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Rostami Z, Salari M, Mahdavi S, Etemadifar M. Abnormal multisensory temporal discrimination in Parkinson's disease. Brain Res 2024; 1834:148901. [PMID: 38561085 DOI: 10.1016/j.brainres.2024.148901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/23/2024] [Accepted: 03/28/2024] [Indexed: 04/04/2024]
Abstract
Cognitive deficits are prevalent in Parkinson's disease (PD), ranging from mild deficits in perception and executive function to severe dementia. Multisensory integration (MSI), the ability to pool information from different sensory modalities to form a combined, coherent perception of the environment, is known to be impaired in PD. This study investigated the disruption of audiovisual MSI in PD patients by evaluating temporal discrimination ability between auditory and visual stimuli with different stimulus onset asynchronies (SOAs). The experiment was conducted with Fifteen PD patients and fifteen age-matched healthy controls where participants were requested to report whether the audiovisual stimuli pairs were temporal simultaneous. The temporal binding window (TBW), the time during which sensory modalities are perceived as synchronous, was adapted as the comparison index between PD patients and healthy individuals. Our results showed that PD patients had a significantly wider TBW than healthy controls, indicating abnormal audiovisual temporal discrimination. Furthermore, PD patients had more difficulty in discriminating temporal asynchrony in visual-first, but not in auditory-first stimuli, compared to healthy controls. In contrast, no significant difference was observed for auditory-first stimuli. PD patients also had shorter reaction times than healthy controls regardless of stimulus priority. Together, our findings point to abnormal audiovisual temporal discrimination, a major component of MSI irregularity, in PD patients. These results have important implications for future models of MSI experiments and models that aim to uncover the underlying mechanism of MSI in patients afflicted with PD.
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Affiliation(s)
- Zahra Rostami
- Clinical Research Development Unit, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehri Salari
- Clinical Research Development Unit, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Sara Mahdavi
- School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Masoud Etemadifar
- Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
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2
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Devenyi RA, Hamedani AG. Visual dysfunction in dementia with Lewy bodies. Curr Neurol Neurosci Rep 2024:10.1007/s11910-024-01349-8. [PMID: 38907811 DOI: 10.1007/s11910-024-01349-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 06/24/2024]
Abstract
PURPOSE OF REVIEW To review the literature on visual dysfunction in dementia with Lewy bodies (DLB), including its mechanisms and clinical implications. RECENT FINDINGS Recent studies have explored novel aspects of visual dysfunction in DLB, including visual texture agnosia, mental rotation of 3-dimensional drawn objects, and reading fragmented letters. Recent studies have shown parietal and occipital hypoperfusion correlating with impaired visuoconstruction performance. While visual dysfunction in clinically manifest DLB is well recognized, recent work has focused on prodromal or mild cognitive impairment (MCI) due to Lewy body pathology with mixed results. Advances in retinal imaging have recently led to the identification of abnormalities such as parafoveal thinning in DLB. Patients with DLB experience impairment in color perception, form and object identification, space and motion perception, visuoconstruction tasks, and illusions in association with visual cortex and network dysfunction. These symptoms are associated with visual hallucinations, driving impairment, falls, and other negative outcomes.
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Affiliation(s)
- Ryan A Devenyi
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ali G Hamedani
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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3
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Zhou Y, Yang Y, Qi T, Hou Z, Ge Q, Lu Z. Transcriptome Study of rd1Mouse Brain and Association with Parkinson's Disease. ACS OMEGA 2024; 9:25756-25765. [PMID: 38911794 PMCID: PMC11191077 DOI: 10.1021/acsomega.3c09938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 05/10/2024] [Accepted: 05/24/2024] [Indexed: 06/25/2024]
Abstract
Degeneration of the retina is intrinsically associated with the pathogenesis and progression of neurodegenerative diseases. However, the cellular and molecular mechanisms underlying the association between neurodegeneration and retinal degeneration are still under exploration due to the complexity of the connectivity network of the nervous system. In this study, RNA-seq data from the brains of model retinitis pigmentosa (RP) mice and previously studied Parkinson's disease (PD) mice were analyzed to explore the commonalities between retinal degenerative and neurodegenerative diseases. Differentially expressed genes in RP were compared with neurodegenerative disease-related genes and intersecting genes were identified, including Cnr1 and Septin14. These genes were verified by quantitative real-time reverse transcription PCR and Western blotting experiments. The key proteins CNR1 and SEPTIN14 were found to be potential cotherapeutic targets for retinal degeneration and neurodegenerative disease. In conclusion, understanding the commonalities between retinal degenerative diseases and neurodegenerative processes in the brain will not only facilitate the interpretation of the underlying pathomechanisms but also contribute to early diagnosis and the development of new therapeutic strategies.
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Affiliation(s)
- Ying Zhou
- State Key Laboratory of Digital
Medical Engineering, School of Biological Science & Medical Engineering, Southeast University, Nanjing 210096, China
| | - Yuwei Yang
- State Key Laboratory of Digital
Medical Engineering, School of Biological Science & Medical Engineering, Southeast University, Nanjing 210096, China
| | - Ting Qi
- State Key Laboratory of Digital
Medical Engineering, School of Biological Science & Medical Engineering, Southeast University, Nanjing 210096, China
| | - Zhuoran Hou
- State Key Laboratory of Digital
Medical Engineering, School of Biological Science & Medical Engineering, Southeast University, Nanjing 210096, China
| | - Qinyu Ge
- State Key Laboratory of Digital
Medical Engineering, School of Biological Science & Medical Engineering, Southeast University, Nanjing 210096, China
| | - Zuhong Lu
- State Key Laboratory of Digital
Medical Engineering, School of Biological Science & Medical Engineering, Southeast University, Nanjing 210096, China
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4
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Zhong W, Yang Q, Wang F, Lin X, Chen Z, Xue J, Zhao W, Liu X, Rao B, Zhang J. Cell-specific localization of β-synuclein in the mouse retina. Brain Struct Funct 2024; 229:1279-1298. [PMID: 38703218 DOI: 10.1007/s00429-024-02799-z] [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: 12/06/2023] [Accepted: 04/01/2024] [Indexed: 05/06/2024]
Abstract
β-synuclein, a member of the synuclein family, is frequently co-expressed with α-synuclein in the neural system, where it serves to inhibit abnormal aggregation of α-synuclein in neurodegenerative diseases. Beyond its role in pathological conditions, β-synuclein plays various functions independently of α-synuclein. In our investigation, we discovered a broader expression of β-synuclein in the mouse retina compared to α-synuclein. This widespread pattern implies its potential significance in the retina. Through detailed examination via light- and electron-microscopic immunocytochemistry, we identified β-synuclein expression from the inner segment (IS) and outer segment (OS) of photoreceptor cells to the ganglion cell layer (GCL). Our findings unveiled unique features, including β-synuclein immunoreactive IS and OS of cones, higher expression in cone pedicles than in rod spherules, absence in horizontal cells, limited expression in cone bipolar dendrites and somas, higher expression in cone bipolar terminals, presence in most amacrine cells, and expression in almost majority of somas in GCL with an absence in intrinsically photosensitive retinal ganglion cell (ipRGCs) processes. Notably, all cholinergic amacrine cells express high β- but not α-synuclein, while dopaminergic amacrine cells express α-synuclein exclusively. These distinctive expression patterns offer valuable insights for further exploration into the functions of β-synuclein and its potential role in synuclein pathology within the retina.
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Affiliation(s)
- Wenhui Zhong
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- Laboratory of Retinal Physiology and Disease, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China.
| | - Qingwen Yang
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Laboratory of Retinal Physiology and Disease, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Fenglan Wang
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Laboratory of Retinal Physiology and Disease, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Xin Lin
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Laboratory of Retinal Physiology and Disease, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Zhongqun Chen
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Laboratory of Retinal Physiology and Disease, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Jing Xue
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Laboratory of Retinal Physiology and Disease, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Wenna Zhao
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Laboratory of Retinal Physiology and Disease, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Xiaoqing Liu
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Laboratory of Retinal Physiology and Disease, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Bilin Rao
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Laboratory of Retinal Physiology and Disease, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Jun Zhang
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- Laboratory of Retinal Physiology and Disease, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China.
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Xu T, Liu X, Lin X, Xiao J, Zhang D, Ye F, Lu F, Qu J, Zhang J, Chen JF. Abnormal α-Synuclein Aggregates Cause Synaptic- and Microcircuit-Specific Deficits in the Retinal Rod Pathway. THE AMERICAN JOURNAL OF PATHOLOGY 2024; 194:796-809. [PMID: 38395146 DOI: 10.1016/j.ajpath.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/30/2023] [Accepted: 01/10/2024] [Indexed: 02/25/2024]
Abstract
α-Synuclein (α-Syn) is a key determinator of Parkinson disease (PD) pathology, but synapse and microcircuit pathologies in the retina underlying visual dysfunction are poorly understood. Herein, histochemical and ultrastructural analyses and ophthalmologic measurements in old transgenic M83 PD model (mice aged 16 to 18 months) indicated that abnormal α-Syn aggregation in the outer plexiform layer (OPL) was associated with degeneration in the C-terminal binding protein 2 (CtBP2)+ ribbon synapses of photoreceptor terminals and protein kinase C alpha (PKCα)+ rod bipolar cell terminals, whereas α-Syn aggregates in the inner retina correlated with the reduction and degeneration of tyrosine hydroxylase- and parvalbumin-positive amacrine cells. Phosphorylated Ser129 α-synuclein expression was strikingly restricted in the OPL, with the most severe degenerations in the entire retina, including mitochondrial degeneration and loss of ribbon synapses in 16- to 18-month-old mice. These synapse- and microcircuit-specific deficits of the rod pathway at the CtBP2+ rod terminals and PKCα+ rod bipolar and amacrine cells were associated with attenuated a- and b-wave amplitudes and oscillatory potentials on the electroretinogram. They were also associated with the impairment of visual functions, including reduced contrast sensitivity and impairment of the middle range of spatial frequencies. Collectively, these findings demonstrate that α-Syn aggregates cause the synapse- and microcircuit-specific deficits of the rod pathway and the most severe damage to the OPL, providing the retinal synaptic and microcircuit basis for visual dysfunctions in PD.
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Affiliation(s)
- Tao Xu
- Molecular Neuropharmacology Laboratory and the Eye-Brain Research Center, Wenzhou Medical University, Wenzhou, China; State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China; Oujiang Laboratory, Wenzhou, China
| | - Xin Liu
- Molecular Neuropharmacology Laboratory and the Eye-Brain Research Center, Wenzhou Medical University, Wenzhou, China; State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Xin Lin
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China; Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jiayi Xiao
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China; Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Di Zhang
- Molecular Neuropharmacology Laboratory and the Eye-Brain Research Center, Wenzhou Medical University, Wenzhou, China; Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fenfen Ye
- Molecular Neuropharmacology Laboratory and the Eye-Brain Research Center, Wenzhou Medical University, Wenzhou, China; Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China; Oujiang Laboratory, Wenzhou, China; Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jia Qu
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China; Oujiang Laboratory, Wenzhou, China; Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jun Zhang
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China; Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China.
| | - Jiang-Fan Chen
- Molecular Neuropharmacology Laboratory and the Eye-Brain Research Center, Wenzhou Medical University, Wenzhou, China; State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China; Oujiang Laboratory, Wenzhou, China.
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6
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Yoon B, Sa HS, Kim HJ. Incidence and risk factors of age-related macular degeneration in patients with Parkinson's disease: a population-based study. Front Aging Neurosci 2024; 16:1331786. [PMID: 38706458 PMCID: PMC11066286 DOI: 10.3389/fnagi.2024.1331786] [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: 11/01/2023] [Accepted: 03/27/2024] [Indexed: 05/07/2024] Open
Abstract
Background and objective The association between age-related macular degeneration (AMD) and Parkinson' disease (PD) remains unclear. The aim of the present study was to assess the incidence of AMD in patients with PD, elucidate differences by age and sex, and investigate potential risk factors for AMD. Methods Data were extracted from the Korean National Health Insurance System database, which covers 97% of the Korean population (2002 through 2019). We calculated the incidence of newly diagnosed AMD in patients with PD and used Cox proportional-hazards models to estimate risk factors for AMD, presenting adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Results Of 172,726 patients with PD, 15,800 were newly diagnosed with AMD during the follow-up, including 5,624 men and 10,176 women. The overall incidence of AMD in patients with PD was 13.59 per 1,000 person-years. Stratified by age group and sex, the incidence was higher in women aged 40-69, and conversely higher in men aged 70-89. Risk of AMD was high in older age groups (aHR = 4.36, 95% CI: 3.74-5.09 in the 70 s), female sex (aHR = 1.07, 95% CI: 1.04-1.11), patients with diabetes mellitus (DM) (aHR = 1.14, 95% CI: 1.10-1.18), and patients with hyperlipidemia (aHR = 1.17, 95% CI: 1.13-1.21). Conclusion Our findings suggest that the AMD incidence is higher in patients with PD than in the general population, with varying patterns of sex differences across age groups. Particularly, old age, female sex, presence of DM, and hyperlipidemia are potential risk factors. Therefore, clinicians should pay greater attention to AMD in patients with PD.
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Affiliation(s)
- Bora Yoon
- Department of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho-Seok Sa
- Department of Ophthalmology, ASAN Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatistics, ASAN Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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7
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Stamatelos P, Economou A, Yannis G, Stefanis L, Papageorgiou SG. Parkinson's Disease and Driving Fitness: A Systematic Review of the Existing Guidelines. Mov Disord Clin Pract 2024; 11:198-208. [PMID: 38164044 DOI: 10.1002/mdc3.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 09/21/2023] [Accepted: 11/05/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Motor/nonmotor symptomatology and antiparkinsonian drugs deteriorate the driving ability of Parkinson's disease (PD) patients. OBJECTIVES Treating neurologists are frequently asked to evaluate driving fitness of their patients and provide evidence-based consultation. Although several guidelines have been published, the exact procedure along with the neurologist's role in this procedure remains obscure. METHODS We systematically reviewed the existing guidelines, regarding driving fitness evaluation of PD patients. We searched MEDLINE and Google Scholar and identified 109 articles. After specified inclusion criteria were applied, 15 articles were included (nine national guidelines, five recommendation papers, and one consensus statement). RESULTS The treating physician is proposed as the initial evaluator in 8 of 15 articles (neurologist in 2 articles) and may refer patients for a second-line evaluation. The evaluation should include motor, cognitive, and visual assessment (proposed in 15, 13, and 8 articles, respectively). Specific motor tests are proposed in eight articles (cutoff values in four), whereas specific neuropsychological and visual tests are proposed in seven articles each (cutoff values in four and three articles, respectively). Conditional licenses are proposed in 11 of 15 articles, to facilitate driving for PD patients. We summarized our findings on a graphic of the procedure for driving fitness evaluation of PD patients. CONCLUSIONS Neurological aspects of driving fitness evaluation of PD patients are recognized in most of the guidelines. Motor, neuropsychological, visual, and sleep assessment and medication review are key components. Clear-cut instructions regarding motor, neuropsychological, and visual tests and relative cutoff values are lacking. Conditional licenses and periodical reevaluation of driving fitness are important safety measures.
