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Bentivoglio AR, Lo Monaco MR, Liperoti R, Fusco D, Di Stasio E, Tondinelli A, Marzullo D, Maino A, Cipriani MC, Silveri MC. Gender may be related to the side of the motor syndrome and cognition in idiopathic Parkinson's disease. Neurologia 2023; 38:467-474. [PMID: 37659837 DOI: 10.1016/j.nrleng.2021.01.006] [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: 09/23/2020] [Accepted: 01/10/2021] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND and Sex and cognitive profile may be related to the laterality of motor symptoms in idiopathic Parkinson's disease. INTRODUCTION Parkinson's disease (PD) is well recognised as an inherently asymmetric disease with unilateral onset of motor symptoms. The laterality of motor symptoms may be linked to sex, clinical and demographic variables, and neuropsychological disorders. However, the available data are inconsistent. This study aimed to explore the potential association between the laterality of motor symptoms and clinical and demographic variables and deficits in specific cognitive domains. MATERIAL AND METHODS We retrospectively recruited 97 participants with idiopathic PD without dementia; 60 presented motor symptoms on the left side and 37 on the right side. Both groups were comparable in terms of age, age at disease onset, disease duration, and severity of the neurological deficits according to the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale. RESULTS Participants with left-side motor symptoms scored lower on the Schwab and England Activities of Daily Living scale. Our sample included more men than women (67% vs. 33%). Both sexes were not equally represented in the 2 groups: there were significantly more men than women in the group of patients with left-side motor symptoms (77% vs. 23%), whereas the percentages of men and women in the group of patients with right-side motor symptoms were similar (51% vs. 49%). Both groups performed similarly in all neuropsychological tasks, but women, independently of laterality, performed better than men in the naming task. CONCLUSION We found a clear prevalence of men in the group of patients with left-side motor symptoms; this group also scored lower on the Schwab and England Scale. Female sex was predictive of better performance in the naming task. Sex should always be considered in disorders that cause asymmetric involvement of the brain, such as PD.
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Affiliation(s)
- A R Bentivoglio
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy; Università Cattolica del Sacro Cuore, Institute of Neurology, 00168 Rome, Italy
| | - M R Lo Monaco
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy.
| | - R Liperoti
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy; Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, 00168 Rome, Italy
| | - D Fusco
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy
| | - E Di Stasio
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy; Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie, Università Cattolica del Sacro Cuore, Roma, Italy
| | - A Tondinelli
- Università Cattolica del Sacro Cuore, Department of Psychology, 20123 Milan, Italy
| | - D Marzullo
- Università Cattolica del Sacro Cuore, Institute of Neurology, 00168 Rome, Italy
| | - A Maino
- Università Cattolica del Sacro Cuore, Institute of Neurology, 00168 Rome, Italy
| | - M C Cipriani
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy
| | - M C Silveri
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy; Università Cattolica del Sacro Cuore, Department of Psychology, 20123 Milan, Italy
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Huh YE, Usnich T, Scherzer CR, Klein C, Chung SJ. GBA1 Variants and Parkinson's Disease: Paving the Way for Targeted Therapy. J Mov Disord 2023; 16:261-278. [PMID: 37302978 PMCID: PMC10548077 DOI: 10.14802/jmd.23023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/28/2023] [Accepted: 06/09/2023] [Indexed: 06/13/2023] Open
Abstract
Glucosylceramidase beta 1 (GBA1) variants have attracted enormous attention as the most promising and important genetic candidates for precision medicine in Parkinson's disease (PD). A substantial correlation between GBA1 genotypes and PD phenotypes could inform the prediction of disease progression and promote the development of a preventive intervention for individuals at a higher risk of a worse disease prognosis. Moreover, the GBA1-regulated pathway provides new perspectives on the pathogenesis of PD, such as dysregulated sphingolipid metabolism, impaired protein quality control, and disrupted endoplasmic reticulum-Golgi trafficking. These perspectives have led to the development of novel disease-modifying therapies for PD targeting the GBA1-regulated pathway by repositioning treatment strategies for Gaucher's disease. This review summarizes the current hypotheses on a mechanistic link between GBA1 variants and PD and possible therapeutic options for modulating GBA1-regulated pathways in PD patients.
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Affiliation(s)
- Young Eun Huh
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Tatiana Usnich
- Institute of Neurogenetics, University of Lübeck and University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Clemens R. Scherzer
- Advanced Center for Parkinson’s Disease Research, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA
- Precision Neurology Program, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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3
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Droby A, Thaler A, Mirelman A. Imaging Markers in Genetic Forms of Parkinson's Disease. Brain Sci 2023; 13:1212. [PMID: 37626568 PMCID: PMC10452191 DOI: 10.3390/brainsci13081212] [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: 07/19/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Parkinson's disease (PD) is a complex neurodegenerative disorder characterized by motor symptoms such as bradykinesia, rigidity, and resting tremor. While the majority of PD cases are sporadic, approximately 15-20% of cases have a genetic component. Advances in neuroimaging techniques have provided valuable insights into the pathophysiology of PD, including the different genetic forms of the disease. This literature review aims to summarize the current state of knowledge regarding neuroimaging findings in genetic PD, focusing on the most prevalent known genetic forms: mutations in the GBA1, LRRK2, and Parkin genes. In this review, we will highlight the contributions of various neuroimaging modalities, including positron emission tomography (PET), single-photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI), in elucidating the underlying pathophysiological mechanisms and potentially identifying candidate biomarkers for genetic forms of PD.
