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Liu Y, Pan R, Ouyang Y, Gu W, Xiao T, Yang H, Tang L, Wang H, Xiang B, Chen P. Pyroptosis in health and disease: mechanisms, regulation and clinical perspective. Signal Transduct Target Ther 2024; 9:245. [PMID: 39300122 DOI: 10.1038/s41392-024-01958-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/14/2024] [Accepted: 08/26/2024] [Indexed: 09/22/2024] Open
Abstract
Pyroptosis is a type of programmed cell death characterized by cell swelling and osmotic lysis, resulting in cytomembrane rupture and release of immunostimulatory components, which play a role in several pathological processes. Significant cellular responses to various stimuli involve the formation of inflammasomes, maturation of inflammatory caspases, and caspase-mediated cleavage of gasdermin. The function of pyroptosis in disease is complex but not a simple angelic or demonic role. While inflammatory diseases such as sepsis are associated with uncontrollable pyroptosis, the potent immune response induced by pyroptosis can be exploited as a therapeutic target for anti-tumor therapy. Thus, a comprehensive review of the role of pyroptosis in disease is crucial for further research and clinical translation from bench to bedside. In this review, we summarize the recent advancements in understanding the role of pyroptosis in disease, covering the related development history, molecular mechanisms including canonical, non-canonical, caspase 3/8, and granzyme-mediated pathways, and its regulatory function in health and multiple diseases. Moreover, this review also provides updates on promising therapeutic strategies by applying novel small molecule inhibitors and traditional medicines to regulate pyroptosis. The present dilemmas and future directions in the landscape of pyroptosis are also discussed from a clinical perspective, providing clues for scientists to develop novel drugs targeting pyroptosis.
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Affiliation(s)
- Yifan Liu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410013, China
- Department of Oncology, Xiangya Hospital, Central South University, 87th Xiangya road, Changsha, 410008, Hunan province, China
| | - Renjie Pan
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410013, China
| | - Yuzhen Ouyang
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410013, China
- Department of Neurology, Xiangya Hospital, Central South University, 87th Xiangya road, Changsha, 410008, Hunan province, China
| | - Wangning Gu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410013, China
| | - Tengfei Xiao
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410013, China
| | - Hongmin Yang
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410013, China
| | - Ling Tang
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410013, China
| | - Hui Wang
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410013, China.
| | - Bo Xiang
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410013, China.
| | - Pan Chen
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, 410013, China.
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Cooke A, Hindle J, Lawrence C, Bellomo E, Pritchard AW, MacLeod CA, Martin-Forbes P, Jones S, Bracewell M, Linden DEJ, Mehler DMA. Effects of home-based EEG neurofeedback training as a non-pharmacological intervention for Parkinson's disease. Neurophysiol Clin 2024; 54:102997. [PMID: 38991470 DOI: 10.1016/j.neucli.2024.102997] [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: 03/21/2024] [Revised: 06/12/2024] [Accepted: 06/12/2024] [Indexed: 07/13/2024] Open
Abstract
OBJECTIVES Aberrant movement-related cortical activity has been linked to impaired motor function in Parkinson's disease (PD). Dopaminergic drug treatment can restore these, but dosages and long-term treatment are limited by adverse side-effects. Effective non-pharmacological treatments could help reduce reliance on drugs. This experiment reports the first study of home-based electroencephalographic (EEG) neurofeedback training as a non-pharmacological candidate treatment for PD. Our primary aim was to test the feasibility of our EEG neurofeedback intervention in a home setting. METHODS Sixteen people with PD received six home visits comprising symptomology self-reports, a standardised motor assessment, and a precision handgrip force production task while EEG was recorded (visits 1, 2 and 6); and 3 × 1-hr EEG neurofeedback training sessions to supress the EEG mu rhythm before initiating handgrip movements (visits 3 to 5). RESULTS Participants successfully learned to self-regulate mu activity, and this appeared to expedite the initiation of precision movements (i.e., time to reach target handgrip force off-medication pre-intervention = 628 ms, off-medication post-intervention = 564 ms). There was no evidence of wider symptomology reduction (e.g., Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III Motor Examination, off-medication pre-intervention = 29.00, off-medication post intervention = 30.07). Interviews indicated that the intervention was well-received. CONCLUSION Based on the significant effect of neurofeedback on movement-related cortical activity, positive qualitative reports from participants, and a suggestive benefit to movement initiation, we conclude that home-based neurofeedback for people with PD is a feasible and promising non-pharmacological treatment that warrants further research.
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Affiliation(s)
- Andrew Cooke
- Instutute for the Psychology of Elite Performance (IPEP), Bangor University, UK; School of Psychology and Sport Science, Bangor University, UK.
| | - John Hindle
- The Centre for Research in Ageing and Cognitive Health (REACH), University of Exeter, UK; University of Exeter Medical School, UK
| | - Catherine Lawrence
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, UK; School of Health Sciences, Bangor University, UK
| | - Eduardo Bellomo
- Instutute for the Psychology of Elite Performance (IPEP), Bangor University, UK
| | | | - Catherine A MacLeod
- Centre for Population Health Sciences, Usher Institute, The University of Edinburgh, UK
| | | | | | - Martyn Bracewell
- School of Psychology and Sport Science, Bangor University, UK; North Wales Medical School, Bangor University, UK; Walton Centre NHS Foundation Trust, UK
| | - David E J Linden
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, UK; MRC Center for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK
| | - David M A Mehler
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, UK; MRC Center for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK; Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, UK; Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Germany; Institute for Translational Psychiatry, University Hospital Münster, Germany
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Urmeneta-Ortíz MF, Tejeda-Martínez AR, González-Reynoso O, Flores-Soto ME. Potential Neuroprotective Effect of the Endocannabinoid System on Parkinson's Disease. PARKINSON'S DISEASE 2024; 2024:5519396. [PMID: 39104613 PMCID: PMC11300097 DOI: 10.1155/2024/5519396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 06/21/2024] [Accepted: 07/01/2024] [Indexed: 08/07/2024]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by alterations in motor capacity resulting from a decrease in the neurotransmitter dopamine due to the selective death of dopaminergic neurons of the nigrostriatal pathway. Unfortunately, conventional pharmacological treatments fail to halt disease progression; therefore, new therapeutic strategies are needed, and currently, some are being investigated. The endocannabinoid system (ECS), highly expressed in the basal ganglia (BG) circuit, undergoes alterations in response to dopaminergic depletion, potentially contributing to motor symptoms and the etiopathogenesis of PD. Substantial evidence supports the neuroprotective role of the ECS through various mechanisms, including anti-inflammatory, antioxidative, and antiapoptotic effects. Therefore, the ECS emerges as a promising target for PD treatment. This review provides a comprehensive summary of current clinical and preclinical evidence concerning ECS alterations in PD, along with potential pharmacological targets that may exert the protection of dopaminergic neurons.
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Affiliation(s)
- María Fernanda Urmeneta-Ortíz
- Chemical Engineering Department, University Center for Exact and Engineering SciencesUniversity of Guadalajara, Blvd. M. García Barragán # 1451, Guadalajara C.P. 44430, Jalisco, Mexico
- Cellular and Molecular Neurobiology LaboratoryNeurosciences DivisionWestern Biomedical Research Center (CIBO)Mexican Social Security Institute, Sierra Mojada #800, Independencia Oriente, Guadalajara 44340, Jalisco, Mexico
| | - Aldo Rafael Tejeda-Martínez
- Cellular and Molecular Neurobiology LaboratoryNeurosciences DivisionWestern Biomedical Research Center (CIBO)Mexican Social Security Institute, Sierra Mojada #800, Independencia Oriente, Guadalajara 44340, Jalisco, Mexico
| | - Orfil González-Reynoso
- Chemical Engineering Department, University Center for Exact and Engineering SciencesUniversity of Guadalajara, Blvd. M. García Barragán # 1451, Guadalajara C.P. 44430, Jalisco, Mexico
| | - Mario Eduardo Flores-Soto
- Cellular and Molecular Neurobiology LaboratoryNeurosciences DivisionWestern Biomedical Research Center (CIBO)Mexican Social Security Institute, Sierra Mojada #800, Independencia Oriente, Guadalajara 44340, Jalisco, Mexico
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Cano LA, Albarracín AL, Pizá AG, García-Cena CE, Fernández-Jover E, Farfán FD. Assessing Cognitive Workload in Motor Decision-Making through Functional Connectivity Analysis: Towards Early Detection and Monitoring of Neurodegenerative Diseases. SENSORS (BASEL, SWITZERLAND) 2024; 24:1089. [PMID: 38400247 PMCID: PMC10893317 DOI: 10.3390/s24041089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/04/2023] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
Neurodegenerative diseases (NDs), such as Alzheimer's, Parkinson's, amyotrophic lateral sclerosis, and frontotemporal dementia, among others, are increasingly prevalent in the global population. The clinical diagnosis of these NDs is based on the detection and characterization of motor and non-motor symptoms. However, when these diagnoses are made, the subjects are often in advanced stages where neuromuscular alterations are frequently irreversible. In this context, we propose a methodology to evaluate the cognitive workload (CWL) of motor tasks involving decision-making processes. CWL is a concept widely used to address the balance between task demand and the subject's available resources to complete that task. In this study, multiple models for motor planning during a motor decision-making task were developed by recording EEG and EMG signals in n=17 healthy volunteers (9 males, 8 females, age 28.66±8.8 years). In the proposed test, volunteers have to make decisions about which hand should be moved based on the onset of a visual stimulus. We computed functional connectivity between the cortex and muscles, as well as among muscles using both corticomuscular and intermuscular coherence. Despite three models being generated, just one of them had strong performance. The results showed two types of motor decision-making processes depending on the hand to move. Moreover, the central processing of decision-making for the left hand movement can be accurately estimated using behavioral measures such as planning time combined with peripheral recordings like EMG signals. The models provided in this study could be considered as a methodological foundation to detect neuromuscular alterations in asymptomatic patients, as well as to monitor the process of a degenerative disease.
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Affiliation(s)
- Leonardo Ariel Cano
- Neuroscience and Applied Technologies Laboratory (LINTEC), Bioengineering Department, Faculty of Exact Sciences and Technology (FACET), National University of Tucuman, Superior Institute of Biological Research (INSIBIO), National Scientific and Technical Research Council (CONICET), Av. Independencia 1800, San Miguel de Tucuman 4000, Argentina
| | - Ana Lía Albarracín
- Neuroscience and Applied Technologies Laboratory (LINTEC), Bioengineering Department, Faculty of Exact Sciences and Technology (FACET), National University of Tucuman, Superior Institute of Biological Research (INSIBIO), National Scientific and Technical Research Council (CONICET), Av. Independencia 1800, San Miguel de Tucuman 4000, Argentina
| | - Alvaro Gabriel Pizá
- Neuroscience and Applied Technologies Laboratory (LINTEC), Bioengineering Department, Faculty of Exact Sciences and Technology (FACET), National University of Tucuman, Superior Institute of Biological Research (INSIBIO), National Scientific and Technical Research Council (CONICET), Av. Independencia 1800, San Miguel de Tucuman 4000, Argentina
| | - Cecilia Elisabet García-Cena
- ETSIDI-Center for Automation and Robotics, Universidad Politécnica de Madrid, Ronda de Valencia 3, 28012 Madrid, Spain
| | - Eduardo Fernández-Jover
- Institute of Bioengineering, Universidad Miguel Hernández of Elche, 03202 Elche, Spain
- Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| | - Fernando Daniel Farfán
- Neuroscience and Applied Technologies Laboratory (LINTEC), Bioengineering Department, Faculty of Exact Sciences and Technology (FACET), National University of Tucuman, Superior Institute of Biological Research (INSIBIO), National Scientific and Technical Research Council (CONICET), Av. Independencia 1800, San Miguel de Tucuman 4000, Argentina
- Institute of Bioengineering, Universidad Miguel Hernández of Elche, 03202 Elche, Spain
- Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
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Ankar P, Arya NP, Fating T, Sasun AR. Optimizing Physiotherapeutic Approaches in Parkinson's Disease Post-spinal Fixation Surgery: A Case Report. Cureus 2024; 16:e54149. [PMID: 38496068 PMCID: PMC10940556 DOI: 10.7759/cureus.54149] [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: 10/17/2023] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Patients with Parkinson's disease (PD) exhibit both a severe neuromuscular disorder and low bone quality at presentation. These issues are made worse by inactivity and a chairbound state. Each and every pathologic and degenerative process that affects the naturally aging spine also affects these individuals. Stooped posture is a symptom of a disease and can easily cause spinal degeneration. PD is associated with many physical abnormalities that cause a unique and specific need for rehabilitation. Patients' experiences highlight the challenges doctors face in diagnosis, treatment, and rehabilitation. This case report details the rehabilitation of a 67-year-old patient with PD who underwent spinal fixation for spinal stenosis and presented with complaints of weakness in both lower limbs. An advanced rehabilitation program was devised, primarily emphasizing strength training to enhance overall functionality. Pre- and post-intervention assessments were conducted, encompassing range of motion (ROM), manual muscle testing (MMT), Oswestry Disability Index, Functional Independence Measure, Lower Limb Functional Scale, and Berg Balance Scale, all of which demonstrated noteworthy improvements in joints ROM, strength, functional independence, balance, and lower limb function. This case report underscores the significance of rehabilitation programs in such cases, highlighting their important role in enhancing overall functioning.