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Affiliation(s)
- Petros Stamatelos
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Alexandra Economou
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece
| | - George Yannis
- Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Sokratis G Papageorgiou
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
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Tran C, Shen K, Liu K, Ashok A, Ramirez-Zamora A, Chen J, Li Y, Fang R. Deep learning predicts prevalent and incident Parkinson's disease from UK Biobank fundus imaging. Sci Rep 2024; 14:3637. [PMID: 38351326 PMCID: PMC10864361 DOI: 10.1038/s41598-024-54251-1] [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: 05/02/2023] [Accepted: 02/10/2024] [Indexed: 02/16/2024] Open
Abstract
Parkinson's disease is the world's fastest-growing neurological disorder. Research to elucidate the mechanisms of Parkinson's disease and automate diagnostics would greatly improve the treatment of patients with Parkinson's disease. Current diagnostic methods are expensive and have limited availability. Considering the insidious and preclinical onset and progression of the disease, a desirable screening should be diagnostically accurate even before the onset of symptoms to allow medical interventions. We highlight retinal fundus imaging, often termed a window to the brain, as a diagnostic screening modality for Parkinson's disease. We conducted a systematic evaluation of conventional machine learning and deep learning techniques to classify Parkinson's disease from UK Biobank fundus imaging. Our results suggest Parkinson's disease individuals can be differentiated from age and gender-matched healthy subjects with 68% accuracy. This accuracy is maintained when predicting either prevalent or incident Parkinson's disease. Explainability and trustworthiness are enhanced by visual attribution maps of localized biomarkers and quantified metrics of model robustness to data perturbations.
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Affiliation(s)
- Charlie Tran
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Kai Shen
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Kang Liu
- Department of Physics, University of Florida, Gainesville, FL, 32661, USA
| | - Akshay Ashok
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, FL, 32611, USA
| | | | - Jinghua Chen
- Department of Ophthalmology, University of Florida, Gainesville, FL, 32661, USA
| | - Yulin Li
- Department of Biostatistics, University of Florida, Gainesville, FL, 32661, USA
| | - Ruogu Fang
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, 32611, USA.
- J. Crayton Pruitt Family Department of Biomedical Engineering, Herbert Wertheim College of Engineering, University of Florida, 1275 Center Drive, PO Box 116131, Gainesville, FL, 32611-6131, USA.
- Center for Cognitive Aging and Memory, University of Florida, Gainesville, FL, 32611, USA.
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Amini E, Rohani M, Fasano A, Azad Z, Miri S, Habibi SAH, Emamikhah M, Mirshahi R, Joghataei MT, Gholibeigian Z, Ghasemi Falavarjani K. Neurodegeneration with Brain Iron Accumulation Disorders and Retinal Neurovascular Structure. Mov Disord 2024; 39:411-423. [PMID: 37947042 DOI: 10.1002/mds.29644] [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: 05/09/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The unique neurovascular structure of the retina has provided an opportunity to observe brain pathology in many neurological disorders. However, such studies on neurodegeneration with brain iron accumulation (NBIA) disorders are lacking. OBJECTIVES To investigate NBIA's neurological and ophthalmological manifestations. METHODS This cross-sectional study was conducted on genetically confirmed NBIA patients and an age-gender-matched control group. The thickness of retinal layers, central choroidal thickness (CCT), and capillary plexus densities were measured by spectral domain-optical coherence tomography (SD-OCT) and OCT angiography, respectively. The patients also underwent funduscopy, electroretinography (ERG), visual evoked potential (VEP), and neurological examination (Pantothenate-Kinase Associated Neurodegeneration-Disease Rating Scale [PKAN-DRS]). The generalized estimating equation model was used to consider inter-eye correlations. RESULTS Seventy-four patients' and 80 controls' eyes were analyzed. Patients had significantly decreased visual acuity, reduced inner or outer sectors of almost all evaluated layers, increased CCT, and decreased vessel densities, with abnormal VEP and ERG in 32.4% and 45.9%, respectively. There were correlations between visual acuity and temporal peripapillary nerve fiber layer (positive) and between PKAN-DRS score and disease duration (negative), and scotopic b-wave amplitudes (positive). When considering only the PKAN eyes, ONL was among the significantly decreased retinal layers, with no differences in retinal vessel densities. Evidence of pachychoroid was only seen in patients with Kufor Rakeb syndrome. CONCLUSION Observing pathologic structural and functional neurovascular changes in NBIA patients may provide an opportunity to elucidate the underlying mechanisms and differential retinal biomarkers in NBIA subtypes in further investigations. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Elahe Amini
- ENT and Head and Neck Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
- Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rohani
- Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Alfonso Fasano
- University Health Network University of Toronto, Toronto, Ontario, Canada
| | - Zahra Azad
- Skull Base Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Shahnaz Miri
- Vision Neurology Center, San Francisco, California, USA
| | - Seyed Amir Hassan Habibi
- Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Maziar Emamikhah
- Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Mirshahi
- Eye Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | | | - Zeinab Gholibeigian
- Skull Base Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Khalil Ghasemi Falavarjani
- Eye Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
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10
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Casciano F, Zauli E, Celeghini C, Caruso L, Gonelli A, Zauli G, Pignatelli A. Retinal Alterations Predict Early Prodromal Signs of Neurodegenerative Disease. Int J Mol Sci 2024; 25:1689. [PMID: 38338966 PMCID: PMC10855697 DOI: 10.3390/ijms25031689] [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: 12/21/2023] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
Neurodegenerative diseases are an increasingly common group of diseases that occur late in life with a significant impact on personal, family, and economic life. Among these, Alzheimer's disease (AD) and Parkinson's disease (PD) are the major disorders that lead to mild to severe cognitive and physical impairment and dementia. Interestingly, those diseases may show onset of prodromal symptoms early after middle age. Commonly, the evaluation of these neurodegenerative diseases is based on the detection of biomarkers, where functional and structural magnetic resonance imaging (MRI) have shown a central role in revealing early or prodromal phases, although it can be expensive, time-consuming, and not always available. The aforementioned diseases have a common impact on the visual system due to the pathophysiological mechanisms shared between the eye and the brain. In Parkinson's disease, α-synuclein deposition in the retinal cells, as well as in dopaminergic neurons of the substantia nigra, alters the visual cortex and retinal function, resulting in modifications to the visual field. Similarly, the visual cortex is modified by the neurofibrillary tangles and neuritic amyloid β plaques typically seen in the Alzheimer's disease brain, and this may reflect the accumulation of these biomarkers in the retina during the early stages of the disease, as seen in postmortem retinas of AD patients. In this light, the ophthalmic evaluation of retinal neurodegeneration could become a cost-effective method for the early diagnosis of those diseases, overcoming the limitations of functional and structural imaging of the deep brain. This analysis is commonly used in ophthalmic practice, and interest in it has risen in recent years. This review will discuss the relationship between Alzheimer's disease and Parkinson's disease with retinal degeneration, highlighting how retinal analysis may represent a noninvasive and straightforward method for the early diagnosis of these neurodegenerative diseases.
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Affiliation(s)
- Fabio Casciano
- Department of Translational Medicine and LTTA Centre, University of Ferrara, 44121 Ferrara, Italy
| | - Enrico Zauli
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Claudio Celeghini
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Lorenzo Caruso
- Department of Environment and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Arianna Gonelli
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Giorgio Zauli
- Research Department, King Khaled Eye Specialistic Hospital, Riyadh 12329, Saudi Arabia
| | - Angela Pignatelli
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44124 Ferrara, Italy
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11
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Ma JP, Robbins CB, Pead E, McGrory S, Hamid C, Grewal DS, Scott BL, Trucco E, MacGillivray TJ, Fekrat S. Ultra-Widefield Imaging of the Retinal Macrovasculature in Parkinson Disease Versus Controls With Normal Cognition Using Alpha-Shapes Analysis. Transl Vis Sci Technol 2024; 13:15. [PMID: 38231496 PMCID: PMC10795547 DOI: 10.1167/tvst.13.1.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 12/13/2023] [Indexed: 01/18/2024] Open
Abstract
Purpose To investigate retinal vascular characteristics using ultra-widefield (UWF) scanning laser ophthalmoscopy in Parkinson disease (PD). Methods Individuals with an expert-confirmed clinical diagnosis of PD and controls with normal cognition without PD underwent Optos California UWF imaging. Patients with diabetes, uncontrolled hypertension, glaucoma, dementia, other movement disorders, or known retinal or optic nerve pathology were excluded. Images were analyzed using Vasculature Assessment and Measurement Platform for Images of the Retina (VAMPIRE-UWF) software, which describes retinal vessel width gradient and tortuosity, provides vascular network fractal dimensions, and conducts alpha-shape analysis to further characterize vascular morphology (complexity, Opαmin; spread, OpA). Results In the PD cohort, 53 eyes of 38 subjects were assessed; in the control cohort, 51 eyes of 33 subjects were assessed. Eyes with PD had more tortuous retinal arteries in the superotemporal quadrant (P = 0.043). In eyes with PD, alpha-shape analysis revealed decreased OpA, indicating less retinal vasculature spread compared to controls (P = 0.032). Opαmin was decreased in PD (P = 0.044), suggesting increased vascular network complexity. No differences were observed in fractal dimension in any region of interest. Conclusions This pilot study suggests that retinal vasculature assessment on UWF images using alpha-shape analysis reveals differences in retinal vascular network spread and complexity in PD and may be a more sensitive metric compared to fractal dimension. Translational Relevance Retinal vasculature assessment using these novel methods may be useful in understanding ocular manifestations of PD and the development of retinal biomarkers.
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Affiliation(s)
- Justin P. Ma
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Cason B. Robbins
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Emma Pead
- VAMPIRE Project, Centre for Clinical Brain Science, University of Edinburgh, Edinburgh, UK
| | - Sarah McGrory
- VAMPIRE Project, Centre for Clinical Brain Science, University of Edinburgh, Edinburgh, UK
| | - Charlene Hamid
- VAMPIRE Project, Centre for Clinical Brain Science, University of Edinburgh, Edinburgh, UK
| | - Dilraj S. Grewal
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Burton L. Scott
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | | | - Tom J. MacGillivray
- VAMPIRE Project, Centre for Clinical Brain Science, University of Edinburgh, Edinburgh, UK
| | - Sharon Fekrat
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
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12
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Liang K, Li X, Guo Q, Ma J, Yang H, Fan Y, Yang D, Shi X, She Z, Qi X, Gu Q, Chen S, Zheng J, Li D. Structural changes in the retina and serum HMGB1 levels are associated with decreased cognitive function in patients with Parkinson's disease. Neurobiol Dis 2024; 190:106379. [PMID: 38104911 DOI: 10.1016/j.nbd.2023.106379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Cognitive impairment is a serious nonmotor symptom in patients with Parkinson's disease (PD). Currently, there are few studies investigating the relationship of serum markers and retinal structural changes with cognitive function in PD. OBJECTIVE To investigate the relationship between retinal structural changes, serum high mobility group box-1 (HMGB1) levels and cognitive function and motor symptoms in PD patients. METHODS Eighty-nine participants, including 47 PD patients and 42 healthy subjects, were enrolled. PD patients were divided into Parkinson's disease with normal cognitive (PD-NC), Parkinson's disease with mild cognitive impairment (PD-MCI), and Parkinson's disease with dementia (PDD) groups. The motor and nonmotor symptoms of PD patients were evaluated with clinical scale. Serum HMGB1 levels were detected by enzyme-linked immunosorbent assay (ELISA), and ganglion cell-inner plexiform layer complex (GCIPL) thickness changes in the macula were quantitatively analyzed by swept source optical coherence tomography (SS-OCT) in all patients. RESULTS Compared with the control group, the macular GCIPL (t = -2.308, P = 0.023) was thinner and serum HMGB1 (z = -2.285, P = 0.022) was increased in PD patients. Macular GCIPL thickness in patients with PD-MCI and PDD were significantly lower than that in PD-NC patients, but there were no significant difference between the PD-MCI and PDD groups. Serum HMGB1 levels in patients with PD-MCI and PDD were significantly higher than those in PD-NC patients, and serum HMGB1 levels in PDD patients were higher than those in PD-MCI patients. Correlation analysis showed that serum HMGB1 levels in PD patients were positively correlated with disease duration, HY stage, UPDRS-I score, UPDRS-III score, and UPDRS total score and negatively correlated with MOCA score. Macular GCIPL thickness was negatively correlated with HY stage and positively correlated with MOCA score, and macular GCIPL thickness was negatively correlated with serum HMGB1 level. Logistic regression analysis showed that elevated serum HMGB1 level, thinner macular GCIPL thickness, and higher HY stage were independent risk factors for Parkinson's disease with cognitive impairment (PD-CI). The areas under the receiver operating characteristic curve (AUC) for the serum HMGB1 level and macular GCIPL thickness-based diagnosis of PD-MCI, PDD and PD-CI based on in patients with PD were 0.786 and 0.825, 0.915 and 0.856, 0.852 and 0.841, respectively. The AUC for the diagnosis of PD-MCI, PDD and PD-CI with serum HMGB1 level and GCIPL thickness combined were 0.869, 0.967 and 0.916, respectively. CONCLUSION The macular GCIPL thickness and serum HMGB1 level are potential markers of cognitive impairment in PD patients, and their combination can significantly improve the accuracy of the diagnosis of cognitive impairment in PD.
