/N -Dois Irmãos, CEP:52171-900, Recife, PE, Brazil
| | | | - Amdore Guescel C Asano
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.,Pro-Parkinson Program of the Clinical Hospital of the Federal University of Pernambuco Recife (HC/UFPE), Recife, PE, Brazil
| | - Nadja Maria Jorge Asano
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.,Pro-Parkinson Program of the Clinical Hospital of the Federal University of Pernambuco Recife (HC/UFPE), Recife, PE, Brazil
| | | | - Paulo Roberto Eleutério de Souza
- Graduate Program in Applied Cellular and Molecular Biology, University of Pernambuco (UPE), Rua Dom Manuel de Medeiros, S/N -Dois Irmãos, CEP:52171-900, Recife, PE, Brazil. .,Graduate Program in Genetics, Federal University of Pernambuco (UFPE), Recife, PE, Brazil. .,Department of Biology, Federal Rural University of Pernambuco (UFRPE), Recife, PE, Brazil.
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20
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Ursino M, Véronneau-Veilleux F, Nekka F. A non-linear deterministic model of action selection in the basal ganglia to simulate motor fluctuations in Parkinson's disease. CHAOS (WOODBURY, N.Y.) 2020; 30:083139. [PMID: 32872807 DOI: 10.1063/5.0013666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/27/2020] [Indexed: 06/11/2023]
Abstract
Motor fluctuations and dyskinesias are severe complications of Parkinson's disease (PD), especially evident at its advanced stage, under long-term levodopa therapy. Despite their strong clinical prevalence, the neural origin of these motor symptoms is still a subject of intense debate. In this work, a non-linear deterministic neurocomputational model of the basal ganglia (BG), inspired by biology, is used to provide more insights into possible neural mechanisms at the basis of motor complications in PD. In particular, the model is used to simulate the finger tapping task. The model describes the main neural pathways involved in the BG to select actions [the direct or Go, the indirect or NoGo, and the hyperdirect pathways via the action of the sub-thalamic nucleus (STN)]. A sensitivity analysis is performed on some crucial model parameters (the dopamine level, the strength of the STN mechanism, and the strength of competition among different actions in the motor cortex) at different levels of synapses, reflecting major or minor motor training. Depending on model parameters, results show that the model can reproduce a variety of clinically relevant motor patterns, including normokinesia, bradykinesia, several attempts before movement, freezing, repetition, and also irregular fluctuations. Motor symptoms are, especially, evident at low or high dopamine levels, with excessive strength of the STN and with weak competition among alternative actions. Moreover, these symptoms worsen if the synapses are subject to insufficient learning. The model may help improve the comprehension of motor complications in PD and, ultimately, may contribute to the treatment design.
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Affiliation(s)
- Mauro Ursino
- Department of Electrical, Electronic and Information Engineering Guglielmo Marconi, University of Bologna, I 40136 Bologna, Italy
| | | | - Fahima Nekka
- Faculté de Pharmacie, Université de Montréal, Montréal, Québec H3T 1J4, Canada
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21
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Lu J, Feng Z, Shi X, Jiang L, Hao Y. Correlation between programmed stimulation parameters and their efficacy after deep brain electrode implantation for Parkinson’s disease. JOURNAL OF NEURORESTORATOLOGY 2020. [DOI: 10.26599/jnr.2019.9040018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an indispensable and effective surgery for patients with primary Parkinson’s disease (PD). Nonetheless, its postoperative effects can be decided by many factors including the optimal programmed stimulation parameters. In this study, we analyzed the correlation between different postoperative programmed stimulation parameters and their efficacy after STN–DBS electrode implantation in patients with PD. Methods: A total of 87 patients underwent electrode implantation and completed at least one year follow-up. Then, various combinations of stimulation parameters, including stimulus intensity, frequency, and pulse width, were examined for their effects on the clinical improvement of the patients. Improvements in motor and nonmotor symptoms were analyzed using Mini-Mental State Examination, Parkinson’s Disease Quality of Life Questionnaire-39, and Unified Parkinson’s Disease Rating Scale (UPDRS) scores before and after surgery. Results: We found significantly improved UPDRS scores, quality of life, and neuropsychiatric symptoms postoperatively considering the findings of the aforementioned stimulation parameters compared with those observed preoperatively. Conclusion: This study provides a better understanding on how programmed stimulation parameters help relieve PD symptoms and improve quality of life in patients with PD undergoing STN–DBS.
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22
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Cai CZ, Zhou HF, Yuan NN, Wu MY, Lee SMY, Ren JY, Su HX, Lu JJ, Chen XP, Li M, Tan JQ, Lu JH. Natural alkaloid harmine promotes degradation of alpha-synuclein via PKA-mediated ubiquitin-proteasome system activation. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 61:152842. [PMID: 31048127 DOI: 10.1016/j.phymed.2019.152842] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/17/2019] [Accepted: 01/25/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is an age-dependent progressive movement disorder characterized by a profound and selective loss of nigrostriatal dopaminergic neurons. Accumulation of <alpha>-synuclein (<alpha>-syn) positive protein aggregates in the substantia nigra is a pathological hallmark of PD, indicating that protein turnover defect is implicated in PD pathogenesis. PURPOSE This study aims to identify neuroprotective compounds which can alleviate the accumulation of <alpha>-syn in neuronal cells and dissect the underlying mechanisms. METHODS High throughput screening was performed by dot blot assay. The degradation of different forms of <alpha>-syn by candidate compounds were assessed by western blot. The autophagy lysosome pathway and ubiquitin-proteasome system were examined to dissect the degradation pathway. The UPS activity was assessed by cellular UPS substrates degradation assay and biochemical proteasome activity assay. Q-PCR was performed to test the mRNA level of different proteasome subunits. Furthermore, Neuroprotective effect of candidate compound was tested by LDH assay and PI staining. RESULTS Through the high throughput screening, harmine was identified as a potent <alpha>-syn lowering compound. The time-dependent and dose-dependent effects of harmine on the degradation of different forms of <alpha>-syn were further confirmed. Harmine could dramatically promote the degradation of UPS substrates GFP-CL1, Ub-R-GFP and Ub-G76V-GFP, and activate cellular proteasome activity. Mechanistically, harmine dramatically enhanced PKA phosphorylation to enhance proteasome subunit PSMD1 expression. PKA inhibitor blocked the effects of harmine in activating UPS, up regulating PSMD1 and promoting <alpha>-syn degradation, indicating that harmine enhances UPS function via PKA activation. Moreover, harmine efficiently rescued cell death induced by over-expression of <alpha>-syn, via UPS-dependent manner. CONCLUSION Harmine, as a new proteasome enhancer, may have potential to be developed into therapeutic agent against neurodegenerative diseases associated with UPS dysfunction and aberrant proteins accumulation.
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Affiliation(s)
- Cui-Zan Cai
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - He-Feng Zhou
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Ning-Ning Yuan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Ming-Yue Wu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Simon Ming-Yuen Lee
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Jiao-Yan Ren
- School of Food Science and Engineering, South China University of Technology, Wushan RD., Tianhe District, Guangzhou, China
| | - Huan-Xing Su
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Jin-Jian Lu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Xiu-Ping Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Min Li
- Mr. and Mrs. Ko Chi Ming Centre for Parkinson's Disease Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Jie-Qiong Tan
- Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China.
| | - Jia-Hong Lu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China.
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