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Affiliation(s)
- Prajyot Ankar
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neha P Arya
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejaswini Fating
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anam R Sasun
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Lee MH, Um KH, Lee SW, Sun YJ, Gu DH, Jo YO, Kim SH, Seol W, Hwang H, Baek K, Choi JW. Bi-directional regulation of AIMP2 and its splice variant on PARP-1-dependent neuronal cell death; Therapeutic implication for Parkinson's disease. Acta Neuropathol Commun 2024; 12:5. [PMID: 38172953 PMCID: PMC10765824 DOI: 10.1186/s40478-023-01697-5] [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: 09/07/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Parthanatos represents a critical molecular aspect of Parkinson's disease, wherein AIMP2 aberrantly activates PARP-1 through direct physical interaction. Although AIMP2 ought to be a therapeutic target for the disease, regrettably, it is deemed undruggable due to its non-enzymatic nature and predominant localization within the tRNA synthetase multi-complex. Instead, AIMP2 possesses an antagonistic splice variant, designated DX2, which counteracts AIMP2-induced apoptosis in the p53 or inflammatory pathway. Consequently, we examined whether DX2 competes with AIMP2 for PARP-1 activation and is therapeutically effective in Parkinson's disease. METHODS The binding affinity of AIMP2 and DX2 to PARP-1 was contrasted through immunoprecipitation. The efficacy of DX2 in neuronal cell death was assessed under 6-OHDA and H2O2 in vitro conditions. Additionally, endosomal and exosomal activity of synaptic vesicles was gauged in AIMP2 or DX2 overexpressed hippocampal primary neurons utilizing optical live imaging with VAMP-vGlut1 probes. To ascertain the role of DX2 in vivo, rotenone-induced behavioral alterations were compared between wild-type and DX2 transgenic animals. A DX2-encoding self-complementary adeno-associated virus (scAAV) was intracranially injected into 6-OHDA induced in vivo animal models, and their mobility was examined. Subsequently, the isolated brain tissues were analyzed. RESULTS DX2 translocates into the nucleus upon ROS stress more rapidly than AIMP2. The binding affinity of DX2 to PARP-1 appeared to be more robust compared to that of AIMP2, resulting in the inhibition of PARP-1 induced neuronal cell death. DX2 transgenic animals exhibited neuroprotective behavior in rotenone-induced neuronal damage conditions. Following a single intracranial injection of AAV-DX2, both behavior and mobility were consistently ameliorated in neurodegenerative animal models induced by 6-OHDA. CONCLUSION AIMP2 and DX2 are proposed to engage in bidirectional regulation of parthanatos. They physically interact with PARP-1. Notably, DX2's cell survival properties manifest exclusively in the context of abnormal AIMP2 accumulation, devoid of any tumorigenic effects. This suggests that DX2 could represent a distinctive therapeutic target for addressing Parkinson's disease in patients.
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Affiliation(s)
- Min Hak Lee
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
- Department of Biomedical and Pharmaceutical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
- Department of Regulatory Science, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Ki-Hwan Um
- Department of Biomedical and Pharmaceutical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
- Department of Regulatory Science, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Seok Won Lee
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
- Department of Biomedical and Pharmaceutical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Ye Ji Sun
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
- Department of Biomedical and Pharmaceutical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
- Department of Regulatory Science, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Da-Hye Gu
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
- Department of Biomedical and Pharmaceutical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Young Ok Jo
- Department of Neuroscience, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Sung Hyun Kim
- Department of Neuroscience, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
- Department of Physiology, School of Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Wongi Seol
- InAm Neuroscience Research Center, Sanbon Medical Center, College of Medicine, Wonkwang University, Sanbonro 321, Gunposi, Gyeonggido, 15865, Republic of Korea
| | - Hyorin Hwang
- Generoath Ltd., Seoul, 04168, Republic of Korea
- Department of Pharmacology, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung, Gangwon-Do, 25457, Republic of Korea
| | - Kyunghwa Baek
- Department of Pharmacology, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung, Gangwon-Do, 25457, Republic of Korea
| | - Jin Woo Choi
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea.
- Department of Biomedical and Pharmaceutical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea.
- Department of Regulatory Science, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea.
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Qian K, Jiang X, Liu ZQ, Zhang J, Fu P, Su Y, Brazhe NA, Liu D, Zhu LQ. Revisiting the critical roles of reactive astrocytes in neurodegeneration. Mol Psychiatry 2023; 28:2697-2706. [PMID: 37037874 DOI: 10.1038/s41380-023-02061-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
Astrocytes, an integral component of the central nervous system (CNS), contribute to the maintenance of physiological homeostasis through their roles in synaptic function, K+ buffering, blood-brain barrier (BBB) maintenance, and neuronal metabolism. Reactive astrocytes refer to astrocytes undergoing morphological, molecular and functional remodelling in response to pathological stimuli. The activation and differentiation of astrocytes are implicated in the pathogenesis of multiple neurodegenerative diseases. However, there are still controversies regarding their subset identification, function and nomenclature in neurodegeneration. In this review, we revisit the multidimensional roles of reactive astrocytes in Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS). Furthermore, we propose a precise linkage between astrocyte subsets and their functions based on single-cell sequencing analyses.
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Affiliation(s)
- Kang Qian
- Department of Pathophysiology, Key Lab of Neurological Disorder of Education Ministry, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Neurosurgery, Union Hospital, Huazhong University of Science and Technology, Jiefang Avenue No. 1277, 430022, Wuhan, China
| | - Xiaobing Jiang
- Department of Neurosurgery, Union Hospital, Huazhong University of Science and Technology, Jiefang Avenue No. 1277, 430022, Wuhan, China
| | - Zhi-Qiang Liu
- Department of Pathophysiology, Key Lab of Neurological Disorder of Education Ministry, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Zhang
- Department of Pathophysiology, Key Lab of Neurological Disorder of Education Ministry, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng Fu
- Department of Neurosurgery, Union Hospital, Huazhong University of Science and Technology, Jiefang Avenue No. 1277, 430022, Wuhan, China
| | - Ying Su
- Department of Neurology, Union Hospital, Huazhong University of Science and Technology, Jiefang Avenue No. 1277, 430022, Wuhan, China
| | - Nadezda A Brazhe
- Biophysics Department, Biological Faculty, Moscow State University, Moscow, Russia
| | - Dan Liu
- Department of Medical Genetics, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ling-Qiang Zhu
- Department of Pathophysiology, Key Lab of Neurological Disorder of Education Ministry, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Aldegheri S, Artusi CA, Camozzi S, Di Marco R, Geroin C, Imbalzano G, Lopiano L, Tinazzi M, Bombieri N. Camera- and Viewpoint-Agnostic Evaluation of Axial Postural Abnormalities in People with Parkinson's Disease through Augmented Human Pose Estimation. SENSORS (BASEL, SWITZERLAND) 2023; 23:3193. [PMID: 36991904 PMCID: PMC10058715 DOI: 10.3390/s23063193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/02/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
Axial postural abnormalities (aPA) are common features of Parkinson's disease (PD) and manifest in over 20% of patients during the course of the disease. aPA form a spectrum of functional trunk misalignment, ranging from a typical Parkinsonian stooped posture to progressively greater degrees of spine deviation. Current research has not yet led to a sufficient understanding of pathophysiology and management of aPA in PD, partially due to lack of agreement on validated, user-friendly, automatic tools for measuring and analysing the differences in the degree of aPA, according to patients' therapeutic conditions and tasks. In this context, human pose estimation (HPE) software based on deep learning could be a valid support as it automatically extrapolates spatial coordinates of the human skeleton keypoints from images or videos. Nevertheless, standard HPE platforms have two limitations that prevent their adoption in such a clinical practice. First, standard HPE keypoints are inconsistent with the keypoints needed to assess aPA (degrees and fulcrum). Second, aPA assessment either requires advanced RGB-D sensors or, when based on the processing of RGB images, they are most likely sensitive to the adopted camera and to the scene (e.g., sensor-subject distance, lighting, background-subject clothing contrast). This article presents a software that augments the human skeleton extrapolated by state-of-the-art HPE software from RGB pictures with exact bone points for posture evaluation through computer vision post-processing primitives. This article shows the software robustness and accuracy on the processing of 76 RGB images with different resolutions and sensor-subject distances from 55 PD patients with different degrees of anterior and lateral trunk flexion.
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Affiliation(s)
- Stefano Aldegheri
- Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy
| | - Carlo Alberto Artusi
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy
- Neurology 2 Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Serena Camozzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Roberto Di Marco
- Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy
| | - Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Gabriele Imbalzano
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy
- Neurology 2 Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Leonardo Lopiano
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy
- Neurology 2 Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Nicola Bombieri
- Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy
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Ge W, Lueck C, Suominen H, Apthorp D. Has machine learning over-promised in healthcare? A critical analysis and a proposal for improved evaluation, with evidence from Parkinson’s disease. Artif Intell Med 2023; 139:102524. [PMID: 37100503 DOI: 10.1016/j.artmed.2023.102524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 03/17/2023]
Abstract
Adoption of artificial intelligence (AI) by the medical community has long been anticipated, endorsed by a stream of machine learning literature showcasing AI systems that yield extraordinary performance. However, many of these systems are likely over-promising and will under-deliver in practice. One key reason is the community's failure to acknowledge and address the presence of inflationary effects in the data. These simultaneously inflate evaluation performance and prevent a model from learning the underlying task, thus severely misrepresenting how that model would perform in the real world. This paper investigated the impact of these inflationary effects on healthcare tasks, as well as how these effects can be addressed. Specifically, we defined three inflationary effects that occur in medical data sets and allow models to easily reach small training losses and prevent skillful learning. We investigated two data sets of sustained vowel phonation from participants with and without Parkinson's disease, and revealed that published models which have achieved high classification performances on these were artificially enhanced due to the inflationary effects. Our experiments showed that removing each inflationary effect corresponded with a decrease in classification accuracy, and that removing all inflationary effects reduced the evaluated performance by up to 30%. Additionally, the performance on a more realistic test set increased, suggesting that the removal of these inflationary effects enabled the model to better learn the underlying task and generalize. Source code is available at https://github.com/Wenbo-G/pd-phonation-analysis under the MIT license.
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Youn J, Won JH, Kim M, Kwon J, Moon SH, Kim M, Ahn JH, Mun JK, Park H, Cho JW. Extra-Basal Ganglia Brain Structures Are Related to Motor Reserve in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2023; 13:39-48. [PMID: 36565134 PMCID: PMC9912725 DOI: 10.3233/jpd-223542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The "motor reserve" is an emerging concept based on the discrepancy between the severity of parkinsonism and dopaminergic degeneration; however, the related brain structures have not yet been elucidated. OBJECTIVE We investigated brain structures relevant to the motor reserve in Parkinson's disease (PD) in this study. METHODS Patients with drug-naïve, early PD were enrolled, who then underwent dopamine transporter (DAT) scan and diffusion tensor imaging (DTI). The severity of motor symptoms was evaluated with the Unified Parkinson's Disease Rating Scale score of bradykinesia and rigidity on the more affected side and dopaminergic degeneration of DAT uptake of the more affected putamen. Individual motor reserve estimate (MRE) was evaluated based on the discrepancy between the severity of motor symptoms and dopaminergic degeneration. Using DTI and the Brainnetome atlas, brain structures correlated with MRE were identified. RESULTS We enrolled 193 patients with drug-naïve PD (mean disease duration of 15.6±13.2 months), and the MRE successfully predicted the increase of levodopa equivalent dose after two years. In the DTI analysis, fractional anisotropy values of medial, inferior frontal, and temporal lobes, limbic structures, nucleus accumbens, and thalamus were positively correlated with the MRE, while no brain structures were correlated with mean diffusivity. Additionally, degree centrality derived from the structural connectivity of the frontal and temporal lobes and limbic structures was positively correlated with the MRE. CONCLUSION Our results show empirical evidence for MR in PD and brain structures relevant to MR, particularly, the extra-basal ganglia system including the limbic and frontal structures.
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Affiliation(s)
- Jinyoung Youn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Ji Hye Won
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Korea,Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea
| | - Mansu Kim
- Department of Artificial Intelligence, Gwangju Institute of Science and Technology, Gwangju, Korea
| | - Junmo Kwon
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Korea,Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea
| | - Seung Hwan Moon
- Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Minkyeong Kim
- Department of Neurology, Gyeongsang National University Hospital, Jinju, Korea
| | - Jong Hyun Ahn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Jun Kyu Mun
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hyunjin Park
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea,School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, Korea,Correspondence to: Jin Whan Cho, MD, PhD, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-Gu, Seoul, 06351, Korea. Tel.: +82 2 3410 1279; Fax: +82 2 3410 0052; E-mail: and Hyunjin Park, PhD, Center for Neuroscience Imaging Research and School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, 16419, Korea. Tel.: +82 31 299 4956; Fax: +82 31 290 5819; E-mail:
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea,Neuroscience Center, Samsung Medical Center, Seoul, Korea,Correspondence to: Jin Whan Cho, MD, PhD, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-Gu, Seoul, 06351, Korea. Tel.: +82 2 3410 1279; Fax: +82 2 3410 0052; E-mail: and Hyunjin Park, PhD, Center for Neuroscience Imaging Research and School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, 16419, Korea. Tel.: +82 31 299 4956; Fax: +82 31 290 5819; E-mail:
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11
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Chen W, Zhang C, Jiang N, Jiang L, Guo Q, Gu J, Xian W, Ling Y, Liu Y, Zheng Y, Wu L, Yang C, Xu S, Hu Y, Yang Y, Chen J, Xuan R, Liu Y, Liu J, Chen L. The efficacy and safety of asleep and awake subthalamic deep brain stimulation for Parkinson's disease patients: A 1-year follow-up. Front Aging Neurosci 2023; 15:1120468. [PMID: 37143693 PMCID: PMC10153089 DOI: 10.3389/fnagi.2023.1120468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/10/2023] [Indexed: 05/06/2023] Open
Abstract
Introduction Traditional DBS is usually conducted under local anesthesia (LA) which is intolerable to some patients, DBS under general anesthesia (GA) was opted to extended surgical indication. This study aimed to compare the efficacy and safety of bilateral subthalamic deep brain stimulation (STN-DBS) for Parkinson's disease (PD) under asleep and awake anesthesia state in 1-year postoperative follow-up. Methods Twenty-one PD patients were assigned to asleep group and 25 patients to awake group. Patients received bilateral STN-DBS under different anesthesia state. The PD participants were interviewed and assessed preoperatively and at 1-year postoperative follow-up. Results At 1-year follow-up, compared surgical coordinate in two groups, the left-side Y of asleep group showed more posterior than awake group (Y was-2.39 ± 0.23 in asleep group, -1.46 ± 0.22 in awake group, p = 0.007). Compared with preoperative OFF MED state, MDS-UPDRS III scores in OFF MED/OFF STIM state remained unchanged, while in OFF MED/ON STIM state were significantly improved in awake and asleep groups, yet without significant difference. Compared with preoperative ON MED state, MDS-UPDRS III scores in ON MED/OFF STIM, and ON MED/ON STIM state remained unchanged in both groups. In non-motor outcomes, PSQI, HAMD, and HAMA score significantly improved in asleep group compared to awake group at 1-year follow-up (PSQI, HAMD, and HAMA score in 1-year follow-up were 9.81 ± 4.43; 10.00 ± 5.80; 5.71 ± 4.75 in awake group, 6.64 ± 4.14; 5.32 ± 3.78; 3.76 ± 3.87 in asleep group, p = 0.009; 0.008; 0.015, respectively), while there was no significant difference in PDQ-39, NMSS, ESS, PDSS score, and cognitive function. Anesthesia methods was significantly associated with improvement of HAMA and HAMD score (p = 0.029; 0.002, respectively). No difference in LEDD, stimulation parameters and adverse events was observed between two groups. Discussion Asleep STN-DBS may be considered a good alternative method for PD patients. It is largely consistent with awake STN-DBS in motor symptoms and safety. Yet, it showed higher improvement in terms of mood and sleep compared to awake group at 1-year follow-up.