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Affiliation(s)
- Keke Liang
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaohuan Li
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Qingge Guo
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jianjun Ma
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China.
| | - Hongqi Yang
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China.
| | - Yongyan Fan
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Dawei Yang
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xiaoxue Shi
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Zonghan She
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xuelin Qi
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Qi Gu
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Siyuan Chen
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jinhua Zheng
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Dongsheng Li
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
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13
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Tran KK, Lee PY, Finkelstein DI, McKendrick AM, Nguyen BN, Bui BV, Nguyen CT. Altered Outer Retinal Structure, Electrophysiology and Visual Perception in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:167-180. [PMID: 38189711 PMCID: PMC10836541 DOI: 10.3233/jpd-230293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Visual biomarkers of Parkinson's disease (PD) are attractive as the retina is an outpouching of the brain. Although inner retinal neurodegeneration in PD is well-established this has overlap with other neurodegenerative diseases and thus outer retinal (photoreceptor) measures warrant further investigation. OBJECTIVE To examine in a cross-sectional study whether clinically implementable measures targeting outer retinal function and structure can differentiate PD from healthy ageing and whether these are sensitive to intraday levodopa (L-DOPA) dosing. METHODS Centre-surround perceptual contrast suppression, macular visual field sensitivity, colour discrimination, light-adapted electroretinography and optical coherence tomography (OCT) were tested in PD participants (n = 16) and controls (n = 21). Electroretinography and OCT were conducted before and after midday L-DOPA in PD participants, or repeated after ∼2 hours in controls. RESULTS PD participants had decreased center-surround contrast suppression (p < 0.01), reduced macular visual field sensitivity (p < 0.05), color vision impairment (p < 0.01) photoreceptor dysfunction (a-wave, p < 0.01) and photoreceptor neurodegeneration (outer nuclear layer thinning, p < 0.05), relative to controls. Effect size comparison between inner and outer retinal parameters showed that photoreceptor metrics were similarly robust in differentiating the PD group from age-matched controls as inner retinal changes. Electroretinography and OCT were unaffected by L-DOPA treatment or time. CONCLUSIONS We show that outer retinal outcomes of photoreceptoral dysfunction (decreased cone function and impaired color vision) and degeneration (i.e., outer nuclear layer thinning) were equivalent to inner retinal metrics at differentiating PD from healthy age-matched adults. These findings suggest outer retinal metrics may serve as useful biomarkers for PD.
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Affiliation(s)
- Katie K.N. Tran
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Pei Ying Lee
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - David I. Finkelstein
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Allison M. McKendrick
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
- Division of Optometry, School of Allied Health, The University of Western Australia, Crawley, WA, Australia
- Lions Eye Institute, Nedlands, WA, Australia
| | - Bao N. Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Bang V. Bui
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Christine T.O. Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
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14
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Nunes A, Serranho P, Guimarães P, Ferreira J, Castelo-Branco M, Bernardes R. When Sex Matters: Differences in the Central Nervous System as Imaged by OCT through the Retina. J Imaging 2023; 10:6. [PMID: 38248991 PMCID: PMC10817590 DOI: 10.3390/jimaging10010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Retinal texture has gained momentum as a source of biomarkers of neurodegeneration, as it is sensitive to subtle differences in the central nervous system from texture analysis of the neuroretina. Sex differences in the retina structure, as detected by layer thickness measurements from optical coherence tomography (OCT) data, have been discussed in the literature. However, the effect of sex on retinal interocular differences in healthy adults has been overlooked and remains largely unreported. METHODS We computed mean value fundus images for the neuroretina layers as imaged by OCT of healthy individuals. Texture metrics were obtained from these images to assess whether women and men have the same retina texture characteristics in both eyes. Texture features were tested for group mean differences between the right and left eye. RESULTS Corrected texture differences exist only in the female group. CONCLUSIONS This work illustrates that the differences between the right and left eyes manifest differently in females and males. This further supports the need for tight control and minute analysis in studies where interocular asymmetry may be used as a disease biomarker, and the potential of texture analysis applied to OCT imaging to spot differences in the retina.
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Affiliation(s)
- Ana Nunes
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548 Coimbra, Portugal; (A.N.)
| | - Pedro Serranho
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548 Coimbra, Portugal; (A.N.)
- Department of Sciences and Technology, Universidade Aberta, 1269-001 Lisboa, Portugal
| | - Pedro Guimarães
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548 Coimbra, Portugal; (A.N.)
| | - João Ferreira
- Faculty of Sciences and Technology, University of Coimbra, 3030-201 Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548 Coimbra, Portugal; (A.N.)
- Clinical Academic Center of Coimbra (CACC), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Rui Bernardes
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548 Coimbra, Portugal; (A.N.)
- Clinical Academic Center of Coimbra (CACC), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
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15
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Lapointe N, Akitegetse C, Poirier J, Picard M, Sauvageau P, Sauvageau D. Targeted spectroscopy in the eye fundus. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:126004. [PMID: 38111476 PMCID: PMC10725981 DOI: 10.1117/1.jbo.28.12.126004] [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: 05/03/2023] [Revised: 11/18/2023] [Accepted: 11/21/2023] [Indexed: 12/20/2023]
Abstract
Significance The assessment of biomarkers in the eye is rapidly gaining traction for the screening, diagnosis, and monitoring of ocular and neurological diseases. Targeted ocular spectroscopy is a technology that enables concurrent imaging of the eye fundus and analysis of high-quality spectra from a targeted region within the imaged area. This provides structural, compositional, and functional information of specific regions of the eye fundus from a non-invasive approach to ocular biomarker detection. Aim The aim of our study was to demonstrate the multimodal functionality and validation of targeted ocular spectroscopy. This was done in vitro, using a reference target and a model eye, and in vivo. Approach Images and spectra from different regions of a reference target and a model eye were acquired and analyzed to validate the system. Targeted ocular fluorescence spectroscopy was also demonstrated with the same model. Subsequently, in vivo imaging and diffuse reflectance spectra were acquired to assess blood oxygen saturation in the optic nerve head and the parafovea of healthy subjects. Results Tests conducted with the reference target showed accurate spectral analysis within specific areas of the imaging space. In the model eye, distinct spectral signatures were observed for the optic disc, blood vessels, the retina, and the macula, consistent with the variations in tissue composition and functions between these regions. An ocular oximetry algorithm was applied to in vivo spectra from the optic nerve head and parafovea of healthy patients, showing significant differences in blood oxygen saturation. Finally, targeted fluorescence spectral analysis was performed in vitro. Conclusions Diffuse reflectance and fluorescence spectroscopy in specific regions of the eye fundus open the door to a whole new range of monitoring and diagnostic capabilities, from assessment of oxygenation in glaucoma and diabetic retinopathy to photo-oxidation and photodegradation in age-related macular degeneration.
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Affiliation(s)
| | | | | | | | | | - Dominic Sauvageau
- Zilia Inc., Quebec City, Québec, Canada
- University of Alberta, Department of Chemical and Materials Engineering, Edmonton, Alberta, Canada
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16
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Tester NJ, Liu CJ, Shin YC, Shukla AW. Visual Dysfunction and Occupational Performance in Persons With Parkinson's Disease. Am J Occup Ther 2023; 77:7706205060. [PMID: 38048262 PMCID: PMC10846416 DOI: 10.5014/ajot.2023.050235] [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] [Indexed: 12/06/2023] Open
Abstract
IMPORTANCE Visual function is critical to support occupational performance for persons with Parkinson's disease (PwP), yet it can be adversely affected by the disease. OBJECTIVE To evaluate the prevalence and general awareness of visual dysfunction and identify the association between visual dysfunction and occupational performance in PwP. DESIGN Self-reported cross-sectional electronic survey. PARTICIPANTS PwP, identified from a registered database at a neurological institute, were invited to complete the survey through emails and newsletters. OUTCOMES AND MEASURES The survey contained items of self-reported visual difficulties, diagnosed eye conditions, and about general awareness about disease-related visual dysfunction. Ophthalmological symptoms and occupational performance were measured with the Visual Impairment Parkinson's disease Questionnaire and the Revised Self-Reported Functional Visual Performance Scale, respectively. RESULTS Data from PwP (n = 92; Mage = 69 yr) were analyzed. Nearly half were unaware that their disease could affect vision. Awareness was not associated with disease duration. Individuals reporting awareness tended to report difficulties with vision. Functional activities requiring vision were mildly impaired, and the frequency of ophthalmologic symptoms (commonly related to ocular surface disorder) was low. Nevertheless, a higher frequency of ophthalmologic symptoms was positively associated with a higher degree of disability in activities of daily living (Spearman's ρ = .49, p < .01). CONCLUSIONS AND RELEVANCE Visual dysfunction related to Parkinson's disease may affect occupational performance. Screening for changes in vision in these individuals may aid occupational therapists in addressing functional independence and activity engagement. What This Article Adds: People with Parkinson's disease may not have a general awareness that the disease can adversely affect visual function. Those individuals with awareness tend to notice changes in vision, and this disease-related visual dysfunction may limit engagement and participation in everyday activities. Active evaluation of visual function in people with Parkinson's disease is recommended. Occupational therapists could play a key role by screening for visual dysfunction and providing patient education in the clinic.
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Affiliation(s)
- Nicole J Tester
- Nicole J. Tester, PhD, MOT, OTR/L, MSCS, is Occupational Therapist, Occupational Therapy, University of Florida Health Rehabilitation at the Norman Fixel Institute for Neurological Disorders, University of Florida, Gainesville;
| | - Chiung-Ju Liu
- Chiung-ju Liu, PhD, OTR/L, FGSA, is Associate Professor, Occupational Therapy, University of Florida, Gainesville
| | - Yun Chan Shin
- Yun Chan Shin, MOT, is PhD Student, Occupational Therapy, University of Florida, Gainesville
| | - Aparna Wagle Shukla
- Aparna Wagle Shukla, MD, is Professor and Clinical Trial Director, Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida and University of Florida Health, Gainesville
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17
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Subramaniam MD, Aishwarya Janaki P, Abishek Kumar B, Gopalarethinam J, Nair AP, Mahalaxmi I, Vellingiri B. Retinal Changes in Parkinson's Disease: A Non-invasive Biomarker for Early Diagnosis. Cell Mol Neurobiol 2023; 43:3983-3996. [PMID: 37831228 DOI: 10.1007/s10571-023-01419-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023]
Abstract
Parkinson's disease (PD) is caused due to degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNpc) which leads to the depletion of dopamine in the body. The lack of dopamine is mainly due to aggregation of misfolded α-synuclein which causes motor impairment in PD. Dopamine is also required for normal retinal function and the light-dark vision cycle. Misfolded α-synuclein present in inner retinal layers causes vision-associated problems in PD patients. Hence, individuals with PD also experience structural and functional changes in the retina. Mutation in LRRK2, PARK2, PARK7, PINK1, or SNCA genes and mitochondria dysfunction also play a role in the pathophysiology of PD. In this review, we discussed the different etiologies which lead to PD and future prospects of employing non-invasive techniques and retinal changes to diagnose the onset of PD earlier.
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Affiliation(s)
- Mohana Devi Subramaniam
- SN ONGC Department of Genetics and Molecular Biology, Vision Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, 600 006, India.
| | - P Aishwarya Janaki
- SN ONGC Department of Genetics and Molecular Biology, Vision Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, 600 006, India
| | - B Abishek Kumar
- SN ONGC Department of Genetics and Molecular Biology, Vision Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, 600 006, India
| | - Janani Gopalarethinam
- SN ONGC Department of Genetics and Molecular Biology, Vision Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, 600 006, India
| | - Aswathy P Nair
- SN ONGC Department of Genetics and Molecular Biology, Vision Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, 600 006, India
| | - I Mahalaxmi
- Department of Biotechnology, Karpagam Academy of Higher Education (Deemed to be University), Coimbatore, 641021, India
| | - Balachandar Vellingiri
- Department of Zoology, School of Basic Sciences, Central University of Punjab, Bathinda, India
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18
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Shi H, Koronyo Y, Fuchs DT, Sheyn J, Jallow O, Mandalia K, Graham SL, Gupta VK, Mirzaei M, Kramerov AA, Ljubimov AV, Hawes D, Miller CA, Black KL, Carare RO, Koronyo-Hamaoui M. Retinal arterial Aβ 40 deposition is linked with tight junction loss and cerebral amyloid angiopathy in MCI and AD patients. Alzheimers Dement 2023; 19:5185-5197. [PMID: 37166032 PMCID: PMC10638467 DOI: 10.1002/alz.13086] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Vascular amyloid beta (Aβ) protein deposits were detected in retinas of mild cognitively impaired (MCI) and Alzheimer's disease (AD) patients. We tested the hypothesis that the retinal vascular tight junctions (TJs) were compromised and linked to disease status. METHODS TJ components and Aβ expression in capillaries and larger blood vessels were determined in post mortem retinas from 34 MCI or AD patients and 27 cognitively normal controls and correlated with neuropathology. RESULTS Severe decreases in retinal vascular zonula occludens-1 (ZO-1) and claudin-5 correlating with abundant arteriolar Aβ40 deposition were identified in MCI and AD patients. Retinal claudin-5 deficiency was closely associated with cerebral amyloid angiopathy, whereas ZO-1 defects correlated with cerebral pathology and cognitive deficits. DISCUSSION We uncovered deficiencies in blood-retinal barrier markers for potential retinal imaging targets of AD screening and monitoring. Intense retinal arteriolar Aβ40 deposition suggests a common pathogenic mechanism of failed Aβ clearance via intramural periarterial drainage.