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Affiliation(s)
- Wanru Chen
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Changming Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Nan Jiang
- Department of Anesthesiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lulu Jiang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Qiyu Guo
- Department of Neurology, The First People’s Hospital of Huizhou City, Huizhou, Guangdong, China
| | - Jing Gu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wenbiao Xian
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Yuting Ling
- Department of Anesthesiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanmei Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Yifan Zheng
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Lei Wu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Chao Yang
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shaohua Xu
- The East Division of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu Hu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yang Yang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Jinhua Chen
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Ruoheng Xuan
- Department of Anesthesiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yi Liu
- Department of Anesthesiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jinlong Liu
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Jinlong Liu,
| | - Ling Chen
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
- Ling Chen,
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An Efficient Rotation Forest-Based Ensemble Approach for Predicting Severity of Parkinson’s Disease. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:5524852. [PMID: 35783585 PMCID: PMC9246609 DOI: 10.1155/2022/5524852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 10/07/2021] [Accepted: 05/10/2022] [Indexed: 12/03/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative nervous system disorder that mainly affects body movement, and it is one of the most common diseases, particularly in elderly individuals. This paper proposes a new machine learning approach to predict Parkinson's disease severity using UCI's Parkinson's telemonitoring voice dataset. The proposed method analyses the patient's voice data and classifies them into “severe” and “nonsevere” classes. At first, a subset of features was selected, then a novel approach with a combination of Rotation Forest and Random Forest was applied on selected features to determine each patient's disease severity. Analysis of the experimental results shows that the proposed approach can detect the severity of PD patients in the early stages. Moreover, the proposed model is compared with several algorithms, and the results indicate that the model is highly successful in classifying records and outperformed the other methods concerning classification accuracy and F1-measure rate.
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13
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Rehman RZU, Guan Y, Shi JQ, Alcock L, Yarnall AJ, Rochester L, Del Din S. Investigating the Impact of Environment and Data Aggregation by Walking Bout Duration on Parkinson's Disease Classification Using Machine Learning. Front Aging Neurosci 2022; 14:808518. [PMID: 35391750 PMCID: PMC8981298 DOI: 10.3389/fnagi.2022.808518] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/14/2022] [Indexed: 12/14/2022] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disease. PD misdiagnosis can occur in early stages. Gait impairment in PD is typical and is linked with an increased fall risk and poorer quality of life. Applying machine learning (ML) models to real-world gait has the potential to be more sensitive to classify PD compared to laboratory data. Real-world gait yields multiple walking bouts (WBs), and selecting the optimal method to aggregate the data (e.g., different WB durations) is essential as this may influence classification performance. The objective of this study was to investigate the impact of environment (laboratory vs. real world) and data aggregation on ML performance for optimizing sensitivity of PD classification. Gait assessment was performed on 47 people with PD (age: 68 ± 9 years) and 52 controls [Healthy controls (HCs), age: 70 ± 7 years]. In the laboratory, participants walked at their normal pace for 2 min, while in the real world, participants were assessed over 7 days. In both environments, 14 gait characteristics were evaluated from one tri-axial accelerometer attached to the lower back. The ability of individual gait characteristics to differentiate PD from HC was evaluated using the Area Under the Curve (AUC). ML models (i.e., support vector machine, random forest, and ensemble models) applied to real-world gait showed better classification performance compared to laboratory data. Real-world gait characteristics aggregated over longer WBs (WB 30-60 s, WB > 60 s, WB > 120 s) resulted in superior discriminative performance (PD vs. HC) compared to laboratory gait characteristics (0.51 ≤ AUC ≤ 0.77). Real-world gait speed showed the highest AUC of 0.77. Overall, random forest trained on 14 gait characteristics aggregated over WBs > 60 s gave better performance (F1 score = 77.20 ± 5.51%) as compared to laboratory results (F1 Score = 68.75 ± 12.80%). Findings from this study suggest that the choice of environment and data aggregation are important to achieve maximum discrimination performance and have direct impact on ML performance for PD classification. This study highlights the importance of a harmonized approach to data analysis in order to drive future implementation and clinical use. Clinical Trial Registration [09/H0906/82].
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Affiliation(s)
- Rana Zia Ur Rehman
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Yu Guan
- School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jian Qing Shi
- School of Mathematics, Statistics and Physics, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, China
| | - Lisa Alcock
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Alison J. Yarnall
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Lynn Rochester
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Silvia Del Din
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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14
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Alzghool OM, van Dongen G, van de Giessen E, Schoonmade L, Beaino W. α-Synuclein Radiotracer Development and In Vivo Imaging: Recent Advancements and New Perspectives. Mov Disord 2022; 37:936-948. [PMID: 35289424 PMCID: PMC9310945 DOI: 10.1002/mds.28984] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 12/13/2022] Open
Abstract
α-Synucleinopathies including idiopathic Parkinson's disease, dementia with Lewy bodies and multiple systems atrophy share overlapping symptoms and pathological hallmarks. Selective neurodegeneration and Lewy pathology are the main hallmarks of α-synucleinopathies. Currently, there is no imaging biomarker suitable for a definitive early diagnosis of α-synucleinopathies. Although dopaminergic deficits detected with single-photon emission computed tomography (SPECT) and positron emission tomography (PET) radiotracers can support clinical diagnosis by confirming the presence of dopaminergic neurodegeneration, dopaminergic imaging cannot visualize the preceding disease process, nor distinguish α-synucleinopathies from tauopathies with dopaminergic neurodegeneration, especially at early symptomatic disease stage when clinical presentation is often overlapping. Aggregated α-synuclein (αSyn) could be a suitable imaging biomarker in α-synucleinopathies, because αSyn aggregation and therefore, Lewy pathology is evidently an early driver of α-synucleinopathies pathogenesis. Additionally, several antibodies and small molecule compounds targeting aggregated αSyn are in development for therapy. However, there is no way to directly measure if or how much they lower the levels of aggregated αSyn in the brain. There is clearly a paramount diagnostic and therapeutic unmet medical need. To date, aggregated αSyn and Lewy pathology inclusion bodies cannot be assessed ante-mortem with SPECT or PET imaging because of the suboptimal binding characteristics and/or physicochemical properties of current radiotracers. The aim of this narrative review is to highlight the suitability of aggregated αSyn as an imaging biomarker in α-synucleinopathies, the current limitations with and lessons learned from αSyn radiotracer development, and finally to propose antibody-based ligands for imaging αSyn aggregates as a complementary tool rather than an alternative to small molecule ligands. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson Movement Disorder Society.
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Affiliation(s)
- Obada M Alzghool
- Department of Radiology and Nuclear Medicine, Tracer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.,Turku PET Centre, University of Turku, Turku, Finland
| | - Guus van Dongen
- Department of Radiology and Nuclear Medicine, Tracer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Elsmarieke van de Giessen
- Department of Radiology and Nuclear Medicine, Tracer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Linda Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Wissam Beaino
- Department of Radiology and Nuclear Medicine, Tracer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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Di Marco R, Pistonesi F, Cianci V, Biundo R, Weis L, Tognolo L, Baba A, Rubega M, Gentile G, Tedesco C, Carecchio M, Antonini A, Masiero S. Effect of Intensive Rehabilitation Program in Thermal Water on a Group of People with Parkinson's Disease: A Retrospective Longitudinal Study. Healthcare (Basel) 2022; 10:368. [PMID: 35206982 PMCID: PMC8871929 DOI: 10.3390/healthcare10020368] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 02/01/2023] Open
Abstract
The main objective of this study is to test the effect of thermal aquatic exercise on motor symptoms and quality of life in people with Parkinson's Disease (PD). Fourteen participants with diagnosis of idiopathic PD completed the whole rehabilitation session and evaluation protocol (Hoehn and Yahr in OFF state: 2-3; Mini Mental State Examination >24; stable pharmacological treatment in the 3 months prior participating in the study). Cognitive and motor status, functional abilities and quality of life were assessed at baseline and after an intensive rehabilitation program in thermal water (12 sessions of 45 min in a 1.4 m depth pool at 32-36 ∘C). The Mini Balance Evaluation System Test (Mini-BESTest) and the PD Quality of Life Questionnaire (PDQ-39) were considered as main outcomes. Secondary assessment measures evaluated motor symptoms and quality of life and psychological well-being. Participants kept good cognitive and functional status after treatment. Balance of all the participants significantly improved (Mini-BESTest: p<0.01). The PDQ-39 significantly improved after rehabilitation (p=0.038), with significance being driven by dimensions strongly related to motor status. Thermal aquatic exercise may represent a promising rehabilitation tool to prevent the impact of motor symptoms on daily-life activities of people with PD. PDQ-39 improvement foreshows good effects of the intervention on quality of life and psychological well-being.
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Affiliation(s)
- Roberto Di Marco
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Via Giustiniani 5, 35128 Padova, Italy; (F.P.); (V.C.); (L.W.); (G.G.); (C.T.); (M.C.); (A.A.)
- Department of Neuroscience, School of Physical Medicine and Rehabilitation, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (L.T.); (M.R.); (S.M.)
- Physical Medicine and Rehabilitation Unit, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy;
| | - Francesca Pistonesi
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Via Giustiniani 5, 35128 Padova, Italy; (F.P.); (V.C.); (L.W.); (G.G.); (C.T.); (M.C.); (A.A.)
| | - Valeria Cianci
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Via Giustiniani 5, 35128 Padova, Italy; (F.P.); (V.C.); (L.W.); (G.G.); (C.T.); (M.C.); (A.A.)
| | - Roberta Biundo
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Via Giustiniani 5, 35128 Padova, Italy; (F.P.); (V.C.); (L.W.); (G.G.); (C.T.); (M.C.); (A.A.)
- Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy;
| | - Luca Weis
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Via Giustiniani 5, 35128 Padova, Italy; (F.P.); (V.C.); (L.W.); (G.G.); (C.T.); (M.C.); (A.A.)
| | - Lucrezia Tognolo
- Department of Neuroscience, School of Physical Medicine and Rehabilitation, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (L.T.); (M.R.); (S.M.)
- Physical Medicine and Rehabilitation Unit, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy;
| | - Alfonc Baba
- Physical Medicine and Rehabilitation Unit, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy;
| | - Maria Rubega
- Department of Neuroscience, School of Physical Medicine and Rehabilitation, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (L.T.); (M.R.); (S.M.)
| | - Giovanni Gentile
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Via Giustiniani 5, 35128 Padova, Italy; (F.P.); (V.C.); (L.W.); (G.G.); (C.T.); (M.C.); (A.A.)
| | - Chiara Tedesco
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Via Giustiniani 5, 35128 Padova, Italy; (F.P.); (V.C.); (L.W.); (G.G.); (C.T.); (M.C.); (A.A.)
| | - Miryam Carecchio
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Via Giustiniani 5, 35128 Padova, Italy; (F.P.); (V.C.); (L.W.); (G.G.); (C.T.); (M.C.); (A.A.)
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Via Giustiniani 5, 35128 Padova, Italy; (F.P.); (V.C.); (L.W.); (G.G.); (C.T.); (M.C.); (A.A.)
| | - Stefano Masiero
- Department of Neuroscience, School of Physical Medicine and Rehabilitation, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (L.T.); (M.R.); (S.M.)
- Physical Medicine and Rehabilitation Unit, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy;
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Alanazi AO, Boqaeid AA, Alnuwaysir MA. Management of Psychotic Symptoms in a Patient With Parkinson’s Disease Maintained on Levodopa-Carbidopa Intestinal Gel by Paliperidone Long-Acting Injection: A Case Report. Cureus 2022; 14:e21491. [PMID: 35223269 PMCID: PMC8860238 DOI: 10.7759/cureus.21491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2022] [Indexed: 11/24/2022] Open
Abstract
This case presents a 47-year-old man, without known past psychiatric history who developed psychotic symptoms including delusions of infidelity and had homicidal plans against his wife after 10 months of Levodopa-Carbidopa intestinal gel insertion (LCIG). The patient was diagnosed with Parkinson’s disease at age 34, which is being managed with LCIG. Patient Parkinson's symptoms were not well controlled with other pharmacological and surgical interventions tried previously. Despite the current guidelines in treating Parkinson’s disease psychosis, the treating teams have faced many difficulties with the management of this patient’s psychotic symptoms. After trying Risperidone Consta on August 24, 2018, the patient improved gradually, then he was shifted to Paliperidone long-acting injection (LAI) on September 12, 2018. One month later, the patient was seen in the outpatient department with much improvement in Paliperidone LAI. Reporting this case as the patient was seen on November 29, 2021, the patient is stable and doing well overall in terms of absent psychotic symptoms with minimal resting tremors. The success story of using LAIs such as our patient’s response to Paliperidone LAI can help other psychiatrists expand their treatment options when facing such difficulties.
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Pedrosa Carrasco AJ, Mügge F, Pedrosa DJ. Non-lesional treatment options for tremor in idiopathic Parkinson syndrome: a protocol for a systematic literature review. BMJ Open 2021; 11:e048367. [PMID: 34404706 PMCID: PMC8372820 DOI: 10.1136/bmjopen-2020-048367] [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] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Idiopathic Parkinson syndrome (iPS) is one of the most common neurodegenerative disorders characterised by the triad of bradykinesia, rigidity and tremor. Tremor at rest predominantly at one side is often perceived by patients as severely disabling and yet ranges among the most difficult symptoms to treat. In medically refractory cases, lesional approaches have proven to be effective alternatives. However, to date, there is no comprehensive analysis of non-surgical therapies to manage iPS-patients' tremor. We therefore present a detailed study protocol for a systematic literature review assessing efficacy/effectiveness and safety of non-lesional treatments for tremor in iPS. METHODS AND ANALYSIS We will search three electronic databases (MEDLINE, EMBASE and PsycINFO) using a combination of title/abstract keywords. Additionally, hand-searched reference and citation lists of key reviews identified through the search strategy will be screened. Eligible studies should investigate the efficacy/effectiveness and safety of therapeutic options for tremor in iPS excluding lesional interventions. Publications will be independently assessed for inclusion criteria by two investigators and study information summarised using a standardised template including quality assessment according to the QualSyst tool. We will provide a narrative synthesis of results and conduct a meta-analysis whenever possible. ETHICS AND DISSEMINATION We commit to present contemporary evidence on the efficacy/effectiveness and safety of non-lesional interventions for tremor in iPS in a future publication. We aim to compile rich data of published studies to inform healthcare professionals in order to ultimately improve patient outcomes. PROSPERO REGISTRATION NUMBER CRD42020202911).
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Affiliation(s)
- Anna Julia Pedrosa Carrasco
- Research Group Ethics in Medicine, Philipps University Marburg, Faculty of Medicine, Marburg, Hessen, Germany
| | - Felicitas Mügge
- Department of Neurology, University Hospital of Giessen and Marburg, Marburg, Hessen, Germany
| | - David José Pedrosa
- Department of Neurology, University Hospital of Giessen and Marburg, Marburg, Hessen, Germany
- Center for Mind, Brain and Behavior, Philipps University Marburg, Marburg, Hessen, Germany
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18
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Diagnosis of Dementia Using a Generative Deep Convolution Neural Network. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2021. [DOI: 10.1007/s13369-021-05982-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Fu J, Li Z, Wang F, Yu K. Prevalence of malnutrition/malnutrition risk and nutrition-related risk factors among patients with Parkinson's disease: systematic review and meta-analysis. Nutr Neurosci 2021; 25:2228-2238. [PMID: 34238139 DOI: 10.1080/1028415x.2021.1948655] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION The clinical symptoms and nutritional status of patients with Parkinson's disease (PwP) are interrelated, and the clinical outcomes in malnourished patients are often poor. Only a few studies have reviewed the prevalence of malnutrition and nutrition-related risk factors in PwP. OBJECTIVE To explore the prevalence of malnutrition/ malnutrition risk among PwP, and estimate nutrition-related risk factors. METHODS PubMed, EMBASE, and Cochrane Library were systematically searched. Literatures published between 1 January 1995 and 1 November 2020, subjects were patients with idiopathic PD underwent Mini Nutritional Assessment (MNA) were included. RESULT Sixteen articles, including 1650 PwP from 13 countries/regions, were included in the meta-analysis. The prevalence of malnutrition and malnutrition risk were 8.8% (Confidence interval [CI] 95%, 5.3%-12.2%) and 35.3% (CI 95%, 29.0%-41.7%), and the prevalence of nutritional disorders was 42.3% (CI 95%, 33.7%-51%). The prevalence of malnutrition in developing countries was higher than that in the developed countries. Meta-analysis reveals there were significant differences in the course of the disease (0.88 years; 95% CI, 0.26-1.50), levodopa equivalent daily dose (LEDD; 60.77 mg/day; 95% CI, 2.7-118.8), Hoehn and Yahr (H&Y) staging (0.323; CI 95%, 0.164-0.482), and unified Parkinson's disease rating scale (UPDRS) scores (total: 13.66, CI 95%: 10.57-16.75 and part III: 5.52, CI 95%: 3.79-7.25) between normal and nutritional disorder groups. CONCLUSIONS Malnutrition/malnutrition risk prevalence in PwP are high. The duration of the disease, LEDD, H&Y staging, and UPDRS score (part III and total) may be nutrition-related risk factors in PwP.
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Affiliation(s)
- Ji Fu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College (PUMC) and Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Zhuo Li
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College (PUMC) and Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Fang Wang
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College (PUMC) and Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Kang Yu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College (PUMC) and Chinese Academy of Medical Sciences (CAMS), Beijing, China
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20
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García-Pardo J, Novio F, Nador F, Cavaliere I, Suárez-García S, Lope-Piedrafita S, Candiota AP, Romero-Gimenez J, Rodríguez-Galván B, Bové J, Vila M, Lorenzo J, Ruiz-Molina D. Bioinspired Theranostic Coordination Polymer Nanoparticles for Intranasal Dopamine Replacement in Parkinson's Disease. ACS NANO 2021; 15:8592-8609. [PMID: 33885286 PMCID: PMC8558863 DOI: 10.1021/acsnano.1c00453] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/12/2021] [Indexed: 05/07/2023]
Abstract
Dopamine (DA) is one of the main neurotransmitters found in the central nervous system and has a vital role in the function of dopaminergic (DArgic) neurons. A progressive loss of this specific subset of cells is one of the hallmarks of age-related neurodegenerative disorders such as Parkinson's disease (PD). Symptomatic therapy for PD has been centered in the precursor l-DOPA administration, an amino acid precursor of DA that crosses the blood-brain barrier (BBB) while DA does not, although this approach presents medium- to long-term side effects. To overcome this limitation, DA-nanoencapsulation therapies are actively being searched as an alternative for DA replacement. However, overcoming the low yield of encapsulation and/or poor biodistribution/bioavailability of DA is still a current challenge. Herein, we report the synthesis of a family of neuromelanin bioinspired polymeric nanoparticles. Our system is based on the encapsulation of DA within nanoparticles through its reversible coordination complexation to iron metal nodes polymerized with a bis-imidazol ligand. Our methodology, in addition to being simple and inexpensive, results in DA loading efficiencies of up to 60%. In vitro, DA nanoscale coordination polymers (DA-NCPs) exhibited lower toxicity, degradation kinetics, and enhanced uptake by BE(2)-M17 DArgic cells compared to free DA. Direct infusion of the particles in the ventricle of rats in vivo showed a rapid distribution within the brain of healthy rats, leading to an increase in striatal DA levels. More importantly, after 4 days of nasal administrations with DA-NCPs equivalent to 200 μg of the free drug per day, the number and duration of apomorphine-induced rotations was significantly lower from that in either vehicle or DA-treated rats performed for comparison purposes. Overall, this study demonstrates the advantages of using nanostructured DA for DA-replacement therapy.
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Affiliation(s)
- Javier García-Pardo
- Catalan
Institute of Nanoscience and Nanotechnology (ICN2), CSIC and BIST, Campus UAB, 08193 Bellaterra, Barcelona, Spain
- Institut
de Biotecnologia i de Biomedicina (IBB), Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
- Departament
de Bioquímica i Biologia Molecular, Unitat de Bioquímica
de Biociències, Edifici C, Universitat
Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
| | - Fernando Novio
- Catalan
Institute of Nanoscience and Nanotechnology (ICN2), CSIC and BIST, Campus UAB, 08193 Bellaterra, Barcelona, Spain
- Departament
de Química, Universitat Autònoma
de Barcelona (UAB), Campus UAB, 08193 Cerdanyola del Vallès, Barcelona, Spain
| | - Fabiana Nador
- Catalan
Institute of Nanoscience and Nanotechnology (ICN2), CSIC and BIST, Campus UAB, 08193 Bellaterra, Barcelona, Spain
| | - Ivana Cavaliere
- Catalan
Institute of Nanoscience and Nanotechnology (ICN2), CSIC and BIST, Campus UAB, 08193 Bellaterra, Barcelona, Spain
| | - Salvio Suárez-García
- Catalan
Institute of Nanoscience and Nanotechnology (ICN2), CSIC and BIST, Campus UAB, 08193 Bellaterra, Barcelona, Spain
| | - Silvia Lope-Piedrafita
- Centro
de Investigacion Biomédica en Red en Bioingeniería,
Biomateriales y Nanomedicina (CIBER-BBN), 08193 Cerdanyola del Vallés, Spain
- Servei de Ressonància Magnètica
Nuclear, Institut de Neurociències,
Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, 08193 Cerdanyola
del Vallès, Spain
| | - Ana Paula Candiota
- Institut
de Biotecnologia i de Biomedicina (IBB), Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
- Departament
de Bioquímica i Biologia Molecular, Unitat de Bioquímica
de Biociències, Edifici C, Universitat
Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
- Centro
de Investigacion Biomédica en Red en Bioingeniería,
Biomateriales y Nanomedicina (CIBER-BBN), 08193 Cerdanyola del Vallés, Spain
| | - Jordi Romero-Gimenez
- Neurodegenerative
Diseases Research Group, Vall d’Hebron Research Institute (VHIR)-Center
for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Edifici Collserola Hospital Universitari Vall d’Hebron, Passeig de la Vall d’Hebron,
129, 08035 Barcelona, Spain
| | - Beatriz Rodríguez-Galván
- Neurodegenerative
Diseases Research Group, Vall d’Hebron Research Institute (VHIR)-Center
for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Edifici Collserola Hospital Universitari Vall d’Hebron, Passeig de la Vall d’Hebron,
129, 08035 Barcelona, Spain
| | - Jordi Bové
- Neurodegenerative
Diseases Research Group, Vall d’Hebron Research Institute (VHIR)-Center
for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Edifici Collserola Hospital Universitari Vall d’Hebron, Passeig de la Vall d’Hebron,
129, 08035 Barcelona, Spain
| | - Miquel Vila
- Servei de Ressonància Magnètica
Nuclear, Institut de Neurociències,
Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, 08193 Cerdanyola
del Vallès, Spain
- Neurodegenerative
Diseases Research Group, Vall d’Hebron Research Institute (VHIR)-Center
for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Edifici Collserola Hospital Universitari Vall d’Hebron, Passeig de la Vall d’Hebron,
129, 08035 Barcelona, Spain
- ICREA-Institució
Catalana de Recerca i Estudis Avancats, 08010 Barcelona, Spain
| | - Julia Lorenzo
- Institut
de Biotecnologia i de Biomedicina (IBB), Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
- Departament
de Bioquímica i Biologia Molecular, Unitat de Bioquímica
de Biociències, Edifici C, Universitat
Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
| | - Daniel Ruiz-Molina
- Catalan
Institute of Nanoscience and Nanotechnology (ICN2), CSIC and BIST, Campus UAB, 08193 Bellaterra, Barcelona, Spain
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Mitochondrial Metabolism as Target of the Neuroprotective Role of Erythropoietin in Parkinson's Disease. Antioxidants (Basel) 2021; 10:antiox10010121. [PMID: 33467745 PMCID: PMC7830512 DOI: 10.3390/antiox10010121] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/30/2020] [Accepted: 01/12/2021] [Indexed: 12/11/2022] Open
Abstract
Existing therapies for Parkinson's disease (PD) are only symptomatic. As erythropoietin (EPO) is emerging for its benefits in neurodegenerative diseases, here, we test the protective effect driven by EPO in in vitro (SH-SY5Y cells challenged by MPP+) and in vivo (C57BL/6J mice administered with MPTP) PD models. EPO restores cell viability in both protective and restorative layouts, enhancing the dopaminergic recovery. Specifically, EPO rescues the PD-induced damage to mitochondria, as shown by transmission electron microscopy, Mitotracker assay and PINK1 expression. Moreover, EPO promotes a rescue of mitochondrial respiration while markedly enhancing the glycolytic rate, as shown by the augmented extracellular acidification rate, contributing to elevated ATP levels in MPP+-challenged cells. In PD mice, EPO intrastriatal infusion markedly improves the outcome of behavioral tests. This is associated with the rescue of dopaminergic markers and decreased neuroinflammation. This study demonstrates cellular and functional recovery following EPO treatment, likely mediated by the 37 Kda isoform of the EPO-receptor. We report for the first time, that EPO-neuroprotection is exerted through restoring ATP levels by accelerating the glycolytic rate. In conclusion, the redox imbalance and neuroinflammation associated with PD may be successfully treated by EPO.