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Affiliation(s)
- Haoshen Shi
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Yosef Koronyo
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Dieu-Trang Fuchs
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Julia Sheyn
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ousman Jallow
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Krishna Mandalia
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Stuart L. Graham
- Macquarie Medical school, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
| | - Vivek K. Gupta
- Macquarie Medical school, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
| | - Mehdi Mirzaei
- Macquarie Medical school, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
| | - Andrei A. Kramerov
- Department of Biomedical Sciences and Eye Program, Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Alexander V. Ljubimov
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences and Eye Program, Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Division of Applied Cell Biology and Physiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Debra Hawes
- Department of Pathology Program in Neuroscience, Keck School of Medicine, University of Southern California, Los Angeles, CA 90048, USA
| | - Carol A. Miller
- Department of Pathology Program in Neuroscience, Keck School of Medicine, University of Southern California, Los Angeles, CA 90048, USA
| | - Keith L. Black
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Roxana O. Carare
- Department of Clinical Neuroanatomy, University of Southampton, Southampton SO16 6YD, UK
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Division of Applied Cell Biology and Physiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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Lee YW, Lim MN, Lee JY, Yoo YJ. Central retina thickness measured with spectral-domain optical coherence tomography in Parkinson disease: A meta-analysis. Medicine (Baltimore) 2023; 102:e35354. [PMID: 37800768 PMCID: PMC10553016 DOI: 10.1097/md.0000000000035354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/01/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Optical coherence tomography (OCT) can detect visual alterations associated with Parkinson disease, such as damage to the retinal nerve fiber layer or changes in retinal vasculature. Macula thinning in association with Parkinson disease (PD) remains controversial. Therefore, we conducted a meta-analysis to investigate the central retina thickness in PD measured using spectral-domain OCT (SD-OCT). METHODS We searched PubMed and the Excerpta Medica database to identify studies that compared macular thickness between patients with PD and healthy controls published before July 31, 2021. A random-effects model was used to examine PD-associated changes in macular thickness. Meta-regression analysis was performed by assessing heterogeneity, publication bias, and study quality. RESULTS Thirty-two studies with a cross-sectional design were selected, including 2118 patients with PD and 2338 controls. We identified significant differences in the thickness of the ganglion cell-inner plexiform layer (standardized mean difference [SMD], -0.41; 95% confidence interval [CI], -0.66 to -0.16; I2 = 80%), ganglion cell complex (SMD, -0.33; 95% CI, -0.50 to -0.17; I2 = 0%), and of all inner and outer sectors of the macula (SMD range, -0.21 to -0.56; all P < .05) between patients with PD and controls. DISCUSSION These results corroborate the increased prevalence of changes in OCT measures in individuals with PD, highlighting the efficacy of SD-OCT-determined macular thickness as a biomarker for PD. Our findings may provide helpful guidelines for clinicians in rapidly evolving areas of PD diagnosis.
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Affiliation(s)
- Yong Woo Lee
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
- Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, Korea
| | - Myung-Nam Lim
- Biomedical Research Institute, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jae Yeon Lee
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Yung-Ju Yoo
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
- Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, Korea
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20
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Umar MS, Ibrahim BM. Vitamin A and vitamin D3 protect the visual apparatus during the development of dopamine-2 receptor knockout mouse model of Parkinsonism. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:577-589. [PMID: 37311120 DOI: 10.1515/jcim-2023-0053] [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: 02/28/2023] [Accepted: 05/19/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Dopamine-related movement disorders are associated with a loss of visual acuity. Studies have shown that chemical stimulation of the vitamin D3 receptor (VDR) ameliorates movement disorders; however, the chemical stimulation is not effective when there is a deficiency of vitamin A in the cells. In the study, we examine the role of VDR and its interplay with vitamin A in impaired visual function in the dopamine deficit model. METHODS Thirty (30) male mice with an average weight of 26 g ± (2) were divided into six group (NS,-D2,-D2 + VD D2 + VD, -D2 + VA, -D2 + (VD + VA) and -D2 + D2 groups). Dopamine deficit models of movement disorders were created using 15 mg/kg of haloperidol (-D2) injected intraperitoneally daily for 21 days. In the -D2 + (VD + VA) group, 800 IU/day of vitamin D3 (VD) and 1000 IU/day of vitamin A were concurrently used, while in the -D2 + D2 group, bromocriptine (+D2) was used as the standard treatment of the model. At the end of the treatment phase, the animals were subjected to visual water box test for visual acuity. The level of oxidative stress was measured using Superoxide dismutase (SOD) and malondialdehyde (MDA) in the retina and visual cortex. The level of cytotoxicity in these tissues was measured using Lactate dehydrogenase (LDH) assay, while the structural integrity of these tissues was assessed using a light microscope by assessing slide mounted sections that were stained with haematoxylin and eosin. RESULTS A significant decline in time taken to reach the escape platform in the visual water box test was observed in the -D2 (p<0.005) and -D2 + D2 (p<0.05) group. In the retina and the visual cortex, a significant increase in LDH, MDA and the density of degenerating neurons was observed in the -D2 and -D2 + D2 groups. LDH level in the retina was also found to be significantly increased in (-D2 + VD, -D2 + VA, -D2 + (VD + VA). A Significant decrease in SOD was found in the retina and visual cortex of -D2 and -D2 + D2 group. In the histology of the retina, thinning of the retina, retinal fold, distortion and retinal detachment were all seen in the -D2 group. These structural alterations were not seen in other groups. Histological hallmarks of degeneration were observed in the visual cortex of the mice from the -D2 (p<0.001), -D2 + D2 (p<0.005) and -D2 + VD (p<0.05) groups only. CONCLUSIONS Dopamine-deficient models of movement disorders are associated with loss of visual functions, especially due to thinning of the retina, retinal fold, retinal detachment, and neurodegeneration in the visual cortex. Supplementation during the development of the model with vitamin D3 and vitamin A prevented the deterioration of the retina and visual cortex by reducing the degree of oxidative stress and cytotoxicity.
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21
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Zhang L, Zhuang C, Wang Y, Wang H, Cui G, Guo J. Clinical Observation of Macular Superficial Capillary Plexus and Ganglion Cell Complex in Patients with Parkinson's Disease. Ophthalmic Res 2023; 66:1181-1190. [PMID: 37562366 PMCID: PMC10614441 DOI: 10.1159/000533158] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 07/04/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION We investigated macular superficial capillary plexus (SCP) density and the thicknesses of the ganglion cell complex (GCC) in patients with Parkinson's disease (PD) and correlated them. We also observed the correlations between SCP density and clinical parameters of PD patients. The retina might be a novel biomarker of PD and will be useful in the future for the early diagnosis of PD and detecting disease progression. METHODS Seventy-four participants (38 patients with PD and 36 healthy controls) were recruited at the Affiliated Hospital of Xuzhou Medical University between January 2022 and June 2022 in this study. The macular SCP densities was measured by optical coherence tomography angiography (OCTA), and the GCC thickness was measured by optical coherence tomography (OCT). The parameters were compared between PD patients and healthy controls. The correlation between SCP and clinical parameters was tested. RESULTS Compared with the control group, PD patients showed reduced SCP densities in all areas of the macular region (parafovea-temporal: t = 3.053, p = 0.003; parafovea-superior: t = 3.680, p = 0.001; parafovea-nasal: t = 4.643, p < 0.001; parafovea-inferior: t = 2.254, p = 0.027; perifovea-temporal: t = 3.798, p < 0.001; perifovea-superior: t = 3.014, p = 0.004; perifovea-nasal: t = 2.948, p = 0.004; perifovea-inferior: t = 3.337, p = 0.021). The average GCC thickness in the PD patients was significantly reduced (t = 2.365, p = 0.021). There were positive correlations between the average GCC thickness and the SCP densities in most of the areas of the macular regions in PD patients (parafovea-temporal: r = 0.325, p = 0.005; parafovea-superior: r = 0.295, p = 0.011; parafovea-nasal: r = 0.335, p = 0.003; perifovea-superior: r = 0.362, p = 0.002; perifovea-nasal: r = 0.290, p = 0.012; perifovea-inferior: r = 0.333, p = 0.004). We found significant correlations between SCP densities and Hoehn and Yahr (H and Y) scales, UPDRS III scores, and MMSE scores. No significant correlation was observed between SCP density and PD disease duration (all p > 0.05). CONCLUSIONS We demonstrated that the macular SCP density was decreased, and the average GCC thickness was reduced in PD patients. The correlation between SCP density damage and GCC thinning also suggested that the retinal microvascular damage may be associated with retinal structural degeneration in PD patients. OCTA and OCT may be considered objective biomarkers for detecting microvascular impairment and neuronal damage in the early stages of PD in the future.
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Affiliation(s)
- Ling Zhang
- Department of Ophthalmology, Xuzhou Medical University, Xuzhou, China
| | - Chuchu Zhuang
- Department of Ophthalmology, Xuzhou Medical University, Xuzhou, China
| | - Yining Wang
- Department of Ophthalmology, Xuzhou Medical University, Xuzhou, China
| | - He Wang
- Department of Ophthalmology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Guiyun Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jianxin Guo
- Department of Ophthalmology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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22
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Ungureanu L, Chaudhuri KR, Diaconu S, Falup-Pecurariu C. Dry eye in Parkinson's disease: a narrative review. Front Neurol 2023; 14:1236366. [PMID: 37602267 PMCID: PMC10436221 DOI: 10.3389/fneur.2023.1236366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
In Parkinson's disease (PD) patients, a wide range of ocular and visual disorders are present. Tear film instability, inflammation and dysfunction of the ocular surface, and the presence of symptoms of visual disturbance characterize dry eye, a multifactorial disease of the ocular surface. Based on a literature search, we discuss the frequency, pathogenesis, and influence on the quality of life of patients with dry eye in Parkinson's disease. Furthermore, we review the available means of diagnosis and management of dry eye. An improvement in awareness and recognition of dry eye is needed to provide suitable, personalized therapeutic options for PD patients, aiming to improve their quality of life, independence, and safety.
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Affiliation(s)
- Larisa Ungureanu
- Department of Neurology, County Clinic Hospital, Braşov, Romania
- Faculty of Medicine, Transilvania University, Braşov, Romania
| | - K. Ray Chaudhuri
- Department Basic and Clinical Neuroscience, Parkinson Foundation Centre of Excellence, King's College London, Denmark Hill Campus, King's College Hospital, The Maurice Wohl Clinical Neuroscience Institute, London, United Kingdom
| | - Stefania Diaconu
- Department of Neurology, County Clinic Hospital, Braşov, Romania
- Faculty of Medicine, Transilvania University, Braşov, Romania
| | - Cristian Falup-Pecurariu
- Department of Neurology, County Clinic Hospital, Braşov, Romania
- Faculty of Medicine, Transilvania University, Braşov, Romania
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23
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Maran JJ, Adesina MM, Green CR, Kwakowsky A, Mugisho OO. The central role of the NLRP3 inflammasome pathway in the pathogenesis of age-related diseases in the eye and the brain. Ageing Res Rev 2023; 88:101954. [PMID: 37187367 DOI: 10.1016/j.arr.2023.101954] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 05/17/2023]
Abstract
With increasing age, structural changes occur in the eye and brain. Neuronal death, inflammation, vascular disruption, and microglial activation are among many of the pathological changes that can occur during ageing. Furthermore, ageing individuals are at increased risk of developing neurodegenerative diseases in these organs, including Alzheimer's disease (AD), Parkinson's disease (PD), glaucoma and age-related macular degeneration (AMD). Although these diseases pose a significant global public health burden, current treatment options focus on slowing disease progression and symptomatic control rather than targeting underlying causes. Interestingly, recent investigations have proposed an analogous aetiology between age-related diseases in the eye and brain, where a process of chronic low-grade inflammation is implicated. Studies have suggested that patients with AD or PD are also associated with an increased risk of AMD, glaucoma, and cataracts. Moreover, pathognomonic amyloid-β and α-synuclein aggregates, which accumulate in AD and PD, respectively, can be found in ocular parenchyma. In terms of a common molecular pathway that underpins these diseases, the nucleotide-binding domain, leucine-rich-containing family, and pyrin domain-containing-3 (NLRP3) inflammasome is thought to play a vital role in the manifestation of all these diseases. This review summarises the current evidence regarding cellular and molecular changes in the brain and eye with age, similarities between ocular and cerebral age-related diseases, and the role of the NLRP3 inflammasome as a critical mediator of disease propagation in the eye and the brain during ageing.
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Affiliation(s)
- Jack J Maran
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology and the New Zealand National Eye Centre, University of Auckland, New Zealand
| | - Moradeke M Adesina
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology and the New Zealand National Eye Centre, University of Auckland, New Zealand
| | - Colin R Green
- Department of Ophthalmology and the New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Andrea Kwakowsky
- Pharmacology and Therapeutics, School of Medicine, Galway Neuroscience Centre, University of Galway, Galway, Ireland
| | - Odunayo O Mugisho
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology and the New Zealand National Eye Centre, University of Auckland, New Zealand.
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24
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Qamar MA, Rota S, Batzu L, Subramanian I, Falup-Pecurariu C, Titova N, Metta V, Murasan L, Odin P, Padmakumar C, Kukkle PL, Borgohain R, Kandadai RM, Goyal V, Chaudhuri KR. Chaudhuri's Dashboard of Vitals in Parkinson's syndrome: an unmet need underpinned by real life clinical tests. Front Neurol 2023; 14:1174698. [PMID: 37305739 PMCID: PMC10248458 DOI: 10.3389/fneur.2023.1174698] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
We have recently published the notion of the "vitals" of Parkinson's, a conglomeration of signs and symptoms, largely nonmotor, that must not be missed and yet often not considered in neurological consultations, with considerable societal and personal detrimental consequences. This "dashboard," termed the Chaudhuri's vitals of Parkinson's, are summarized as 5 key vital symptoms or signs and comprise of (a) motor, (b) nonmotor, (c) visual, gut, and oral health, (d) bone health and falls, and finally (e) comorbidities, comedication, and dopamine agonist side effects, such as impulse control disorders. Additionally, not addressing the vitals also may reflect inadequate management strategies, leading to worsening quality of life and diminished wellness, a new concept for people with Parkinson's. In this paper, we discuss possible, simple to use, and clinically relevant tests that can be used to monitor the status of these vitals, so that these can be incorporated into clinical practice. We also use the term Parkinson's syndrome to describe Parkinson's disease, as the term "disease" is now abandoned in many countries, such as the U.K., reflecting the heterogeneity of Parkinson's, which is now considered by many as a syndrome.