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22
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Ge W, Lueck CJ, Apthorp D, Suominen H. Which features of postural sway are effective in distinguishing Parkinson's disease from controls? A systematic review. Brain Behav 2021; 11:e01929. [PMID: 33145991 PMCID: PMC7821610 DOI: 10.1002/brb3.1929] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/06/2020] [Accepted: 10/14/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Postural sway may be useful as an objective measure of Parkinson's disease (PD). Existing studies have analyzed many different features of sway using different experimental paradigms. We aimed to determine what features have been used to measure sway and then to assess which feature(s) best differentiate PD patients from controls. We also aimed to determine whether any refinements might improve discriminative power and so assist in standardizing experimental conditions and analysis of data. METHODS In this systematic review of the literature, effect size (ES) was calculated for every feature reported by each article and then collapsed across articles where appropriate. The influence of clinical medication status, visual state, and sampling rate on ES was also assessed. RESULTS Four hundred and forty-three papers were retrieved. 25 contained enough information for further analysis. The most commonly used features were not the most effective (e.g., PathLength, used 14 times, had ES of 0.47, while TotalEnergy, used only once, had ES of 1.78). Increased sampling rate was associated with increased ES (PathLength ES increased to 1.12 at 100 Hz from 0.40 at 10 Hz). Measurement during "OFF" clinical status was associated with increased ES (PathLength ES was 0.83 OFF compared to 0.21 ON). CONCLUSIONS This review identified promising features for analysis of postural sway in PD, recommending a sampling rate of 100 Hz and studying patients when OFF to maximize ES. ES complements statistical significance as it is clinically relevant and is easily compared across experiments. We suggest that machine learning is a promising tool for the future analysis of postural sway in PD.
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Affiliation(s)
- Wenbo Ge
- Research School of Computer Science, Australian National University, Canberra, ACT, Australia
| | - Christian J Lueck
- Department of Neurology, Canberra Hospital, Canberra, ACT, Australia.,Australian National University Medical School, Canberra, ACT, Australia
| | - Deborah Apthorp
- Research School of Computer Science, Australian National University, Canberra, ACT, Australia.,School of Psychology, University of New England, Armidale, NSW, Australia
| | - Hanna Suominen
- Research School of Computer Science, Australian National University, Canberra, ACT, Australia.,Machine Learning Research Group, Data61/CSIRO, Canberra, ACT, Australia.,Department of Future Technologies, University of Turku, Turku, Finland
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23
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Espinoza-Valdés Y, Córdova-Arellano R, Espinoza-Espinoza M, Méndez-Alfaro D, Bustamante-Aguirre JP, Maureira-Pareja HA, Zamunér AR. Association between Cardiac Autonomic Control and Postural Control in Patients with Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E249. [PMID: 33396272 PMCID: PMC7796175 DOI: 10.3390/ijerph18010249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/26/2020] [Accepted: 12/28/2020] [Indexed: 11/18/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder that affects postural and cardiac autonomic control. However, since it is unknown whether these changes are associated, the objective of this study was to determine whether such a relationship exists. Twenty-three patients with PD participated. The RR intervals were recorded in different positions and heart rate variability (HRV) was analyzed. Postural sway was analyzed based on the center of pressure. No significant differences on HRV indices were induced by postural change. A correlation was found between these indices and postural control, high frequency (HF), and anterior-posterior (AP) root mean square (RMS-AP) (r = 0.422, p = 0.045), low frequency (LF)/HF, and AP mean velocity (r = 0.478, p = 0.021). A correlation was found between HRV induced by postural change and postural control, Δ LF/HF and RMS-AP (r = 0.448, p = 0.032), Δ LF/HF and ellipse area (r = 0.505, p = 0.014), Δ LF/HF and AP mean velocity (r = -0.531; p = 0.009), and Δ LF and AP mean velocity (r = -0.424, p = 0.044). There is an association between the autonomic and postural systems, such that PD patients with blunted cardiac autonomic function in both the supine and orthostatic positions have worse postural control.
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Affiliation(s)
- Yoan Espinoza-Valdés
- Laboratorio de Investigación Clínica en Kinesiología, Department of Kinesiology, Universidad Católica del Maule, 3605 Talca, Chile; (Y.E.-V.); (R.C.-A.); (M.E.-E.); (D.M.-A.); (J.P.B.-A.)
| | - Rocio Córdova-Arellano
- Laboratorio de Investigación Clínica en Kinesiología, Department of Kinesiology, Universidad Católica del Maule, 3605 Talca, Chile; (Y.E.-V.); (R.C.-A.); (M.E.-E.); (D.M.-A.); (J.P.B.-A.)
| | - Maiter Espinoza-Espinoza
- Laboratorio de Investigación Clínica en Kinesiología, Department of Kinesiology, Universidad Católica del Maule, 3605 Talca, Chile; (Y.E.-V.); (R.C.-A.); (M.E.-E.); (D.M.-A.); (J.P.B.-A.)
| | - Diego Méndez-Alfaro
- Laboratorio de Investigación Clínica en Kinesiología, Department of Kinesiology, Universidad Católica del Maule, 3605 Talca, Chile; (Y.E.-V.); (R.C.-A.); (M.E.-E.); (D.M.-A.); (J.P.B.-A.)
| | - Juan Pablo Bustamante-Aguirre
- Laboratorio de Investigación Clínica en Kinesiología, Department of Kinesiology, Universidad Católica del Maule, 3605 Talca, Chile; (Y.E.-V.); (R.C.-A.); (M.E.-E.); (D.M.-A.); (J.P.B.-A.)
| | - Hernán Antonio Maureira-Pareja
- Laboratorio de Biomecánica y Análisis de Movimiento Humano, Department of Kinesiology, Universidad Católica del Maule, 3605 Talca, Chile;
| | - Antonio Roberto Zamunér
- Laboratorio de Investigación Clínica en Kinesiología, Department of Kinesiology, Universidad Católica del Maule, 3605 Talca, Chile; (Y.E.-V.); (R.C.-A.); (M.E.-E.); (D.M.-A.); (J.P.B.-A.)
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24
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Marcante A, Di Marco R, Gentile G, Pellicano C, Assogna F, Pontieri FE, Spalletta G, Macchiusi L, Gatsios D, Giannakis A, Chondrogiorgi M, Konitsiotis S, Fotiadis DI, Antonini A. Foot Pressure Wearable Sensors for Freezing of Gait Detection in Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2020; 21:E128. [PMID: 33379174 PMCID: PMC7794778 DOI: 10.3390/s21010128] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 12/29/2022]
Abstract
Freezing of Gait (FoG) is a common symptom in Parkinson's Disease (PD) occurring with significant variability and severity and is associated with increased risk of falls. FoG detection in everyday life is not trivial, particularly in patients manifesting the symptom only in specific conditions. Various wearable devices have been proposed to detect PD symptoms, primarily based on inertial sensors. We here report the results of the validation of a novel system based on a pair of pressure insoles equipped with a 3D accelerometer to detect FoG episodes. Twenty PD patients attended a motor assessment protocol organized into eight multiple video recorded sessions, both in clinical and ecological settings and both in the ON and OFF state. We compared the FoG episodes detected using the processed data gathered from the insoles with those tagged by a clinician on video recordings. The algorithm correctly detected 90% of the episodes. The false positive rate was 6% and the false negative rate 4%. The algorithm reliably detects freezing of gait in clinical settings while performing ecological tasks. This result is promising for freezing of gait detection in everyday life via wearable instrumented insoles that can be integrated into a more complex system for comprehensive motor symptom monitoring in PD.
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Affiliation(s)
- Andrea Marcante
- UOC Recupero e Riabilitazione Funzionale, Ospedale di Lonigo, Azienda ULSS 8 Berica, 36045 Lonigo, Italy;
| | - Roberto Di Marco
- Department of Neuroscience, University of Padova, 35128 Padova, Italy;
| | - Giovanni Gentile
- Department of Neuroscience, University of Padova, 35128 Padova, Italy;
- Fondazione Ospedale San Camillo IRCCS, 30126 Venezia, Italy
| | - Clelia Pellicano
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (C.P.); (F.A.); (F.E.P.); (G.S.); (L.M.)
- Department of Neurology, Belcolle Hospital, 01100 Viterbo, Italy
| | - Francesca Assogna
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (C.P.); (F.A.); (F.E.P.); (G.S.); (L.M.)
| | - Francesco Ernesto Pontieri
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (C.P.); (F.A.); (F.E.P.); (G.S.); (L.M.)
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00185 Rome, Italy
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (C.P.); (F.A.); (F.E.P.); (G.S.); (L.M.)
| | - Lucia Macchiusi
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (C.P.); (F.A.); (F.E.P.); (G.S.); (L.M.)
| | - Dimitris Gatsios
- Department of Materials Science, Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Stavrou Niarchou Av., University Campus, 451 10 Ioannina, Greece; (D.G.); (D.I.F.)
- Department of Neurology, Medical School, University of Ioannina, Stavrou Niarchou Av., University Campus, 451 10 Ioannina, Greece; (A.G.); (M.C.); (S.K.)
| | - Alexandros Giannakis
- Department of Neurology, Medical School, University of Ioannina, Stavrou Niarchou Av., University Campus, 451 10 Ioannina, Greece; (A.G.); (M.C.); (S.K.)
| | - Maria Chondrogiorgi
- Department of Neurology, Medical School, University of Ioannina, Stavrou Niarchou Av., University Campus, 451 10 Ioannina, Greece; (A.G.); (M.C.); (S.K.)
| | - Spyridon Konitsiotis
- Department of Neurology, Medical School, University of Ioannina, Stavrou Niarchou Av., University Campus, 451 10 Ioannina, Greece; (A.G.); (M.C.); (S.K.)
| | - Dimitrios I. Fotiadis
- Department of Materials Science, Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Stavrou Niarchou Av., University Campus, 451 10 Ioannina, Greece; (D.G.); (D.I.F.)
| | - Angelo Antonini
- Department of Neuroscience, University of Padova, 35128 Padova, Italy;
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Flores-Soto ME, Corona-Angeles JA, Tejeda-Martinez AR, Flores-Guzman PA, Luna-Mujica I, Chaparro-Huerta V, Viveros-Paredes JM. β-Caryophyllene exerts protective antioxidant effects through the activation of NQO1 in the MPTP model of Parkinson's disease. Neurosci Lett 2020; 742:135534. [PMID: 33271195 DOI: 10.1016/j.neulet.2020.135534] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 11/16/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder, caused by the selective death of dopaminergic neurons in the substantia nigra pars compacta. β-caryophyllene (BCP) is a phytocannabinoid with several pharmacological properties, producing anti-inflammatory and antihypertensive effects. In addition, BCP protects dopaminergic neurons from neuronal death induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), yet it remains unclear if this effect is due to its antioxidant activity. To assess whether this is the case, the effect of BCP on the expression and activity of NAD(P)H quinone oxidoreductase (NQO1) was evaluated in mice after the administration of MPTP. Male C57BL/6 J mice were divided into four groups, the first of which received saline solution i.p. in equivalent volume and served as a control group. The second group received MPTP. The second group received MPTP hydrochloride (5 mg/kg, i.p.) daily for seven consecutive days. The third group received BCP (10 mg/kg) for seven days, administered orally and finally, the fourth group received MPTP as described above and BCP for 7 days from the fourth day of MPTP administration. The results showed that BCP inhibits oxidative stress-induced cell death of dopaminergic neurons exposed to MPTP at the same time as it enhances the expression and enzymatic activity of NQO1. Also, the BCP treatment ameliorated motor dysfunction and protected the dopaminergic cells of the SNpc from damage induced by MPTP. Hence, BCP appears to achieve at least some of its antioxidant effects by augmenting NQO1 activity, which protects cells from MPTP toxicity. Accordingly, this phytocannabinoid may represent a promising pharmacological option to safeguard dopaminergic neurons and prevent the progression of PD.
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Affiliation(s)
- M E Flores-Soto
- Laboratorio de Neurobiología Celular y Molecular, División de Neurociencias, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social, 44340, Guadalajara, Jalisco, Mexico
| | - J A Corona-Angeles
- Laboratorio de Neurobiología Celular y Molecular, División de Neurociencias, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social, 44340, Guadalajara, Jalisco, Mexico
| | - A R Tejeda-Martinez
- Laboratorio de Neurobiología Celular y Molecular, División de Neurociencias, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social, 44340, Guadalajara, Jalisco, Mexico
| | - P A Flores-Guzman
- Laboratorio de Neurobiología Celular y Molecular, División de Neurociencias, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social, 44340, Guadalajara, Jalisco, Mexico
| | - I Luna-Mujica
- Laboratorio de Neurobiología Celular y Molecular, División de Neurociencias, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social, 44340, Guadalajara, Jalisco, Mexico
| | - V Chaparro-Huerta
- Laboratorio de Neurobiología Celular y Molecular, División de Neurociencias, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social, 44340, Guadalajara, Jalisco, Mexico
| | - J M Viveros-Paredes
- Laboratorio de Investigación y Desarrollo Farmacéutico, Departamento de Farmacología, Centro Universitario de Ciencias Exactas e Ingenierías, 44430, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.
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Effectiveness of Cabergoline Treatment in Patients with Acromegaly Uncontrolled with SSAs: Experience of a Single Tertiary Center. Exp Clin Endocrinol Diabetes 2020; 129:644-650. [PMID: 33096579 DOI: 10.1055/a-1274-1276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the effectiveness of cabergoline and the parameters affecting cabergoline response as add-on treatment to somatostatin analaogues (SSA) in patients with acromegaly uncontrolled with SSAs. MATERIAL AND METHOD One hundred and twenty-nine acromegalic patients uncontrolled with SSA who had cabergoline added to their treatment were included in this retrospective study. Patients were divided into the SSAs + cabergoline-responsive (group 1) and non-responsive groups (group 2), and biochemical, pathologic, and radiologic parameters were assessed. RESULTS IGF-1 normalization was achieved in 75 of 129 patients (58%) when cabergoline was added to the SSA treatment. Female patients were significantly higher in group 1 compared to group 2 (p=0.006). Group 1 had significantly smaller pre- and post-cabergoline tumor size (p=0.011, p=0.007 respectively), lower levels of IGF-1 in pre-and post-operative period (p=0.040, p=0.001), and lower levels of IGF-1 in pre- and post-cabergoline treatment (p<0.001). Cavernous invasion on sellar magnetic resonance imaging, dural invasion in pathologic examination were not significantly different between the groups. Sellar invasion in pathologic examination was significantly higher in group 1 (p=0.011). No significant difference was found in proliferation indices between two groups. The presence of fibrous bodies was significantly lower in group 1 (p=0.010). CONCLUSION Cabergoline can be added to the treatment of acromegalic patients uncontrolled with SSAs due to its ease of use and low economic cost, especially in patients with acromegaly who have small adenomas and no fibrous bodies.
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Rey F, Barzaghini B, Nardini A, Bordoni M, Zuccotti GV, Cereda C, Raimondi MT, Carelli S. Advances in Tissue Engineering and Innovative Fabrication Techniques for 3-D-Structures: Translational Applications in Neurodegenerative Diseases. Cells 2020; 9:cells9071636. [PMID: 32646008 PMCID: PMC7407518 DOI: 10.3390/cells9071636] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022] Open
Abstract
In the field of regenerative medicine applied to neurodegenerative diseases, one of the most important challenges is the obtainment of innovative scaffolds aimed at improving the development of new frontiers in stem-cell therapy. In recent years, additive manufacturing techniques have gained more and more relevance proving the great potential of the fabrication of precision 3-D scaffolds. In this review, recent advances in additive manufacturing techniques are presented and discussed, with an overview on stimulus-triggered approaches, such as 3-D Printing and laser-based techniques, and deposition-based approaches. Innovative 3-D bioprinting techniques, which allow the production of cell/molecule-laden scaffolds, are becoming a promising frontier in disease modelling and therapy. In this context, the specific biomaterial, stiffness, precise geometrical patterns, and structural properties are to be considered of great relevance for their subsequent translational applications. Moreover, this work reports numerous recent advances in neural diseases modelling and specifically focuses on pre-clinical and clinical translation for scaffolding technology in multiple neurodegenerative diseases.
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Affiliation(s)
- Federica Rey
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Via Grassi 74, 20157 Milan, Italy; (F.R.); (G.V.Z.)
- Pediatric Clinical Research Center Fondazione “Romeo ed Enrica Invernizzi”, University of Milano, Via Grassi 74, 20157 Milano, Italy
| | - Bianca Barzaghini
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; (B.B.); (A.N.)
| | - Alessandra Nardini
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; (B.B.); (A.N.)
| | - Matteo Bordoni
- Dipartimento di Scienze Farmacologiche e Biomolecolari (DiSFeB), Centro di Eccellenza sulle Malattie Neurodegenerative, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, Italy;
| | - Gian Vincenzo Zuccotti
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Via Grassi 74, 20157 Milan, Italy; (F.R.); (G.V.Z.)
- Pediatric Clinical Research Center Fondazione “Romeo ed Enrica Invernizzi”, University of Milano, Via Grassi 74, 20157 Milano, Italy
| | - Cristina Cereda
- Genomic and post-Genomic Center, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy;
| | - Manuela Teresa Raimondi
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; (B.B.); (A.N.)
- Correspondence: (M.T.R.); (S.C.); Tel.: +390-223-994-306 (M.T.R.); +390-250-319-825 (S.C.)
| | - Stephana Carelli
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Via Grassi 74, 20157 Milan, Italy; (F.R.); (G.V.Z.)
- Pediatric Clinical Research Center Fondazione “Romeo ed Enrica Invernizzi”, University of Milano, Via Grassi 74, 20157 Milano, Italy
- Correspondence: (M.T.R.); (S.C.); Tel.: +390-223-994-306 (M.T.R.); +390-250-319-825 (S.C.)
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Mechanical somatosensory stimulation decreases blood pressure in patients with Parkinson's disease. J Hypertens 2020; 37:1714-1721. [PMID: 31107357 DOI: 10.1097/hjh.0000000000002084] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The current study aimed to assess the effects of five cycles of automated mechanical somatosensory stimulation (AMSS) of the fore-feet on blood pressure (BP) and cardiovascular autonomic control in Parkinson's Disease patients. METHODS Out of 23 patients, 16 underwent an AMSS session every 72 h, for a total of five sessions per patient. Electrocardiogram, noninvasive beat-to-beat blood pressure and respiratory activity were recorded for 20 min in supine position at baseline and after the AMSS sessions. Main outcomes were the changes in SBP and DBP, in the spectral indices of cardiac sympathetic (LFRRn.u.) and vagal (HFRR) modulatory activities, cardiac sympathovagal relationship (LF/HF), vascular sympathetic modulation (LFSAP) and arterial baroreflex sensitivity (sequence technique). Symbolic analysis of heart rate variability provided additional indices of cardiac sympathetic (0V%) and vagal (2UV%) modulation to the sinoatrial node. RESULTS After five AMSS trials a reduction in SBP (baseline: 131.2 ± 15.5 mmHg; post-AMSS: 122.4 ± 16.2 mmHg; P = 0.0004) and DBP (baseline: 73.2 ± 6.1 mmHg; post-AMSS: 68.9 ± 6.2 mmHg; P = 0.008) was observed. Post-AMSS, spectral and symbolic indices of cardiovascular sympathetic control decreased and arterial baroreflex sensitivity increased (baseline: 5.7 ± 1.3 ms/mmHg; post-AMSS: 11.27 ± 2.7 ms/mmHg). CONCLUSION AMSS sessions were effective in reducing BP, increasing baroreflex sensitivity and decreasing cardiovascular sympathetic modulation in Parkinson's disease patients. AMSS might be useful to control supine hypertension in Parkinson's disease.
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Rey F, Balsari A, Giallongo T, Ottolenghi S, Di Giulio AM, Samaja M, Carelli S. Erythropoietin as a Neuroprotective Molecule: An Overview of Its Therapeutic Potential in Neurodegenerative Diseases. ASN Neuro 2020; 11:1759091419871420. [PMID: 31450955 PMCID: PMC6712762 DOI: 10.1177/1759091419871420] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Erythropoietin (EPO) is a cytokine mainly induced in hypoxia conditions. Its major production site is the kidney. EPO primarily acts on the erythroid progenitor cells in the bone marrow. More and more studies are highlighting its secondary functions, with a crucial focus on its role in the central nervous system. Here, EPO may interact with up to four distinct isoforms of its receptor (erythropoietin receptor [EPOR]), activating different signaling cascades with roles in neuroprotection and neurogenesis. Indeed, the EPO/EPOR axis has been widely studied in the neurodegenerative diseases field. Its potential therapeutic effects have been evaluated in multiple disorders, such as Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, spinal cord injury, as well as brain ischemia, hypoxia, and hyperoxia. EPO is showing great promise by counteracting secondary neuroinflammatory processes, reactive oxygen species imbalance, and cell death in these diseases. Multiple studies have been performed both in vitro and in vivo, characterizing the mechanisms through which EPO exerts its neurotrophic action. In some cases, clinical trials involving EPO have been performed, highlighting its therapeutic potential. Together, all these works indicate the potential beneficial effects of EPO.
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Affiliation(s)
- Federica Rey
- 1 Laboratory of Pharmacology, Department of Health Sciences, University of Milan, Italy
| | - Alice Balsari
- 1 Laboratory of Pharmacology, Department of Health Sciences, University of Milan, Italy
| | - Toniella Giallongo
- 1 Laboratory of Pharmacology, Department of Health Sciences, University of Milan, Italy
| | - Sara Ottolenghi
- 2 Laboratory of Biochemistry, Department of Health Sciences, University of Milan, Italy
| | - Anna M Di Giulio
- 1 Laboratory of Pharmacology, Department of Health Sciences, University of Milan, Italy.,3 Pediatric Clinical Research Center Fondazione "Romeo ed Enrica Invernizzi", University of Milan, Italy
| | - Michele Samaja
- 2 Laboratory of Biochemistry, Department of Health Sciences, University of Milan, Italy
| | - Stephana Carelli
- 1 Laboratory of Pharmacology, Department of Health Sciences, University of Milan, Italy.,3 Pediatric Clinical Research Center Fondazione "Romeo ed Enrica Invernizzi", University of Milan, Italy
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McNames J, Shah VV, Mancini M, Curtze C, El-Gohary M, Aboy M, Carlson-Kuhta P, Nutt JG, Horak F. A Two-Stage Tremor Detection Algorithm for Wearable Inertial Sensors During Normal Daily Activities. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:2535-2538. [PMID: 31946413 DOI: 10.1109/embc.2019.8857133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Continuous monitoring of tremor with wearable wrist sensors during normal daily activities is more difficult than in a clinical setting when subjects perform prescribed activities because some normal daily activities resemble tremor, many normal movements contain frequency content that overlaps with the tremor frequency, and the tremor amplitude has a large dynamic range during normal daily activities. We describe a novel two-stage algorithm that offers improvement at discriminating tremor from other activities. Some of this improvement is attained by using prior domain knowledge that tremor occurs over a narrow range of frequencies for an individual, but the mean tremor frequency may vary significantly between individuals in a study population. We validated the algorithm in continuous recordings from people with Parkinson's disease and matched control subjects. The algorithm has good face validity, a low rate of false positives on recordings from control subjects (<; 1.1%), and good correspondence with the constancy of rest tremor as measured by this question on the MDS-UPDRS (ρ = 0.54).
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Rehman RZU, Buckley C, Mico-Amigo ME, Kirk C, Dunne-Willows M, Mazza C, Shi JQ, Alcock L, Rochester L, Del Din S. Accelerometry-Based Digital Gait Characteristics for Classification of Parkinson's Disease: What Counts? IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2020; 1:65-73. [PMID: 35402938 PMCID: PMC8979631 DOI: 10.1109/ojemb.2020.2966295] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 11/29/2022] Open
Abstract
Objective: Gait may be a useful biomarker that can be objectively measured with wearable technology to classify Parkinson's disease (PD). This study aims to: (i) comprehensively quantify a battery of commonly utilized gait digital characteristics (spatiotemporal and signal-based), and (ii) identify the best discriminative characteristics for the optimal classification of PD. Methods: Six partial least square discriminant analysis (PLS-DA) models were trained on subsets of 210 characteristics measured in 142 subjects (81 people with PD, 61 controls (CL)). Results: Models accuracy ranged between 70.42-88.73% (AUC: 78.4-94.5%) with a sensitivity of 72.84-90.12% and a specificity of 60.3-86.89%. Signal-based digital gait characteristics independently gave 87.32% accuracy. The most influential characteristics in the classification models were related to root mean square values, power spectral density, step velocity and length, gait regularity and age. Conclusions: This study highlights the importance of signal-based gait characteristics in the development of tools to help classify PD in the early stages of the disease.
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Affiliation(s)
- Rana Zia Ur Rehman
- 1 Translational and Clinical Research InstituteNewcastle University Newcastle Upon Tyne NE4 5PL U.K
| | - Christopher Buckley
- 1 Translational and Clinical Research InstituteNewcastle University Newcastle Upon Tyne NE4 5PL U.K
| | - Maria Encarna Mico-Amigo
- 1 Translational and Clinical Research InstituteNewcastle University Newcastle Upon Tyne NE4 5PL U.K
| | - Cameron Kirk
- 1 Translational and Clinical Research InstituteNewcastle University Newcastle Upon Tyne NE4 5PL U.K
| | - Michael Dunne-Willows
- 2 School of Mathematics, Statistics, and PhysicsNewcastle University Newcastle Upon Tyne NE1 7RU U.K
| | - Claudia Mazza
- 3 Department of Mechanical Engineering and INSIGNEO Institute for in silico MedicineUniversity of Sheffield Sheffield S10 2TN U.K
| | - Jian Qing Shi
- 2 School of Mathematics, Statistics, and PhysicsNewcastle University Newcastle Upon Tyne NE1 7RU U.K
| | - Lisa Alcock
- 1 Translational and Clinical Research InstituteNewcastle University Newcastle Upon Tyne NE4 5PL U.K
| | - Lynn Rochester
- 1 Translational and Clinical Research InstituteNewcastle University Newcastle Upon Tyne NE4 5PL U.K
- 4 Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle Upon Tyne NE7 7DN U.K
| | - Silvia Del Din
- 1 Translational and Clinical Research InstituteNewcastle University Newcastle Upon Tyne NE4 5PL U.K
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Cascarano GD, Loconsole C, Brunetti A, Lattarulo A, Buongiorno D, Losavio G, Sciascio ED, Bevilacqua V. Biometric handwriting analysis to support Parkinson's Disease assessment and grading. BMC Med Inform Decis Mak 2019; 19:252. [PMID: 31830966 PMCID: PMC6907099 DOI: 10.1186/s12911-019-0989-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Handwriting represents one of the major symptom in Parkinson's Disease (PD) patients. The computer-aided analysis of the handwriting allows for the identification of promising patterns that might be useful in PD detection and rating. In this study, we propose an innovative set of features extracted by geometrical, dynamical and muscle activation signals acquired during handwriting tasks, and evaluate the contribution of such features in detecting and rating PD by means of artificial neural networks. METHODS Eleven healthy subjects and twenty-one PD patients were enrolled in this study. Each involved subject was asked to write three different patterns on a graphic tablet while wearing the Myo Armband used to collect the muscle activation signals of the main forearm muscles. We have then extracted several features related to the written pattern, the movement of the pen and the pressure exerted with the pen and the muscle activations. The computed features have been used to classify healthy subjects versus PD patients and to discriminate mild PD patients from moderate PD patients by using an artificial neural network (ANN). RESULTS After the training and evaluation of different ANN topologies, the obtained results showed that the proposed features have high relevance in PD detection and rating. In particular, we found that our approach both detect and rate (mild and moderate PD) with a classification accuracy higher than 90%. CONCLUSIONS In this paper we have investigated the representativeness of a set of proposed features related to handwriting tasks in PD detection and rating. In particular, we used an ANN to classify healthy subjects and PD patients (PD detection), and to classify mild and moderate PD patients (PD rating). The implemented and tested methods showed promising results proven by the high level of accuracy, sensitivity and specificity. Such results suggest the usability of the proposed setup in clinical settings to support the medical decision about Parkinson's Disease.