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Affiliation(s)
- Mubasher A. Qamar
- Institute of Psychiatry, Psychology and Neuroscience, Department of Basic and Clinical Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Silvia Rota
- Institute of Psychiatry, Psychology and Neuroscience, Department of Basic and Clinical Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Lucia Batzu
- Institute of Psychiatry, Psychology and Neuroscience, Department of Basic and Clinical Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Indu Subramanian
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Parkinson’s Disease Research, Education and Clinical Centers, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, CA, United States
| | - Cristian Falup-Pecurariu
- Faculty of Medicine, Transilvania University of Braşov, Brașov, Romania
- Department of Neurology, County Clinic Hospital, Brașov, Romania
| | - Nataliya Titova
- Department of Neurology, Neurosurgery and Medical Genetics, Federal State Autonomous Educational Institution of Higher Education “N.I. Pirogov Russian National Research Medical University” of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department of Neurodegenerative Diseases, Federal State Budgetary Institution “Federal Center of Brain Research and Neurotechnologies” of the Federal Medical Biological Agency, Moscow, Russia
| | - Vinod Metta
- Institute of Psychiatry, Psychology and Neuroscience, Department of Basic and Clinical Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Lulia Murasan
- Faculty of Medicine, Transilvania University of Braşov, Brașov, Romania
- Department of Neurology, County Clinic Hospital, Brașov, Romania
| | - Per Odin
- Department of Neurology, University Hospital, Lund, Sweden
| | | | - Prashanth L. Kukkle
- Center for Parkinson’s Disease and Movement Disorders, Manipal Hospital, Karnataka, India, Bangalore
- Parkinson’s Disease and Movement Disorders Clinic, Bangalore, Karnataka, India
| | - Rupam Borgohain
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Rukmini Mridula Kandadai
- Department of Neurology, Nizam’s Institute of Medical Sciences, Autonomous University, Hyderabad, India
| | - Vinay Goyal
- Neurology Department, Medanta, Gurugram, India
| | - Kallo Ray Chaudhuri
- Institute of Psychiatry, Psychology and Neuroscience, Department of Basic and Clinical Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
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25
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Ahadi S, Wilson KA, Babenko B, McLean CY, Bryant D, Pritchard O, Kumar A, Carrera EM, Lamy R, Stewart JM, Varadarajan A, Berndl M, Kapahi P, Bashir A. Longitudinal fundus imaging and its genome-wide association analysis provide evidence for a human retinal aging clock. eLife 2023; 12:e82364. [PMID: 36975205 PMCID: PMC10110236 DOI: 10.7554/elife.82364] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Biological age, distinct from an individual's chronological age, has been studied extensively through predictive aging clocks. However, these clocks have limited accuracy in short time-scales. Here we trained deep learning models on fundus images from the EyePACS dataset to predict individuals' chronological age. Our retinal aging clocking, 'eyeAge', predicted chronological age more accurately than other aging clocks (mean absolute error of 2.86 and 3.30 years on quality-filtered data from EyePACS and UK Biobank, respectively). Additionally, eyeAge was independent of blood marker-based measures of biological age, maintaining an all-cause mortality hazard ratio of 1.026 even when adjusted for phenotypic age. The individual-specific nature of eyeAge was reinforced via multiple GWAS hits in the UK Biobank cohort. The top GWAS locus was further validated via knockdown of the fly homolog, Alk, which slowed age-related decline in vision in flies. This study demonstrates the potential utility of a retinal aging clock for studying aging and age-related diseases and quantitatively measuring aging on very short time-scales, opening avenues for quick and actionable evaluation of gero-protective therapeutics.
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Affiliation(s)
- Sara Ahadi
- Google ResearchMountain ViewUnited States
| | | | | | | | | | | | - Ajay Kumar
- Department of Biophysics, Post Graduate Institute of Medical Education and ResearchChandigarhIndia
| | | | - Ricardo Lamy
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma CenterSan FranciscoUnited States
| | - Jay M Stewart
- Department of Ophthalmology, University of California, San FranciscoSan FranciscoUnited States
| | | | | | - Pankaj Kapahi
- Buck Institute for Research on AgingNovatoUnited States
| | - Ali Bashir
- Google ResearchMountain ViewUnited States
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26
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Sánchez-Sáez X, Ortuño-Lizarán I, Sánchez-Castillo C, Lax P, Cuenca N. Starburst amacrine cells, involved in visual motion perception, loose their synaptic input from dopaminergic amacrine cells and degenerate in Parkinson's disease patients. Transl Neurodegener 2023; 12:17. [PMID: 37013599 PMCID: PMC10071607 DOI: 10.1186/s40035-023-00348-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/10/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND The main clinical symptoms characteristic of Parkinson's disease (PD) are bradykinesia, tremor, and other motor deficits. However, non-motor symptoms, such as visual disturbances, can be identified at early stages of the disease. One of these symptoms is the impairment of visual motion perception. Hence, we sought to determine if the starburst amacrine cells, which are the main cellular type involved in motion direction selectivity, are degenerated in PD and if the dopaminergic system is related to this degeneration. METHODS Human eyes from control (n = 10) and PD (n = 9) donors were available for this study. Using immunohistochemistry and confocal microscopy, we quantified starburst amacrine cell density (choline acetyltransferase [ChAT]-positive cells) and the relationship between these cells and dopaminergic amacrine cells (tyrosine hydroxylase-positive cells and vesicular monoamine transporter-2-positive presynapses) in cross-sections and wholemount retinas. RESULTS First, we found two different ChAT amacrine populations in the human retina that presented different ChAT immunoreactivity intensity and different expression of calcium-binding proteins. Both populations are affected in PD and their density is reduced compared to controls. Also, we report, for the first time, synaptic contacts between dopaminergic amacrine cells and ChAT-positive cells in the human retina. We found that, in PD retinas, there is a reduction of the dopaminergic synaptic contacts into ChAT cells. CONCLUSIONS Taken together, this work indicates degeneration of starburst amacrine cells in PD related to dopaminergic degeneration and that dopaminergic amacrine cells could modulate the function of starburst amacrine cells. Since motion perception circuitries are affected in PD, their assessment using visual tests could provide new insights into the diagnosis of PD.
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Grants
- FEDER-PID 2019-106230RB-I00 Ministerio de Ciencia e Innovación
- FEDER-PID 2019-106230RB-I00 Ministerio de Ciencia e Innovación
- FPU16/04114 Ministerio de Universidades
- RETICS-FEDER RD16/0008/0016 Instituto de Salud Carlos III
- IDIFEDER/2017/064 Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital, Generalitat Valenciana
- PROMETEO/2021/024 Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital, Generalitat Valenciana
- PROMETEO/2021/024 Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital, Generalitat Valenciana
- APOSTD/2020/245 Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital, Generalitat Valenciana
- 2019/00286/001 Es Retina Asturias
- 2019/00286/001 Es Retina Asturias
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Affiliation(s)
- Xavier Sánchez-Sáez
- Department of Physiology, Genetics and Microbiology, University of Alicante, San Vicente del Raspeig, Spain
| | - Isabel Ortuño-Lizarán
- Department of Physiology, Genetics and Microbiology, University of Alicante, San Vicente del Raspeig, Spain
| | - Carla Sánchez-Castillo
- Department of Physiology, Genetics and Microbiology, University of Alicante, San Vicente del Raspeig, Spain
| | - Pedro Lax
- Department of Physiology, Genetics and Microbiology, University of Alicante, San Vicente del Raspeig, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Nicolás Cuenca
- Department of Physiology, Genetics and Microbiology, University of Alicante, San Vicente del Raspeig, Spain.
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.
- Ramón Margalef Institute, University of Alicante, San Vicente del Raspeig, Spain.
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Hurst J, Schnichels S. Editorial: Brain vs. retina - Differences and commonalities: The role of oxidative stress in neurodegenerative diseases. Front Neurosci 2023; 17:1171235. [PMID: 36992855 PMCID: PMC10040834 DOI: 10.3389/fnins.2023.1171235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
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28
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Alves JN, Westner BU, Højlund A, Weil RS, Dalal SS. Structural and functional changes in the retina in Parkinson's disease. J Neurol Neurosurg Psychiatry 2023; 94:448-456. [PMID: 36806480 PMCID: PMC7614544 DOI: 10.1136/jnnp-2022-329342] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 01/05/2023] [Indexed: 02/19/2023]
Abstract
Parkinson's disease is caused by degeneration of dopaminergic neurons, originating in the substantia nigra pars compacta and characterised by bradykinesia, rest tremor and rigidity. In addition, visual disorders and retinal abnormalities are often present and can be identified by decreased visual acuity, abnormal spatial contrast sensitivity or even difficulty in complex visual task completion. Because of their early onset in patients with de novo Parkinson's disease, the anatomical retinal changes and electrophysiological modification could be valuable markers even at early stages of the disease. However, due to the concomitant occurrence of normal ageing, the relevance and specificity of these predictive values can be difficult to interpret. This review examines retinal dysfunction arising in Parkinson's disease. We highlight the electrophysiological delays and decreased amplitude in the electroretinography recorded in patients and animal models. We relate this to coexisting anatomical changes such as retinal nerve fibre layer and macular thinning, measured using optical coherence tomography, and show that functional measures are more consistent overall than optical coherence-measured structural changes. We review the underlying chemical changes seen with loss of retinal dopaminergic neurons and the effect of levodopa treatment on the retina in Parkinson's disease. Finally, we consider whether retinal abnormalities in Parkinson's disease could have a role as potential markers of poorer outcomes and help stratify patients at early stages of the disease. We emphasise that retinal measures can be valuable, accessible and cost-effective methods in the early evaluation of Parkinson's disease pathogenesis with potential for patient stratification.
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Affiliation(s)
- Jordan N Alves
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Britta U Westner
- Radboud University, Donders Institute for Brain, Cognition and Behaviours, Nijmegen, The Netherlands
| | - Andreas Højlund
- Department of Linguistics, Cognitive Science & Semiotics, Aarhus University, Aarhus, Denmark
| | - Rimona Sharon Weil
- Dementia Research Centre, University College London, London, UK.,Movement Disorders Consortium, University College London, London, UK.,Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Sarang S Dalal
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
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Lai X, Zhang Y, Wu J, Shen M, Yin S, Yan J. Rutin Attenuates Oxidative Stress Via PHB2-Mediated Mitophagy in MPP +-Induced SH-SY5Y Cells. Neurotox Res 2023; 41:242-255. [PMID: 36738374 DOI: 10.1007/s12640-023-00636-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 02/05/2023]
Abstract
Oxidative stress plays a crucial role in the occurrence and development of Parkinson's disease (PD). Rutin, a natural botanical ingredient, has been shown to have antioxidant properties. Therefore, the aim of this study was to investigate the neuroprotective effects of rutin on PD and the underlying mechanisms. MPP+(1-methyl-4-phenylpyridinium ions)-treated SH-SY5Y cells were used as an in vitro model of PD. Human PHB2-shRNA lentiviral particles were transfected into SH-SY5Y cells to interfere with the expression of Prohibitin2 (PHB2). The oxidative damage of cells was analyzed by detecting intracellular reactive oxygen species (ROS), malondialdehyde (MDA), and mitochondrial membrane potential (MMP). Western blotting was used to detect the protein expression of antioxidant factors such as nuclear factor E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), NADPH quinone oxidoreductase-1 (NQO-1), and mitophagy factors PHB2, translocase of outer mitochondrial membrane 20 (TOM20), and LC3II/LC3I (microtubule-associated protein II light chain 3 (LC3II) to microtubule-associated protein I light chain 3 (LC3I)). In addition, we also examined the expression of PHB2 and LC3II/LC3I by immunofluorescence staining. MPP+ treatment significantly increased the generation of ROS and MDA and the level of MMP depolarization and decreased the protein expression of Nrf2, HO-1, NQO1, TOM20, PHB2, and LC3II/LC3I. In MPP+-treated SH-SY5Y cells, rutin significantly decreased the generation of ROS and MDA and the level of MMP depolarization and increased the protein expression of Nrf2, HO-1, NQO-1, TOM20, PHB2, and LC3II/LC3I. However, the protective role of rutin was inhibited in PHB2-silenced cells. Rutin attenuates oxidative damage which may be associated with PHB2-mediated mitophagy in MPP+-induced SH-SY5Y cells. Rutin might be used as a potential drug for the prevention and treatment of PD.
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Affiliation(s)
- Xiaoyi Lai
- Neuromolecular Biology Laboratory, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Jinghua Road 24, Luoyang, 471003, People's Republic of China
| | - Yongjiang Zhang
- Neuromolecular Biology Laboratory, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Jinghua Road 24, Luoyang, 471003, People's Republic of China
| | - Jiannan Wu
- Neuromolecular Biology Laboratory, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Jinghua Road 24, Luoyang, 471003, People's Republic of China
| | - Mengmeng Shen
- Neuromolecular Biology Laboratory, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Jinghua Road 24, Luoyang, 471003, People's Republic of China
| | - Shiyi Yin
- Neuromolecular Biology Laboratory, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Jinghua Road 24, Luoyang, 471003, People's Republic of China
| | - Junqiang Yan
- Neuromolecular Biology Laboratory, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Jinghua Road 24, Luoyang, 471003, People's Republic of China. .,Department of Neurology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, People's Republic of China.
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Ryan AK, Rich W, Reilly MA. Oxidative stress in the brain and retina after traumatic injury. Front Neurosci 2023; 17:1021152. [PMID: 36816125 PMCID: PMC9935939 DOI: 10.3389/fnins.2023.1021152] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023] Open
Abstract
The brain and the retina share many physiological similarities, which allows the retina to serve as a model of CNS disease and disorder. In instances of trauma, the eye can even indicate damage to the brain via abnormalities observed such as irregularities in pupillary reflexes in suspected traumatic brain injury (TBI) patients. Elevation of reactive oxygen species (ROS) has been observed in neurodegenerative disorders and in both traumatic optic neuropathy (TON) and in TBI. In a healthy system, ROS play a pivotal role in cellular communication, but in neurodegenerative diseases and post-trauma instances, ROS elevation can exacerbate neurodegeneration in both the brain and the retina. Increased ROS can overwhelm the inherent antioxidant systems which are regulated via mitochondrial processes. The overabundance of ROS can lead to protein, DNA, and other forms of cellular damage which ultimately result in apoptosis. Even though elevated ROS have been observed to be a major cause in the neurodegeneration observed after TON and TBI, many antioxidants therapeutic strategies fail. In order to understand why these therapeutic approaches fail further research into the direct injury cascades must be conducted. Additional therapeutic approaches such as therapeutics capable of anti-inflammatory properties and suppression of other neurodegenerative processes may be needed for the treatment of TON, TBI, and neurodegenerative diseases.
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Affiliation(s)
- Annie K. Ryan
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States
| | - Wade Rich
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States
| | - Matthew A. Reilly
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States,Department of Ophthalmology and Visual Sciences, The Ohio State University, Columbus, OH, United States,*Correspondence: Matthew A. Reilly,
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Melo P, S Silveira M, Mendes-Pinto I, Relvas JB. MorphoMacro for in vivo and ex vivo quantitative morphometric analysis of microglia. Methods Cell Biol 2023; 174:75-92. [PMID: 36710053 DOI: 10.1016/bs.mcb.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Microglia cells dynamically survey the central nervous system microenvironment and, in response to tissue damage inflicted by radiation therapy, disease or infection, undergo morphological and functional changes that culminate in microglia activation. Cell shape transformation can be assessed descriptively or, alternatively, it can be quantified as a continuous variable for parameters including total cell size as well as protrusion length, ramification and complexity. The purpose of the MorphoMacro method is to quantitatively profile multiple and single microglia cells using the available ImageJ platform. This method outlines the required steps and ImageJ plugins to convert fluorescence and bright-field photomicrographs into representative binary and skeletonized images and to analyze them using the MorphoMacro software plugin for multiparametric and multilevel description of microglia cell morphology in vivo and ex vivo. Overall, the protocol provides a quantitative and comprehensive tool that can be used to identify, stratify, and monitor diverse microglia morphologies in homeostatic, different disease conditions and subsequent therapeutic monitoring.
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Affiliation(s)
- Pedro Melo
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal
| | - Mariana S Silveira
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Inês Mendes-Pinto
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal.
| | - João B Relvas
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Departmento de Biomedicina, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
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32
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Alenikova OA, Dymkovskaya MN. [Features of visual, cognitive and neuroimaging changes in Parkinson's disease patients with freezing of gait]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:59-66. [PMID: 36719120 DOI: 10.17116/jnevro202312301159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To determine visual and cognitive impairments in relation to MRI changes in patients with freezing of Gait (FOG) in Parkinson's disease (PD). MATERIAL AND METHODS We examined 78 patients with PD without dementia, who were divided into groups according to the presence (FOG«+» group) or absence (FOG«-» group) of «freezing» episodes. RESULTS A decrease in contrast sensitivity (CS) and retinal photosensitivity was determined in all subjects with PD, but in patients with FOG, the decrease in CS was more pronounced. There was a significant decrease in the volume of the cuneus, lingual gyrus, posterior cingulate gyrus, superior parietal lobe and middle frontal gyrus in the FOG«+» group. It was revealed that patients with FOG had cognitive impairments of both the frontal and posterior cortical subtypes, while in the FOG«-» group, only visuospatial deficit prevailed. A direct correlation was determined between the severity of FOG and part I of the UPDRS scale, between a decrease in CS and cortical areas related to the dorsal and ventral visual information processing systems. The presence of a negative relationship between the scores of the FOG-Q, Timed Up and Go test and the volume of cortical areas of the frontal lobe responsible for planning and programming of movements indicates their role in the development of FOG in PD. CONCLUSION Thus, visual impairments associated with PD, along with a heterogeneous profile of cognitive impairment, make a significant contribution to the development of FOG.
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Affiliation(s)
- O A Alenikova
- Republican Scientific and Practical Center of Neurology and Neurosurgery, Minsk, Republic of Belarus
| | - M N Dymkovskaya
- Republican Scientific and Practical Center of Neurology and Neurosurgery, Minsk, Republic of Belarus
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Chaitanuwong P, Jariyakosol S, Apinyawasisuk S, Hirunwiwatkul P, Lawanlattanagul H, Hemrungrojn S, Chongpison Y. Changes in Ocular Biomarkers from Normal Cognitive Aging to Alzheimer's Disease: A Pilot Study. Eye Brain 2023; 15:15-23. [PMID: 36891125 PMCID: PMC9986468 DOI: 10.2147/eb.s391608] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/16/2023] [Indexed: 03/05/2023] Open
Abstract
Purpose To identify ophthalmic findings in Alzheimer's type dementia (ATD) compared to normal subjects. Patients and Methods This comparative descriptive study included participants from the institution's cognitive fitness center. Complete ophthalmic examinations were performed. Optical coherence tomography (OCT) and OCT angiography (OCTA) were used to analyze retinal thickness and vascular density. The Ocular Surface Disease Index (OSDI) score and tear breakup time (TBUT) were used to assess dry eye. The blink rate was counted by a well-trained observer. Cognitive function was evaluated using the Thai Mental State Examination (TMSE) score. Correlation analysis was performed to compare OCT, OCTA parameters, and TMSE. Results We included 24 ATD patients and 39 normal participants as a control group by age and sex-matched. The prevalence of dry eye using the Asia Dry Eye Society criteria was 15% and 13% in normal and ATD patients, respectively. The differences in OSDI scores, TBUT, and blink rate between the two groups were not statistically significant. The parafoveal and perifoveal macular thickness of the ATD group were significantly lower than that of the control group (p<0.01). All parameters of the vessel density of the ATD group were significantly lower than in the control group, including the whole macular vessel density (p<0.01), optic disc vessel density at the nerve head level (p<0.01), and optic disc vessel density at the radial peripapillary capillary level (p<0.05). After age adjustment, there were no statistically significant differences in all the OCT and OCTA parameters. There was a positive correlation between retinal thickness and vessel density in the macular and optic disc region and TMSE scores. Conclusion Perifoveal and parafoveal retinal thickness might be more sensitive than peripapillary RNFL thickness to detect neurodegenerative changes in patients with ATD. Macular thickness and vessel density reduction were also positively correlated with cognitive decline.
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Affiliation(s)
- Pareena Chaitanuwong
- Ophthalmology Department, Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand.,Department of Ophthalmology, Faculty of Medicine, Rangsit University, Bangkok, Thailand
| | - Supharat Jariyakosol
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Ophthalmology Department, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Supanut Apinyawasisuk
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Ophthalmology Department, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Parima Hirunwiwatkul
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Ophthalmology Department, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Hathairat Lawanlattanagul
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Ophthalmology Department, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Solaphat Hemrungrojn
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yuda Chongpison
- Biostatistics Excellence Center, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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The Relationship between Visual-Evoked Potential and Optic Coherence Tomography and Clinical Findings in Parkinson Patients. PARKINSON'S DISEASE 2023; 2023:7739944. [PMID: 36873294 PMCID: PMC9981293 DOI: 10.1155/2023/7739944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 12/14/2022] [Accepted: 01/18/2023] [Indexed: 02/25/2023]
Abstract
Background In Parkinson's disease (PD), dopamine deficiency is present not only in the nigrostriatal pathway but also in the retinal and visual pathways. Optic coherence tomography (OCT) can be used as morphological evidence of visual influence from early nonmotor symptoms. The aim of this study was to investigate the relationship of OCT and visual evoked potentials (VEPs) of eyes with the severity of clinical findings and ocular findings in PD. Methods A group of 42 patients diagnosed with idiopathic PD and a control group of 29 people between the ages of 45-85 were included in our study. VEP was recorded in the patient and control groups. OCT measurement was made with the Optovue spectral-domain device. Foveal thickness and macular volume were measured in the foveal region and in the parafoveal and perifoveal regions in the temporal, superior, nasal, and inferior quadrants. RNFL (retinal nerve fiber layer) was measured in temporal, superior, nasal, and inferior quadrants. Ganglion cell complex (GCC) was evaluated in the superior and inferior quadrants. Using the UPDRS clinical scale, the relationship between measurements and the differences between the control group and the patient group were evaluated. Results Among the OCT values in our study, foveal, parafoveal, perifoveal thickness, macular volume, RNFL, and GCC measurements were performed for the right and left eyes, and no difference was found between the patient group and the control group. There was no difference in VEP amplitude and latency values between the patient and control groups. The relationships between UPDRS and modified Hoehn Yahr staging and OCT and VEP measurements in the patient revealed no correlation. Conclusions Studies on whether OCT measurements can functionally be a marker or which segments are more valuable for disease progression in patients with PD are needed. Visual dysfunction in PD cannot be attributed only to retinal pathology; however, the retina may provide monitoring of the status of dopaminergic neurodegeneration and axonal loss in PD.
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Diez-Cirarda M, Cabrera-Zubizarreta A, Murueta-Goyena A, Strafella AP, Del Pino R, Acera M, Lucas-Jiménez O, Ibarretxe-Bilbao N, Tijero B, Gómez-Esteban JC, Gabilondo I. Multimodal visual system analysis as a biomarker of visual hallucinations in Parkinson's disease. J Neurol 2023; 270:519-529. [PMID: 36348068 DOI: 10.1007/s00415-022-11427-x] [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: 07/21/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/09/2022]
Abstract
Visual hallucinations (VH) are present in up to 75% of Parkinson's disease (PD) patients. However, their neural bases and participation of the visual system in VH are not well-understood in PD. Seventy-four participants, 12 PD with VH (PDVH), 35 PD without VH (PDnoVH) and 27 controls underwent a battery of primary visual function and visual cognition tests, retinal optical coherence tomography and structural and resting-state functional brain MRI. We quantified cortical thickness with Freesurfer and functional connectivity (FC) of Visual (VIS), Fronto-Parietal (FP), Ventral Attention (VAN) and Dorsal Attention (DAN) networks with CONN toolbox. Group comparisons were performed with MANCOVA. Area Under the Curve (AUC) was computed to assess the ability of visual variables to differentiate PDVH and PDnoVH. There were no significant PDVH vs PDnoVH differences in disease duration, motor manifestations, general cognition or dopamine agonist therapy (DA) use. Compared to PDnoVH and HC, and regardless of DA use, PDVH showed significantly reduced contrast sensitivity, visuoperceptive and visuospatial abilities, increased retina photoreceptor layer thickness, reduced cortical thickness mostly in right visual associative areas, decreased between-network VIS-VAN and VAN-DAN connectivity and increased within-network DAN connectivity. The combination of clinical and imaging variables that best discriminated PDVH and PDnoVH (highest AUC), where within-network DAN FC, photoreceptor layer thickness and cube analysis test from Visual Object and Space Perception Battery (accuracy of 81.8%). Compared to PDnoVH, PDVH have specific functional and structural abnormalities within the visual system, which can be quantified non-invasively and could potentially constitute biomarkers for VH in PD.
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Affiliation(s)
- Maria Diez-Cirarda
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain.
| | | | - Ane Murueta-Goyena
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain
- Department of Neurosciences, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Antonio P Strafella
- Krembil Brain Institute, UHN & Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, University of Toronto, Toronto, Canada
| | - Rocio Del Pino
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain
| | - Marian Acera
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain
| | - Olaia Lucas-Jiménez
- Department of Psychology, Faculty of Health Sciences, Univesity of Deusto, Bilbao, Spain
| | - Naroa Ibarretxe-Bilbao
- Department of Psychology, Faculty of Health Sciences, Univesity of Deusto, Bilbao, Spain
| | - Beatriz Tijero
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain
- Department of Neurology, Cruces University Hospital, Barakaldo, Spain
| | - Juan Carlos Gómez-Esteban
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain
- Department of Neurosciences, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Neurology, Cruces University Hospital, Barakaldo, Spain
| | - Iñigo Gabilondo
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain.
- Department of Neurology, Cruces University Hospital, Barakaldo, Spain.
- IKERBASQUE: The Basque Foundation for Science, Bilbao, Spain.
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Gunay BO, Usta NC. Retinal pigment epithelial changes in Parkinson's disease: A spectral domain optical coherence tomography study. Photodiagnosis Photodyn Ther 2022; 41:103213. [PMID: 36436734 DOI: 10.1016/j.pdpdt.2022.103213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/23/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate retinal pigment epithelium (RPE) changes in Parkinson's Disease (PD) and to compare choroidal thickness (CT) and retinal layers with healthy controls. METHODS Parkinson's patients older than 18 and the age-sex match control group were included in this prospective observational study. The neurological and ophthalmological evaluation was performed. All participants were examined by spectral-domain optical coherence tomography. Focal RPE changes were defined as local RPE changes observed in any macula scan. RESULTS Forty (24 male, mean age 69.2 years) participants were included in the study group, and 44 (24 male, mean age 68.9 years) participants in the control group. There was no significant difference between groups in terms of age and sex. All patients were using oral dopaminergic and/or non-dopaminergic therapy. The RPE changes in the macular area were observed in 14/40 PD eyes (35%) and were significantly more frequent than in the control group (2/44, 4.5%, P = 0.001). All of the RPE changes were RPE thickening (±additional finding: subretinal deposit, subRPE deposit). The logistic regression model for possible factors that may affect RPE changes revealed statistical significance in prolonging disease duration; however, age, sex, and the presence of hypertension were not significant. Inferior 3-mm RPE layer thickness was found to be thicker in PD. There was no significant difference between groups in terms of CT, retinal layers, and peripapillary retinal nerve fiber layer thickness (RNFLT), except inferonasal RNFLT which was thinner in the study group. CONCLUSIONS The RPE changes are more frequent in patients with PD than in the control group in the macular area. The most frequent RPE change is the focal thickening of RPE, and RPE changes were associated with disease duration. We cannot distinguish a potential drug effect from a true potential effect of the disease in question.
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Affiliation(s)
- Betul Onal Gunay
- Department of Ophthalmology, University of Health Sciences,Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.
| | - Nuray Can Usta
- Department of Neurology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
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Prevalence and characteristics of dry eye disease in Parkinson's disease: a systematic review and meta-analysis. Sci Rep 2022; 12:18348. [PMID: 36319814 PMCID: PMC9626467 DOI: 10.1038/s41598-022-22037-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/07/2022] [Indexed: 11/29/2022] Open
Abstract
We investigated and characterized the prevalence of dry eye disease (DED) in Parkinson's disease (PD). PubMed and EMBASE databases were searched for relevant studies between January 1, 1979 and March 10, 2022. Quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Study-specific estimates were combined using the DerSimonian-Laird random-effects model. Prevalence of subjective DED symptoms in patients with PD and mean differences in blink rate, corneal thickness, tear film breakup time, and tear secretion volume on Schirmer test I were compared to those in controls. Of 383 studies, 13 (1519 patients with PD) and 12 were included in qualitative and quantitative syntheses, respectively. Meta-analysis revealed a 61.1% prevalence of subjective DED symptoms in PD and that, compared with controls, patients with PD had significantly lower blink rate, thinner corneal thickness, shorter tear film breakup time, and lower tear secretion volumes on Schirmer test I, without and with anesthesia.