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Affiliation(s)
- Giacomo Donato Cascarano
- Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, Italy, Via Edoardo Orabona, 4, Bari, Italy.,Apulian Bioengineering s.r.l., Via delle Violette 14, Modugno (BA), Italy
| | - Claudio Loconsole
- Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, Italy, Via Edoardo Orabona, 4, Bari, Italy
| | - Antonio Brunetti
- Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, Italy, Via Edoardo Orabona, 4, Bari, Italy.,Apulian Bioengineering s.r.l., Via delle Violette 14, Modugno (BA), Italy
| | - Antonio Lattarulo
- Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, Italy, Via Edoardo Orabona, 4, Bari, Italy
| | - Domenico Buongiorno
- Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, Italy, Via Edoardo Orabona, 4, Bari, Italy.,Apulian Bioengineering s.r.l., Via delle Violette 14, Modugno (BA), Italy
| | | | - Eugenio Di Sciascio
- Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, Italy, Via Edoardo Orabona, 4, Bari, Italy.,Apulian Bioengineering s.r.l., Via delle Violette 14, Modugno (BA), Italy
| | - Vitoantonio Bevilacqua
- Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, Italy, Via Edoardo Orabona, 4, Bari, Italy. .,Apulian Bioengineering s.r.l., Via delle Violette 14, Modugno (BA), Italy.
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Lim KE, Kim SR, Sung YH, Oh SY, Kim MS, Chung SJ. Factors influencing self-management in Parkinson's disease: A cross-sectional study. Geriatr Nurs 2019; 41:254-260. [PMID: 31784296 DOI: 10.1016/j.gerinurse.2019.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/20/2019] [Accepted: 10/23/2019] [Indexed: 12/21/2022]
Abstract
This study aimed to identify factors influencing self-management in patients with Parkinson's disease (PD) based on social cognitive theory. A cross-sectional design was used; data were collected at three tertiary medical centers in Korea from a convenience sample of 356 PD patients. Higher self-management scores were associated with higher education level, having a religion, and higher family income. Self-management score was positively correlated with activities of daily living, self-efficacy, and social support, and negatively correlated with non-motor symptoms. Hierarchical regression analysis revealed that demographic factors and non-motor symptoms explained 26.2% of the variance in self-management in PD. The explanatory power increased by 7.5% when self-efficacy was added, and by 6.7% when social support was added. Assessment of self-management in patients with PD should consider self-efficacy and social support, along with demographic factors and non-motor symptoms. Self-management programs that reflect these factors may be useful for improving self-management in PD patients.
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Affiliation(s)
- Kyeung Eun Lim
- College of Nursing, Chonbuk National University, Jeonju, Republic of Korea.
| | - Sung Reul Kim
- College of Nursing, Korea University, Anam-ro 145, Seongbuk-gu, Seoul 02841, Republic of Korea.
| | - Young Hee Sung
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
| | - Sun-Young Oh
- Department of Neurology, Medical School of Chonbuk National University, Jeonju, Republic of Korea.
| | - Mi Sun Kim
- Department of Nursing, Asan Medical Center, Seoul, Republic of Korea.
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Li K, Li J, Zheng J, Qin S. Reactive Astrocytes in Neurodegenerative Diseases. Aging Dis 2019; 10:664-675. [PMID: 31165009 PMCID: PMC6538217 DOI: 10.14336/ad.2018.0720] [Citation(s) in RCA: 234] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/20/2018] [Indexed: 12/17/2022] Open
Abstract
Astrocytes, the largest and most numerous glial cells in the central nervous system (CNS), play a variety of important roles in regulating homeostasis, increasing synaptic plasticity and providing neuroprotection, thus helping to maintain normal brain function. At the same time, astrocytes can participate in the inflammatory response and play a key role in the progression of neurodegenerative diseases. Reactive astrocytes are strongly induced by numerous pathological conditions in the CNS. Astrocyte reactivity is initially characterized by hypertrophy of soma and processes, triggered by different molecules. Recent studies have demonstrated that neuroinflammation and ischemia can elicit two different types of reactive astrocytes, termed A1s and A2s. However, in the case of astrocyte reactivity in different neurodegenerative diseases, the recently published research issues remain a high level of conflict and controversy. So far, we still know very little about whether and how the function or reactivity of astrocytes changes in the progression of different neurodegenerative diseases. In this review, we aimed to briefly discuss recent studies highlighting the complex contribution of astrocytes in the process of various neurodegenerative diseases, which may provide us with new prospects for the development of an excellent therapeutic target for neurodegenerative diseases.
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Affiliation(s)
- Kunyu Li
- 1Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Jiatong Li
- 1Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Jialin Zheng
- 2Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai, China
| | - Song Qin
- 1Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
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Setty Y. eBrain: a Three Dimensional Simulation Tool to Study Drug Delivery in the Brain. Sci Rep 2019; 9:6162. [PMID: 30992468 PMCID: PMC6467991 DOI: 10.1038/s41598-019-42261-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 02/20/2019] [Indexed: 12/18/2022] Open
Abstract
Neurodegenerative disorders such as Alzheimer’s and Parkinson’s disease are severe disorders with acute symptoms that gradually progress. In the course of developing disease-modifying treatments for neurodegenerative disorders there is a need to develop novel strategies to increase efficacy of drugs and accelerate the development process. We developed a tool for simulating drug delivery in the brain by translating MRI data into an interactive 3D model. This tool, the eBrain, superimposes simulated drug diffusion and tissue uptake by inferring from the MRI data with a seamless display from any angle, magnification, or position. We discuss a representative implementation of eBrain that is inspired by clinical data in which insulin is intranasally administered to Alzheimer patients. Using extensive analysis of multiple eBrain simulations with varying parameters, we show the potential for eBrain to determine the optimal dosage to ensure drug delivery without overdosing the tissue. Specifically, we examined the efficacy of combined drug doses and potential compounds for tissue stimulation. Interestingly, our analysis uncovered that the drug efficacy is inferred from tissue intensity levels. Finally, we discuss the potential of eBrain and possible applications of eBrain to aid both inexperienced and experienced medical professionals as well as patients.
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Affiliation(s)
- Yaki Setty
- Gateway Institute for Brain Research, 3321 College Avenue, Davie, 33314, Florida, USA.
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Tamtaji OR, Naderi Taheri M, Notghi F, Alipoor R, Bouzari R, Asemi Z. The effects of acupuncture and electroacupuncture on Parkinson's disease: Current status and future perspectives for molecular mechanisms. J Cell Biochem 2019; 120:12156-12166. [PMID: 30938859 DOI: 10.1002/jcb.28654] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/18/2018] [Accepted: 02/07/2019] [Indexed: 12/11/2022]
Abstract
Among the progressive neurodegenerative disorders, Parkinson's disease (PD) is the second most common. Different factors have critical role in pathophysiology of PD such as apoptosis pathways, inflammatory cytokines, oxidative stress, and neurotransmitters and its receptors abnormalities. Acupuncture and electroacupuncture were considered as nondrug therapies for PD. Although numerous studies has been conducted for assessing the mechanism underlying electroacupuncture and acupuncture, various principal aspects of these treatment procedures remain not well-known. There have also been few investigations on the molecular mechanism of acupuncture and electroacupuncture therapy effects in PD. This review evaluates the effects of electroacupuncture and acupuncture on the molecular mechanism in PD.
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Affiliation(s)
- Omid Reza Tamtaji
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Mojtaba Naderi Taheri
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.,Deptartment of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Fahimeh Notghi
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Reza Alipoor
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Reihanesadat Bouzari
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
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Loconsole C, Cascarano GD, Brunetti A, Trotta GF, Losavio G, Bevilacqua V, Di Sciascio E. A model-free technique based on computer vision and sEMG for classification in Parkinson’s disease by using computer-assisted handwriting analysis. Pattern Recognit Lett 2019. [DOI: 10.1016/j.patrec.2018.04.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Torres-Russotto D. Clinical approach to tremor in children. Parkinsonism Relat Disord 2019; 59:111-116. [PMID: 30952437 DOI: 10.1016/j.parkreldis.2019.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 01/22/2023]
Abstract
Pediatric Movement Disorders encompass a very large and complex group of diseases, among which Tremor is one of the least studied. Evaluation of tremors in kids carries significant challenges, in particular the fact that many tremor etiologies have other associated movement disorders that make tremor identification more difficult. Also, it is sometimes difficult to differentiate tremors from other shaking disorders. Yet, the correct identification of tremor leads to appropriate treatments and sometimes practical cures. Thus, in this paper we have strived to provide a succinct, clinically useful and practical review of pediatric tremors. The most useful classification of tremors in based on their predominance during rest or activity. By far, the most common tremor in children is during action. We provide a clinical algorithm on how to assess pediatric tremors at the bedside, as well as multiple useful tables. We also review common tremor etiologies.
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Affiliation(s)
- D Torres-Russotto
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, United States.
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Chen R, Lee C, Lin X, Zhao C, Li X. Novel function of VEGF-B as an antioxidant and therapeutic implications. Pharmacol Res 2019; 143:33-39. [PMID: 30851357 DOI: 10.1016/j.phrs.2019.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 12/14/2022]
Abstract
Oxidative stress, due to insufficiency of antioxidants or over-production of oxidants, can lead to severe cell and tissue damage. Oxidative stress occurs constantly and has been shown to be involved in innumerable diseases, such as degenerative, cardiovascular, neurological, and metabolic disorders, cancer, and aging, thus highlighting the vital need of antioxidant defense mechanisms. Vascular endothelial growth factor B (VEGF-B) was discovered a long time ago, and is abundantly expressed in most types of cells and tissues. VEGF-B remained functionally mysterious for many years and later on has been shown to be minimally angiogenic. Recently, VEGF-B is reported to be a potent antioxidant by boosting the expression of key antioxidant enzymes. Thus, one major role of VEGF-B lies in safeguarding tissues and cells from oxidative stress-induced damage. VEGF-B may therefore have promising therapeutic utilities in treating oxidative stress-related diseases. In this review, we discuss the current knowledge on the newly discovered antioxidant function of VEGF-B and the related molecular mechanisms, particularly, in relationship to some oxidative stress-related diseases, such as retinitis pigmentosa, age-related macular degeneration, diabetic retinopathy, glaucoma, amyotrophic lateral sclerosis, Alzheimer's disease, and Parkinson's disease.
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Affiliation(s)
- Rongyuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Chunsik Lee
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Xianchai Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Chen Zhao
- Eye Institute, Eye and ENT Hospital, Shanghai Medical College, Fudan University, China; Key Laboratory of Myopia of State Health Ministry (Fudan University) and Shanghai Key Laboratory of Visual Impairment and Restoration, 200023, Shanghai, China.
| | - Xuri Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
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Alyamani AM, Alarifi J, Alfadhel A, Alfarawi F, Alshamardl K, Alassaf F, Alyamani M, Alshahrani F. Public knowledge and awareness about Parkinson's disease in Saudi Arabia. J Family Med Prim Care 2019; 7:1216-1221. [PMID: 30613500 PMCID: PMC6293928 DOI: 10.4103/jfmpc.jfmpc_335_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Parkinson's disease (PD) is one of the most prevalent neurologic disorders, leading to progressive disability that can be slowed but not stopped by treatment. It is characterized by tremors, slow movements, stiffness in arms and legs, and balance impairment. Despite advancement in treatment, diagnosis, and care of PD patients, lack of adequate knowledge and associated beliefs among the community might have a key role in limiting access to proper treatment and care. Objectives To identify the level of awareness of our population regarding PD in terms of causes, signs, symptoms, and treatment. Materials and Methods A cross-sectional study was conducted on Saudis, who have active Twitter accounts. Data were collected through a previously validated questionnaire, which tests recognition of PD symptoms and general knowledge regarding PD. The questionnaire was translated into Arabic. Part 1 of the questionnaire is the demographic data collection sheet, Part 2 of the questionnaire tests recognition of PD symptoms, and Part 3 of the questionnaire tests general knowledge regarding PD. Results The questionnaire was administered to 3,050 members of the public, of which 2,609 questionnaires (86.20%) were included in the analysis. The tremor was the most widely recognized symptom (86.10%), and weight loss was the most recognized non-motor symptom (24%). Most respondents (56%) were able to identify imbalance as a symptom of PD, whereas only 4.10% of them were able to identify the reduced sense of smell as a symptom of PD. Motor symptoms were significantly better recognized (range 31.30%-86.10%) than non-motor symptoms (range 4.10%-24%). Conclusion Educational campaigns may be appropriate to improve public awareness of PD and individual knowledge about PD symptoms and treatment.
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Affiliation(s)
- Alwaleed M Alyamani
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Jammaz Alarifi
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulmajeed Alfadhel
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fahad Alfarawi
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khalid Alshamardl
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Faisal Alassaf
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed Alyamani
- Department of Medicine, College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Fahad Alshahrani
- Department of Medicine, Faculty of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Family Medicine and Primary Health Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Vroonen L, Daly AF, Beckers A. Epidemiology and Management Challenges in Prolactinomas. Neuroendocrinology 2019; 109:20-27. [PMID: 30731464 DOI: 10.1159/000497746] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/06/2019] [Indexed: 11/19/2022]
Abstract
Clinically relevant pituitary adenomas are present in about 1 per 1,000 of the general population and prolactinomas are by far the most common clinical subtype of pituitary adenomas. Usually prolactinomas affect premenopausal women and present with typical symptoms of menstrual disturbance and/or galactorrhea. They are generally managed with dopamine agonists to restore fertility and to control symptoms and tumor size. In a subset of prolactinomas, however, management remains challenging. Studies in recent years have identified the factors related to dopamine agonist resistance, such as male sex, genetic features, and aggressive tumor behavior. Certain other patient groups represent particular challenges for management, such as pediatric patients and pregnant women. Treatment with dopamine agonists is usually safe and effective, and adverse effects such as clinically relevant cardiac valvular complications and impulse control disorders may occur in isolated instances. A number of important disease characteristics of prolactinomas remain to be explained, such as the difference in sex prevalence before and after menopause, the higher prevalence of macroadenomas in older males, and the biochemical mechanisms of resistance to dopaminergic agonists.