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Arthur P, Muok L, Nathani A, Zeng EZ, Sun L, Li Y, Singh M. Bioengineering Human Pluripotent Stem Cell-Derived Retinal Organoids and Optic Vesicle-Containing Brain Organoids for Ocular Diseases. Cells 2022; 11:3429. [PMID: 36359825 PMCID: PMC9653705 DOI: 10.3390/cells11213429] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/13/2022] [Accepted: 10/23/2022] [Indexed: 08/24/2023] Open
Abstract
Retinal organoids are three-dimensional (3D) structures derived from human pluripotent stem cells (hPSCs) that mimic the retina's spatial and temporal differentiation, making them useful as in vitro retinal development models. Retinal organoids can be assembled with brain organoids, the 3D self-assembled aggregates derived from hPSCs containing different cell types and cytoarchitectures that resemble the human embryonic brain. Recent studies have shown the development of optic cups in brain organoids. The cellular components of a developing optic vesicle-containing organoids include primitive corneal epithelial and lens-like cells, retinal pigment epithelia, retinal progenitor cells, axon-like projections, and electrically active neuronal networks. The importance of retinal organoids in ocular diseases such as age-related macular degeneration, Stargardt disease, retinitis pigmentosa, and diabetic retinopathy are described in this review. This review highlights current developments in retinal organoid techniques, and their applications in ocular conditions such as disease modeling, gene therapy, drug screening and development. In addition, recent advancements in utilizing extracellular vesicles secreted by retinal organoids for ocular disease treatments are summarized.
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Affiliation(s)
- Peggy Arthur
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
| | - Laureana Muok
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL 32306, USA
| | - Aakash Nathani
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
| | - Eric Z. Zeng
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL 32306, USA
| | - Li Sun
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL 32306, USA
- Department of Biomedical Sciences, College of Medicine, Florida State University, Tallahassee, FL 32306, USA
| | - Yan Li
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL 32306, USA
| | - Mandip Singh
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
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A Comprehensive Assessment of Qualitative and Quantitative Prodromal Parkinsonian Features in Carriers of Gaucher Disease-Identifying Those at the Greatest Risk. Int J Mol Sci 2022; 23:ijms232012211. [PMID: 36293067 PMCID: PMC9603254 DOI: 10.3390/ijms232012211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
Carriers of GBA1 gene variants have a significant risk of developing Parkinson’s disease (PD). A cohort study of GBA carriers between 40−75 years of age was initiated to study the presence of prodromal PD features. Participants underwent non-invasive tests to assess different domains of PD. Ninety-eight unrelated GBA carriers were enrolled (43 males) at a median age (range) of 51 (40−74) years; 71 carried the N370S variant (c.1226A > G) and 25 had a positive family history of PD. The Montreal Cognitive Assessment (MoCA) was the most frequently abnormal (23.7%, 95% CI 15.7−33.4%), followed by the ultrasound hyperechogenicity (22%, 95% CI 14−32%), Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) (17.2%, 95% CI 10.2−26.4%), smell assessment (12.4%, 95% CI 6.6−20.6%) and abnormalities in sleep questionnaires (11%, 95% CI 5.7−19.4%). Significant correlations were found between tests from different domains. To define the risk for PD, we assessed the bottom 10th percentile of each prodromal test, defining this level as “abnormal”. Then we calculated the percentage of “abnormal” tests for each subject; the median (range) was 4.55 (0−43.5%). Twenty-two subjects had more than 15% “abnormal” tests. The limitations of the study included ascertainment bias of individuals with GBA-related PD in relatives, some incomplete data due to technical issues, and a lack of well-characterized normal value ranges in some tests. We plan to enroll additional participants and conduct longitudinal follow-up assessments to build a model for identifying individuals at risk for PD and investigate interventions aiming to delay the onset or perhaps to prevent full-blown PD.
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Das J, Morris R, Barry G, Vitorio R, Oman P, McDonald C, Walker R, Stuart S. Exploring the feasibility of technological visuo-cognitive training in Parkinson's: Study protocol for a pilot randomised controlled trial. PLoS One 2022; 17:e0275738. [PMID: 36206239 PMCID: PMC9543984 DOI: 10.1371/journal.pone.0275738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 08/19/2022] [Indexed: 11/12/2022] Open
Abstract
Visual and cognitive dysfunction are common in Parkinson's disease and relate to balance and gait impairment, as well as increased falls risk and reduced quality of life. Vision and cognition are interrelated (termed visuo-cognition) which makes intervention complex in people with Parkinson's (PwP). Non-pharmacological interventions for visuo-cognitive deficits are possible with modern technology, such as combined mobile applications and stroboscopic glasses, but evidence for their effectiveness in PwP is lacking. We aim to investigate whether technological visuo-cognitive training (TVT) can improve visuo-cognitive function in PwP. We will use a parallel group randomised controlled trial to evaluate the feasibility and acceptability of TVT versus standard care in PwP. Forty PwP who meet our inclusion criteria will be randomly assigned to one of two visuo-cognitive training interventions. Both interventions will be carried out by a qualified physiotherapist in participants own homes (1-hour sessions, twice a week, for 4 weeks). Outcome measures will be assessed on anti-parkinsonian medication at baseline and at the end of the 4-week intervention. Feasibility of the TVT intervention will be assessed in relation to safety and acceptability of the technological intervention, compliance and adherence to the intervention and usability of equipment in participants homes. Additionally, semi structured interviews will be conducted to explore participants' experience of the technology. Exploratory efficacy outcomes will include change in visual attention measured using the Trail Making Test as well as changes in balance, gait, quality of life, fear of falling and levels of activity. This pilot study will focus on the feasibility and acceptability of TVT in PwP and provide preliminary data to support the design of a larger, multi-centre randomised controlled trial. This trial is registered at isrctn.com (ISRCTN46164906).
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Affiliation(s)
- Julia Das
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Rosie Morris
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Gill Barry
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Rodrigo Vitorio
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Paul Oman
- Department of Mathematics, Physics & Electrical Engineering, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Claire McDonald
- Gateshead Health NHS Foundation Trust, Gateshead, United Kingdom
| | - Richard Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Samuel Stuart
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
- * E-mail:
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Hu ZX, Pu JL, Zheng R, Yan YQ, Liu KY, Liu Y, Zheng R, Chen Y, Lin ZH, Xue NJ, Li P, Zhang BR. Mitochondrial morphology and synaptic structure altered in the retina of parkin-deficient mice. Neurosci Lett 2022; 790:136888. [PMID: 36179903 DOI: 10.1016/j.neulet.2022.136888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/28/2022]
Abstract
Mutations in the PRKN gene are the major cause of autosomal recessive Parkinson's disease (PD). However, studies of parkin-/- mice did not show the loss of dopaminergic neurons and motor phenotypes at a young age. Whether pathological changes are associated with nonmotor symptoms of PD remains unclear. Visual impairment is one common nonmotor symptom in patients with PD. This study aimed to examine the effects of parkin-/- on mitochondria and synaptic structures in the retina of 6-month-old mice. Compared with wild-type mice, parkin-/- mice exhibited a slightly thickened retina. Also, the number of normal mitochondria (mito-5 grade) in rod spherules (RSs) significantly decreased (p < 0.01), the average area of mitochondria was significantly larger (p < 0.001), and the number of ribbons in RSs significantly decreased (p = 0.02). The RSs of parkin-/- mice showed severe swelling after flicker stimulation. Our study implicated that parkin-/- led to the impairment of mitochondria and abnormality of the synaptic structure in mouse retina at a young age, which damaged the synaptic transmission between photoreceptors and second-order retinal neurons and resulted in visual impairment.
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Affiliation(s)
- Zheng-Xiang Hu
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Neurology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jia-Li Pu
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Rong Zheng
- State Key Lab of Modern Optical Instrumentation, Department of Optical Engineering, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yi-Qun Yan
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Kai-Yuan Liu
- State Key Lab of Modern Optical Instrumentation, Department of Optical Engineering, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yi Liu
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ran Zheng
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ying Chen
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhi-Hao Lin
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Nai-Jia Xue
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Peng Li
- State Key Lab of Modern Optical Instrumentation, Department of Optical Engineering, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Bao-Rong Zhang
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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Deng Y, Jie C, Wang J, Liu Z, Li Y, Hou X. Evaluation of retina and microvascular changes in the patient with Parkinson's disease: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:957700. [PMID: 36186761 PMCID: PMC9520292 DOI: 10.3389/fmed.2022.957700] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background Parkinson's disease (PD) is a multifaceted neurodegenerative disease. The optic nerve, as a window into the central nervous system (CNS), is known to be an important part of the CNS and can be detected non-invasively. With the widespread availability of optical coherence tomography (OCT) devices, an increasing number of studies have paid attention to the neuropathological disorders in the retina of PD patients in recent years. However, it is still controversial whether OCT can be used as a complementary tool for PD diagnosis. Methods This review is registered with PROSPERO, number CRD42022301258. The Embase, PUBMED, and The Cochrane Library databases were independently retrieved by 2 investigators to identify relevant papers published from 1 January 2017 to 24 January 2022. These studies used OCT or OCTA to evaluate the difference in the retinal nerve fiber layer (RNFL) thickness, ganglion cell layer(GCL) thickness, macula thickness, Cup and disk area superficial retinal capillary plexus (SCP), and deep retinal capillary plexus(DCP). The standard mean difference (SMD) with the 95% confidence interval (CI) was pooled for continuous outcomes. Results In total, 26 studies had been enrolled in this meta-analysis with a total number of 2,790 eyes, including 1,343 eyes from the PD group along with 1,447 eyes from the HC group. The results revealed that the RNFL thickness (SMD: -0.53; 95%CI, -0.71∼-0.35; P < 0.00001), GCL thickness (SMD: -0.43; 95%CI, -0.66 to -0.19; P = 0.0003), macula thickness (SMD: -0.22; 95%CI, -0.22 to -0.11; P < 0.0001) were significantly thinner in patients with PD. The SCP (SMD: -0.61; 95%CI, -1.31to -0.10; P = 0.02) was significantly lower in PD patients. The DCP (SMD: -0.48; 95%CI, -1.02 to -0.06; P = 0.08) is lower in PD patients, but the difference was statistically insignificant. Conclusion Retinal nerve fiber layer thickness, GCL thickness, macular thickness, and SVD of PD patients are lower than those of healthy control. OCT and OCTA could detect morphological retinal changes in PD and might be objective and reproducible auxiliary tools to assist clinician diagnosis. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022301258].
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Affiliation(s)
| | - Chuanhong Jie
- Eye Hospital China Academy of Chinese Medical Sciences, Beijing, China
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Zhang Y, Yang L, Gao Y, Zhang D, Tao Y, Xu H, Chen Y, Xu Y, Zhang M. Choroid and choriocapillaris changes in early-stage Parkinson’s disease: a swept-source optical coherence tomography angiography-based cross-sectional study. Alzheimers Res Ther 2022; 14:116. [PMID: 36008844 PMCID: PMC9404633 DOI: 10.1186/s13195-022-01054-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 07/27/2022] [Indexed: 12/01/2022]
Abstract
Background Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in the aging population. Previous literature has reported thinning of the retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, and photoreceptor layer in PD patients. However, very few studies have used swept-source optical coherence tomography (SS-OCT) to study the choroid and choriocapillaris vascular changes in PD and their correlations with altered contrast sensitivity. Methods PD patients and controls were enrolled in the current study. We used a CSV-1000E instrument to assess contrast sensitivity and performed SS-OCT and SS-OCTA to measure outer retinal thickness, choroidal thickness, choriocapillaris flow density, choroidal vascular volume (CVV), and choroidal vascular index (CVI). Results One hundred eyes of 52 PD patients and 200 eyes of 100 healthy controls were recruited in the present study. Our study found remarkably impaired contrast sensitivity in PD patients (all P < 0.05). Significant thinning of the outer retinal layer and the choroid was appreciated in the PD group compared with the healthy controls (all P < 0.05). Choriocapillaris flow density, CVI, and CVV were significantly decreased in PD patients compared with healthy controls (all P < 0.05). Contrast sensitivity was weakly associated with outer retina thickness in the 3 mm circular area, with 3 cycles per degree being the most relevant (r = 0.535, P < 0.001). Conclusion Our study indicates that there is a significant decrease in contrast sensitivity, outer retina thickness, choriocapillaris flow density, CVI, and CVV in PD patients. This research has also identified a positive correlation between outer retina thickness and contrast sensitivity. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01054-z.
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Chen QX, Zhou L, Long T, Qin DL, Wang YL, Ye Y, Zhou XG, Wu JM, Wu AG. Galangin Exhibits Neuroprotective Effects in 6-OHDA-Induced Models of Parkinson’s Disease via the Nrf2/Keap1 Pathway. Pharmaceuticals (Basel) 2022; 15:ph15081014. [PMID: 36015161 PMCID: PMC9413091 DOI: 10.3390/ph15081014] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/16/2022] Open
Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disease, and there is still no cure for it. PD is characterized by the degeneration of dopaminergic neurons, and oxidative stress has been considered an important pathological mechanism. Therefore, the discovery of antioxidants to alleviate the oxidative damage of dopaminergic neurons is a promising therapeutic strategy for PD. First, a network pharmacology approach was used, and nine common core targets of galangin and PD were screened, mainly involving cell aging, apoptosis, and cellular responses to hydrogen peroxide and hypoxia. In addition, the Gene Ontology (GO) function and pathway enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes (KEGG) identified apoptosis, PI3K/Akt, and HIF-1 signaling pathways. Furthermore, the molecular docking results revealed a strong affinity between galangin and the NFE2L2/Nrf2 protein. To validate the above predictions, we employed 6-hydroxydopamine (6-OHDA) to induce neuronal death in HT22 cells and Caenorhabditis elegans (C. elegans). MTT, cell morphology observation, and Hoechst 33342-PI staining results showed that galangin significantly increased the viability of 6-OHDA-treated HT22 cells. In addition, galangin inhibited 6-OHDA-induced ROS generation and apoptosis in HT22 cells. Mechanistic studies demonstrated that galangin activates the Nrf2/Keap1 signaling pathway, as evidenced by the decreased protein expression of Keap1 and increased protein expression of Nrf2 and HO-1. In the 6-OHDA-induced PD model of C. elegans, galangin indeed inhibited the degeneration of dopaminergic neurons, improved behavioral ability, and decreased ROS generation. In conclusion, the current study is the first to show that galangin has the capacity to inhibit neuronal degeneration via the Nrf2/Keap1 pathway, suggesting that galangin is a possible PD treatment.
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Affiliation(s)
- Qiu-Xu Chen
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Department of Pharmacy, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Ling Zhou
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Tao Long
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Da-Lian Qin
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Yi-Ling Wang
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Yun Ye
- Department of Pharmacy, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Xiao-Gang Zhou
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Jian-Ming Wu
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
- Correspondence: (J.-M.W.); (A.-G.W.)
| | - An-Guo Wu
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
- Correspondence: (J.-M.W.); (A.-G.W.)
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Park Y, Park KW, Lee CN. Regional Metabolic Changes Influencing Three-Dimensional Perception in Parkinson's Disease. J Clin Neurol 2022; 18:447-452. [PMID: 35796270 PMCID: PMC9262454 DOI: 10.3988/jcn.2022.18.4.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background and Purpose Stereopsis refers to the perception of depth and awareness of the distance of an object from the observer that results from the brain receiving visual stimuli from both eyes in combination. Patients with idiopathic Parkinson’s disease (PD patients) typically experience problems with vision, eyeball movements, and visual perception due to degeneration of the cells that generate dopamine in the brain. We therefore hypothesized that stereopsis is affected more by visual cortical dysfunction in idiopathic PD than by retina and subcortical structural dysfunction. Methods We analyzed stereopsis in 12 PD patients and 7 healthy controls using a three-dimensional (3D) television (TV). Before allowing patients to watch TV, we examined their visual acuity and strabismus using the Titmus Stereo Fly Test, and evaluated their cognitive function using cognitive tests. The patients watched 3D and two-dimensional (2D) versions of a movie with an approximate duration of 17 minutes, and then completed a questionnaire about stereopsis. All subjects underwent brain F-18 fluorodeoxyglucose (FDG) positron-emission tomography after watching the 3D version of the movie. One week later, subjects watched the 2D version of the same movie under the same conditions. Each scan was analyzed using statistical parametric mapping (version 8) software. Results The visual cortex was activated less in the PD patients than in the healthy controls when watching the 2D or 3D movie. However, there was no significant difference between watching 2D and 3D movies in the PD patients or healthy controls. Conclusions The lower activation of the primary visual cortex in PD patients suggests the presence of dysfunction of the visual cortex. In addition, there was less activation of the visual association cortex in PD patients when watching a 3D movie than in controls under the same conditions. This might be one reason why PD patients do not recognize real and dynamic stereopsis. These findings have clinical significance since they suggest that safety needs to be considered when making devices or programs using 3D or virtual reality for use by patients with various cerebral degenerative diseases.
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Affiliation(s)
- Yoonah Park
- Department of Neurology, Kosin University College of Medicine, Busan, Korea
| | - Kun-Woo Park
- Department of Neurology, Korea University Medicine, Seoul, Korea
| | - Chan-Nyoung Lee
- Department of Neurology, Korea University Medicine, Seoul, Korea.
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Silverstein SM, Choi JJ, Green KM, Bowles-Johnson KE, Ramchandran RS. Schizophrenia in Translation: Why the Eye? Schizophr Bull 2022; 48:728-737. [PMID: 35640030 PMCID: PMC9212100 DOI: 10.1093/schbul/sbac050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Schizophrenia is increasingly recognized as a systemic disease, characterized by dysregulation in multiple physiological systems (eg, neural, cardiovascular, endocrine). Many of these changes are observed as early as the first psychotic episode, and in people at high risk for the disorder. Expanding the search for biomarkers of schizophrenia beyond genes, blood, and brain may allow for inexpensive, noninvasive, and objective markers of diagnosis, phenotype, treatment response, and prognosis. Several anatomic and physiologic aspects of the eye have shown promise as biomarkers of brain health in a range of neurological disorders, and of heart, kidney, endocrine, and other impairments in other medical conditions. In schizophrenia, thinning and volume loss in retinal neural layers have been observed, and are associated with illness progression, brain volume loss, and cognitive impairment. Retinal microvascular changes have also been observed. Abnormal pupil responses and corneal nerve disintegration are related to aspects of brain function and structure in schizophrenia. In addition, studying the eye can inform about emerging cardiovascular, neuroinflammatory, and metabolic diseases in people with early psychosis, and about the causes of several of the visual changes observed in the disorder. Application of the methods of oculomics, or eye-based biomarkers of non-ophthalmological pathology, to the treatment and study of schizophrenia has the potential to provide tools for patient monitoring and data-driven prediction, as well as for clarifying pathophysiology and course of illness. Given their demonstrated utility in neuropsychiatry, we recommend greater adoption of these tools for schizophrenia research and patient care.
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Affiliation(s)
- Steven M Silverstein
- To whom correspondence should be addressed; Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA; tel: +1 585-275-6742, e-mail:
| | - Joy J Choi
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Kyle M Green
- Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Rajeev S Ramchandran
- Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA,Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
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Lin CW, Lai TT, Chen SJ, Lin CH. Elevated α-synuclein and NfL levels in tear fluids and decreased retinal microvascular densities in patients with Parkinson's disease. GeroScience 2022; 44:1551-1562. [PMID: 35484471 DOI: 10.1007/s11357-022-00576-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/19/2022] [Indexed: 12/21/2022] Open
Abstract
The pathognomonic hallmark of Parkinson's disease (PD), α-synuclein, has been observed in the retina of PD patients. We investigated whether biomarkers in the tears and retinal microvascular changes associate with PD risk and progression. This prospective study enrolled 49 PD patients and 45 age-matched healthy controls. The α-synuclein and neurofilament light chain (NfL) levels were measured using an electrochemiluminescence immunoassay. Retinal vessel density was assessed using optical coherence tomography angiography (OCT-A). The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and Mini-Mental State Examination score were used to assess motor and cognitive progression. The α-synuclein and NfL levels in the tears were higher in PD patients than in controls (α-synuclein: 55.49 ± 8.12 pg/mL vs. 31.71 ± 3.25 pg/mL, P = 0.009; NfL: 2.89 ± 0.52 pg/mL vs. 1.47 ± 0.23 pg/mL, P = 0.02). The vessel densities in the deep plexus of central macula and the radial peripapillary capillary layer of disc region were lower in PD patients with moderate-stage compared with early-stage PD (P < 0.05). The accuracy of predicting PD occurrence using age and sex alone (area under the curve [AUC] 0.612) was significantly improved by adding α-synuclein and NfL levels and retinal vascular densities (AUC 0.752, P = 0.001). After a mean follow-up of 1.5 ± 0.3 years, the accuracy of predicting motor or cognitive progression using age, sex, and baseline motor severity as a basic model was increased by incorporating retinal microvascular and biofluid markers as a full model (P = 0.001). Our results showed that retinal microvascular densities combined with α-synuclein and NfL levels in tears are associated with risk and progression of PD.
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Affiliation(s)
- Chao-Wen Lin
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzu-Ting Lai
- Department of Ophthalmology, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Szu-Ju Chen
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 100, Taiwan.,Department of Neurology, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
| | - Chin-Hsien Lin
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 100, Taiwan.
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48
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Hsu TW, Bai YM, Tsai SJ, Chen TJ, Liang CS, Chen MH. Risk of retinal disease in patients with bipolar disorder: A nationwide cohort study. Psychiatry Clin Neurosci 2022; 76:106-113. [PMID: 34994991 DOI: 10.1111/pcn.13326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/06/2021] [Accepted: 12/21/2021] [Indexed: 12/13/2022]
Abstract
AIMS Patients with brain diseases have been associated with several retinal abnormalities. This study aimed to assess the risk of retinal diseases in patients with bipolar disorder (BD). METHODS This nationwide cohort of 73,271 patients with BD was enrolled between 2001 and 2009. To identify newly diagnosed retinal diseases, the patients were followed to the end of 2011. The control group included 293,084 patients, matched for demographic characteristics and medical and ophthalmological comorbidities. The Kaplan-Meier method was used to estimate incidence rates of retinal diseases. Cox regression was applied to calculate the hazard ratios (HRs) with 95% confidence intervals (CIs) after adjusting for confounders. RESULTS Patients with BD had higher incidence rates of any retinal disease than the controls (1.27% vs 0.48%, P < 0.001), and retinal diseases were diagnosed at a young age (54.23 years [±12.68 years] vs 57.01 years [±13.12 years], P < 0.001). After adjusting for demographic characteristics, physical and ophthalmological comorbidities, and medications, the HR was 3.24 (95% CI, 2.18-4.82) for retinal detachment, 2.35 (95% CI, 1.83-3.03) for primary retinopathy, 2.26 (95% CI, 1.91-2.68) for diabetes retinopathy, 2.39 (95% CI, 1.49-3.82) for hypertensive retinopathy, and 3.46 (95% CI, 2.45-4.89) for retinal vascular complications in patients with BD vs controls. The cumulative daily dose of bipolar medications was not associated with the incidence of any retinal disease. CONCLUSION Patients with BD were associated with a higher risk of retinal detachment, primary retinopathy, diabetes retinopathy, hypertensive retinopathy, and retinal vascular complications than the controls. Further studies are needed to examine the mechanisms mediating these retinal diseases in patients with BD.
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Affiliation(s)
- Tien-Wei Hsu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Sung Liang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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49
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Martinelli I, Tayebati SK, Tomassoni D, Nittari G, Roy P, Amenta F. Brain and Retinal Organoids for Disease Modeling: The Importance of In Vitro Blood–Brain and Retinal Barriers Studies. Cells 2022; 11:cells11071120. [PMID: 35406683 PMCID: PMC8997725 DOI: 10.3390/cells11071120] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
Brain and retinal organoids are functional and dynamic in vitro three-dimensional (3D) structures derived from pluripotent stem cells that spontaneously organize themselves to their in vivo counterparts. Here, we review the main literature data of how these organoids have been developed through different protocols and how they have been technically analyzed. Moreover, this paper reviews recent advances in using organoids to model neurological and retinal diseases, considering their potential for translational applications but also pointing out their limitations. Since the blood–brain barrier (BBB) and blood–retinal barrier (BRB) are understood to play a fundamental role respectively in brain and eye functions, both in health and in disease, we provide an overview of the progress in the development techniques of in vitro models as reliable and predictive screening tools for BBB and BRB-penetrating compounds. Furthermore, we propose potential future directions for brain and retinal organoids, in which dedicated biobanks will represent a novel tool for neuroscience and ophthalmology research.
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Affiliation(s)
- Ilenia Martinelli
- School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (S.K.T.); (G.N.); (F.A.)
- Correspondence:
| | - Seyed Khosrow Tayebati
- School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (S.K.T.); (G.N.); (F.A.)
| | - Daniele Tomassoni
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy; (D.T.); (P.R.)
| | - Giulio Nittari
- School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (S.K.T.); (G.N.); (F.A.)
| | - Proshanta Roy
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy; (D.T.); (P.R.)
| | - Francesco Amenta
- School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (S.K.T.); (G.N.); (F.A.)
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50
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Borm CDJM, Werkmann M, de Graaf D, Visser F, Hofer A, Peball M, Smilowska K, Putz D, Seppi K, Poewe W, Hoyng C, Bloem BR, Theelen T, de Vries NM. Undetected ophthalmological disorders in Parkinson's disease. J Neurol 2022; 269:3821-3832. [PMID: 35262759 PMCID: PMC9217779 DOI: 10.1007/s00415-022-11014-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/16/2022]
Abstract
Background Ophthalmological disorders are common and frequently disabling for people with Parkinson’s disease (PD). However, details on the prevalence, severity and impact of ophthalmological disorders thus far lacking. We aimed to identify PD patients with undetected ophthalmological disorders in a large cross-sectional, observational study. Methods We previously delivered a screening questionnaire to detect ophthalmological symptoms (Visual impairment in PD questionnaire; VIPD-Q) to 848 patients. Here, we report on a subgroup of 102 patients who received complete ophthalmological assessment aimed at identifying clinically relevant ophthalmological diseases, which were classified as either vison-threatening or not. Impact on daily life functioning was measured using the visual functioning-25 questionnaire (VFQ-25) and fall frequency. Results Almost all patients (92%) had one or more clinically relevant ophthalmological disorders. Of those, 77% had a potentially vision-threatening disease, while 34% had a potentially treatable ophthalmological disease which impacted on quality of life. The most prevalent ophthalmological disorders were dry eyes (86%), ocular misalignment (50%) and convergence insufficiency (41%). We found a weak but significant association between clinically relevant ophthalmological diseases and both fall frequency (R2 = 0.15, p = 0.037) and VFQ-25 score (R2 = 0.15, p = 0.02). The VIPD-Q could not correctly identify patients with relevant ophthalmological disorders. Conclusions Surprisingly, in our study sample, many participants manifested previously undetected ophthalmological diseases, most of which threatened vision, impacted on daily life functioning and were amenable to treatment. Screening for these ophthalmological disorders using a questionnaire asking about symptoms seems insufficient. Instead, episodic ophthalmological assessments should be considered for PD patients, aiming to identify vision-threatening yet treatable diseases. Trial registration Dutch Trial Registration, NL7421. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-022-11014-0.
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Affiliation(s)
- Carlijn D J M Borm
- Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Mario Werkmann
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Debbie de Graaf
- Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Femke Visser
- Department of Neurology, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands
| | - Arno Hofer
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Marina Peball
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Katarzyna Smilowska
- Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Diana Putz
- Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Werner Poewe
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Carel Hoyng
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Thomas Theelen
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Nienke M de Vries
- Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
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