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Affiliation(s)
- Laurent Vroonen
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
| | - Adrian F Daly
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
| | - Albert Beckers
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium,
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Alizad V, Meinzer M, Frossard L, Polman R, Smith S, Kerr G. Effects of transcranial direct current stimulation on gait in people with Parkinson's disease: study protocol for a randomized, controlled clinical trial. Trials 2018; 19:661. [PMID: 30486849 PMCID: PMC6263538 DOI: 10.1186/s13063-018-2982-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 10/13/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Gait difficulties are common and frequently devastating to people with Parkinson's disease (PD). These difficulties are often followed by an increased risk of falls, leading to injury, hospitalization and mortality. The dysfunction in the basal ganglia-thalamocortical motor circuits and reduced activity in the premotor and primary motor cortices has raised interest in transcranial direct current stimulation (tDCS) as an adjunct intervention in PD. tDCS might provide a potentially safe and non-invasive treatment by modulating cortical excitability and behavioural outcomes. The aim of this study is to compare the effects of different monopolar and bipolar montages of tDCS administered to the motor cortex and cerebellum on gait speed in PD. METHODS This study will be conducted in a randomized, double-blind cross-over design. Eighteen participants diagnosed with Parkinson's disease will receive anodal and sham tDCS (1 mA, 20 min, 10 × 4 cm2) over the premotor and primary motor cortices with the cathode over the cerebellum during treadmill walking. Three montages will be applied over three sessions and compared: anodal tDCS with a small active cathode (4 × 4 cm2); anodal tDCS with a large, functionally inert cathode (10 × 10 cm2); and sham tDCS. The primary outcome measure is gait speed, and secondary outcome measures include gait parameters (temporospatial, segmental, kinematic), the Timed Up and Go test and lower limb muscle activity patterns as measured by electromyography. DISCUSSION This study will investigate the short-term effects of anodal tDCS over the premotor and primary motor cortices on gait abilities using monopolar and bipolar montages in people with PD. The outcomes will inform future studies aimed at inducing longer-lasting changes in neural excitability and performance using multisession tDCS designs in PD. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12618000063213 . Registered on 17 January 2018. Retrospectively registered.
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Affiliation(s)
- Vida Alizad
- Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia. .,Iranian Research Centre on Ageing, The University of Social Welfare and rehabilitation Sciences, Tehran, Iran.
| | - Marcus Meinzer
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - Laurent Frossard
- Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, QLD, Australia
| | - Remco Polman
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Simon Smith
- Institute for Social Science Research (ISSR), The University of Queensland, Brisbane, QLD, Australia
| | - Graham Kerr
- Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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A new method based on quiet stance baseline is more effective in identifying freezing in Parkinson's disease. PLoS One 2018; 13:e0207945. [PMID: 30475908 PMCID: PMC6258113 DOI: 10.1371/journal.pone.0207945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 11/08/2018] [Indexed: 11/24/2022] Open
Abstract
Freezing, an episodic movement breakdown that goes from disrupted gait patterns to complete arrest, is a disabling symptom in Parkinson’s disease. Several efforts have been made to objectively identify freezing episodes (FEs), although a standardized methodology to discriminate freezing from normal movement is lacking. Novel mathematical approaches that provide information in the temporal and frequency domains, such as the continuous wavelet transform, have demonstrated promising results detecting freezing, although still with limited effectiveness. We aimed to determine whether a computerized algorithm using the continuous wavelet transform based on baseline (i.e. no movement) rather than on amplitude decrease is more effective detecting freezing. Twenty-six individuals with Parkinson’s disease performed two trials of a repetitive stepping-in-place task while they were filmed by a video camera and tracked by a motion capture system. The number of FEs and their total duration were determined from a visual inspection of the videos and from three different computed algorithms. Differences in the number and total duration of the FEs between the video inspection and each of the three methods were obtained. The accuracy to identify the time of occurrence of a FE by each method was also calculated. A significant effect of Method was found for the number (p = 0.016) and total duration (p = 0.013) of the FEs, with the method based on baseline being the closest one to the values reported from the videos. Moreover, the same method was the most accurate in detecting the time of occurrence, and the one reaching the highest sensitivity (88.2%). Findings suggest that threshold detection methods based on baseline and movement amplitude decreases capture different characteristics of Parkinsonian gait, with the first one being more effective at detecting FEs. Moreover, robust approaches that consider both time and frequency characteristics are more sensitive in identifying freezing.
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Prince J, Andreotti F, De Vos M. Multi-Source Ensemble Learning for the Remote Prediction of Parkinson's Disease in the Presence of Source-Wise Missing Data. IEEE Trans Biomed Eng 2018; 66:1402-1411. [PMID: 30403615 PMCID: PMC6487914 DOI: 10.1109/tbme.2018.2873252] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
As the collection of mobile health data becomes pervasive, missing data can make large portions of datasets inaccessible for analysis. Missing data has shown particularly problematic for remotely diagnosing and monitoring Parkinson's disease (PD) using smartphones. This contribution presents multi-source ensemble learning, a methodology which combines dataset deconstruction with ensemble learning and enables participants with incomplete data (i.e., where not all sensor data is available) to be included in the training of machine learning models and achieves a 100% participant retention rate. We demonstrate the proposed method on a cohort of 1513 participants, 91.2% of which contributed incomplete data in tapping, gait, voice, and/or memory tests. The use of multi-source ensemble learning, alongside convolutional neural networks (CNNs) capitalizing on the amount of available data, increases PD classification accuracy from 73.1% to 82.0% as compared to traditional techniques. The increase in accuracy is found to be partly caused by the use of multi-channel CNNs and partly caused by developing models using the large cohort of participants. Furthermore, through bootstrap sampling we reveal that feature selection is better performed on a large cohort of participants with incomplete data than on a small number of participants with complete data. The proposed method is applicable to a wide range of wearable/remote monitoring datasets that suffer from missing data and contributes to improving the ability to remotely monitor PD via revealing novel methods of accounting for symptom heterogeneity.
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Protein Degradation and the Pathologic Basis of Disease. THE AMERICAN JOURNAL OF PATHOLOGY 2018; 189:94-103. [PMID: 30312581 DOI: 10.1016/j.ajpath.2018.09.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/05/2018] [Accepted: 09/17/2018] [Indexed: 12/27/2022]
Abstract
The abundance of any protein is determined by the balance of protein synthesis and protein degradation. Regulated protein degradation has emerged as a powerful means of precisely controlling individual protein abundance within cells and is largely mediated by the ubiquitin-proteasome system (UPS). By controlling the levels of key regulatory proteins, the UPS contributes to nearly every aspect of cellular function. The UPS also functions in protein quality control, rapidly identifying and destroying misfolded or otherwise aberrant proteins that may be toxic to cells. Increasingly, we understand that dysregulation of protein degradation pathways is critical for many human diseases. Conversely, the versatility and scope of the UPS provides opportunities for therapeutic intervention. In this review, we will discuss the basic mechanisms of protein degradation by the UPS. We will then consider some paradigms of human disease related to protein degradation using selected examples. Finally, we will highlight several established and emerging therapeutic strategies based on altering pathways of protein degradation.
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[Prescribing patterns of antiparkinson drugs in a group of Colombian patients, 2015]. BIOMEDICA 2018; 38:417-426. [PMID: 30335247 DOI: 10.7705/biomedica.v38i4.3781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/13/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Parkinson's disease, whose prevalence in Colombia is 4.7 per 1,000 inhabitants, is a public health problem and a therapeutic challenge for health professionals. OBJECTIVE To determine the prescribing patterns of antiparkinson drugs and the variables associated with its use in a population from Colombia. MATERIALS AND METHODS We conducted a descriptive cross-sectional study. We selected patients who had been given antiparkinson drugs uninterruptedly between January 1st and March 31st, 2015 from a systematized database of approximately 3.5 million people affiliated to the Colombian health system. We included sociodemographic, pharmacologic and comedication variables. For the multivariate analysis, we used the IBM SPSS™-22 software. RESULTS A total of 2,898 patients was included; the mean age was 65.1years, and 50.7% were men; 69.4% (n=2010) of people received monotherapy and 30.6% combination therapy with two to five antiparkinson drugs. The most frequently prescribed drugs were: levodopa 45.5% (n=1,318 patients), biperiden 23.1% (670), amantadine 18.3% (531) and pramipexole 16.3% (471). The most commonly used association was levodopa/carbidopa + entacapone (n=311; 10.7%). Multivariate analysis showed that being male (OR=1.56; 95%CI: 1.321-1.837), over 60 years (OR=1.41; 95%CI 1.112-1.782) and receiving treatment in the city of Barranquilla (OR=2.23; 95%CI 1.675-2.975) were statistically associated with a greater risk of using combination therapy; 68.2% (n=1,977) patients were given concomitant treatment with other drugs. CONCLUSIONS Prescribing habits of drugs with high therapeutic value predominated, mainly in antiparkinson drugs monotherapy. Most were employed in the usual recommended doses. It is necessary to explore the clinical effectiveness of the medications studied and differentiate between disease and parkinsonian syndromes subtypes.
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Heusinkveld LE, Hacker ML, Turchan M, Davis TL, Charles D. Impact of Tremor on Patients With Early Stage Parkinson's Disease. Front Neurol 2018; 9:628. [PMID: 30123178 PMCID: PMC6085452 DOI: 10.3389/fneur.2018.00628] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 07/11/2018] [Indexed: 01/03/2023] Open
Abstract
Tremor is one of the most visible features of Parkinson's disease (PD), and the majority of PD patients experience tremor during the course of the disease. However, the distress caused by this cardinal motor feature for patients early in the course of their PD is commonly underappreciated. People living with early stage PD often experience intense embarrassment and difficulties due to their tremor that limit social interactions, and tremor frequently interferes with the ability to perform activities of daily living and simple tasks at home and work. Although tremor is primarily managed with medications, both tremor response and satisfaction with medical therapy are highly variable. This review offers an overview of reports of the patient experience of tremor in early stage PD and current management options for this cardinal motor feature.
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Affiliation(s)
- Lauren E Heusinkveld
- Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Mallory L Hacker
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Maxim Turchan
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Thomas L Davis
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - David Charles
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
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Growth Factors and Neuroglobin in Astrocyte Protection Against Neurodegeneration and Oxidative Stress. Mol Neurobiol 2018; 56:2339-2351. [PMID: 29982985 DOI: 10.1007/s12035-018-1203-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 06/26/2018] [Indexed: 12/21/2022]
Abstract
Neurodegenerative diseases, such as Parkinson and Alzheimer, are among the main public health issues in the world due to their effects on life quality and high mortality rates. Although neuronal death is the main cause of disruption in the central nervous system (CNS) elicited by these pathologies, other cells such as astrocytes are also affected. There is no treatment for preventing the cellular death during neurodegenerative processes, and current drug therapy is focused on decreasing the associated motor symptoms. For these reasons, it has been necessary to seek new therapeutical procedures, including the use of growth factors to reduce α-synuclein toxicity and misfolding in order to recover neuronal cells and astrocytes. Additionally, it has been shown that some growth factors are able to reduce the overproduction of reactive oxygen species (ROS), which are associated with neuronal death through activation of antioxidative enzymes such as catalase, superoxide dismutase, glutathione peroxidase, and neuroglobin. In the present review, we discuss the use of growth factors such as PDGF-BB, VEGF, BDNF, and the antioxidative enzyme neuroglobin in the protection of astrocytes and neurons during the development of neurodegenerative diseases.
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Reinertsen E, Clifford GD. A review of physiological and behavioral monitoring with digital sensors for neuropsychiatric illnesses. Physiol Meas 2018; 39:05TR01. [PMID: 29671754 PMCID: PMC5995114 DOI: 10.1088/1361-6579/aabf64] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Physiological, behavioral, and psychological changes associated with neuropsychiatric illness are reflected in several related signals, including actigraphy, location, word sentiment, voice tone, social activity, heart rate, and responses to standardized questionnaires. These signals can be passively monitored using sensors in smartphones, wearable accelerometers, Holter monitors, and multimodal sensing approaches that fuse multiple data types. Connection of these devices to the internet has made large scale studies feasible and is enabling a revolution in neuropsychiatric monitoring. Currently, evaluation and diagnosis of neuropsychiatric disorders relies on clinical visits, which are infrequent and out of the context of a patient's home environment. Moreover, the demand for clinical care far exceeds the supply of providers. The growing prevalence of context-aware and physiologically relevant digital sensors in consumer technology could help address these challenges, enable objective indexing of patient severity, and inform rapid adjustment of treatment in real-time. Here we review recent studies utilizing such sensors in the context of neuropsychiatric illnesses including stress and depression, bipolar disorder, schizophrenia, post traumatic stress disorder, Alzheimer's disease, and Parkinson's disease.
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Affiliation(s)
- Erik Reinertsen
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
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Nassif DV, Pereira JS. Fatigue in Parkinson's disease: concepts and clinical approach. Psychogeriatrics 2018; 18:143-150. [PMID: 29409156 DOI: 10.1111/psyg.12302] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/25/2017] [Accepted: 07/30/2017] [Indexed: 12/16/2022]
Abstract
Parkinson's disease (PD) is a progressive neurological disorder characterized by a large number of motor and non-motor features. Fatigue is one of the most common and most disabling symptoms among patients with PD, and it has a significant impact on their quality of life. Although fatigue has been recognized for a long time, its pathophysiology remains poorly understood, and there is no evidence to support any therapeutic approach in PD patients. Expert consensus on case definition and diagnostic criteria for PD-related fatigue have been recently published, and although they still need to be adequately validated, they provide a great step forward in the study of fatigue. The goal of this article is to provide relevant information for the identification and management of patients with fatigue.
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Affiliation(s)
- Daniel V Nassif
- Department of Neurology, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - João S Pereira
- Department of Neurology, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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