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Affiliation(s)
- Amgad Droby
- Laboratory for Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6801298, Israel; (A.T.); (A.M.)
- Movement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 39040, Israel
| | - Avner Thaler
- Laboratory for Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6801298, Israel; (A.T.); (A.M.)
- Movement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 39040, Israel
| | - Anat Mirelman
- Laboratory for Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6801298, Israel; (A.T.); (A.M.)
- Movement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 39040, Israel
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4
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Kim MS, Park DG, An YS, Yoon JH. Dual-phase 18 F-FP-CIT positron emission tomography and cardiac 123 I-MIBG scintigraphy of Parkinson's disease patients with GBA mutations: evidence of the body-first type? Eur J Neurol 2023; 30:344-352. [PMID: 36288409 DOI: 10.1111/ene.15615] [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: 07/28/2022] [Revised: 10/12/2022] [Accepted: 10/18/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE Parkinson's disease (PD) with glucocerebrosidase (GBA) gene mutation (GBA-PD) is known to show more rapid clinical progression than sporadic PD without GBA mutation (sPD). This study was performed to delineate the specific patterns of cortical hypoperfusion, dopamine transporter uptake and cardiac meta-iodobenzylguanidine (MIBG) uptake of GBA-PD in comparison to sPD. METHODS Through next-generation sequencing analysis targeting 41 genes, a total of 16 GBA-PD and 24 sPD patients (sex, age matched) were enrolled in the study, and the clinical, dual-phase [18 F]-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane (1 8 F-FP-CIT) positron emission tomography (PET) and cardiac 123 I-MIBG scintigraphy results were compared between the two groups. RESULTS The GBA-PD group had higher rates of rapid eye movement sleep behavior disorder, orthostatic hypotension and neuropsychiatric symptoms than the sPD group. Early-phase 18 F-FP-CIT PET showed significantly lower standard uptake value ratio on bilateral posterior parietal cortex (0.94 ± 0.05 vs. 1.02 ± 0.04, p = 0.011) and part of the occipital cortex (p < 0.05) in the GBA-PD group than the sPD group. In striatal dopamine transporter uptake, the regional standard uptake value ratio, asymmetry index and caudate-to-putamen ratio were similar between the two groups. The GBA-PD group had a lower heart-to-mediastinum uptake ratio in 123 I-MIBG scintigraphy than the sPD group. CONCLUSIONS The GBA-PD patients showed decreased regional perfusion in the bilateral posterior parietal and occipital cortex. Cardiac sympathetic denervation and non-motor symptoms (orthostatic hypotension, rapid eye movement sleep behavior disorder) were more common in GBA-PD than sPD. These findings suggest that GBA-PD patients have more widespread peripheral (extranigral) α-synuclein accumulation, representing a body-first PD subtype.
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Affiliation(s)
- Min Seung Kim
- Department of Neurology, Parkinson Center, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Don Gueu Park
- Department of Neurology, Parkinson Center, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Young-Sil An
- Department of Nuclear Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jung Han Yoon
- Department of Neurology, Parkinson Center, Ajou University School of Medicine, Suwon, Republic of Korea
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5
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Ghatti S, Yoon E, Lopez G, Ehrlich D, Horovitz SG. Imaging and genetics in Parkinson's disease: assessment of the GBA1 mutation. J Neurol 2022; 269:5347-5355. [PMID: 35604467 PMCID: PMC10402751 DOI: 10.1007/s00415-022-11181-0] [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: 11/23/2021] [Revised: 04/21/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Several genetic variants are associated with an increased risk for developing Parkinson's Disease (PD) and limited genotype/phenotype correlation. Specifically, mutations in GBA1, the gene coding for the lysosomal enzyme glucocerebrosidase, are associated with an earlier age of onset and faster disease progression. Given these phenotypic differences associated with GBA1 variants, we explored whether cortical thickness and other biomarkers of neurodegeneration differed in healthy controls and PD patients with and without GBA1 variants. METHODS To understand how different GBA1 variants influence PD phenotype early in the disease, we retrieved neuroimaging and biospecimen data from the Parkinson's Progression Markers Initiative database. Using FreeSurfer, we compared T1-weighted MRI images from healthy controls (N = 47) to PD patients with heterozygous N370S (N = 21), heterozygous E326K (N = 18) or heterozygous T369M (N = 8) variants, and GBA1 non-mutation carriers (N = 47). RESULTS Cortical thickness in PD patients differed from controls in the parietal cortex, with E365K, T369M variants, and GBA1 non-mutation carriers showing more cortical thinning than N370S variants. Patients with N370S variants had significantly higher serum neurofilament light levels among all groups. CONCLUSION Our results demonstrate significant cortical thinning in PD patients independent of genotype in superior parietal and postcentral regions when compared to the controls. They highlight the impact of GBA1 variants on cortical thickness in the parietal cortex. Finally, they suggest that recently diagnosed PD patients with N370S variants have a higher cortical thickness and increased active neurodegeneration when compared to PD patients without GBA1 mutations and PD patients with E326K or T369M variants.
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Affiliation(s)
- Sweta Ghatti
- National Institutes of Neurological Disease and Stroke, Bethesda, MD, USA.
| | - Esther Yoon
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Grisel Lopez
- National Human Genome Research Institutes, Bethesda, MD, USA
| | - Debra Ehrlich
- National Institutes of Neurological Disease and Stroke, Bethesda, MD, USA
| | - Silvina G Horovitz
- National Institutes of Neurological Disease and Stroke, Bethesda, MD, USA
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6
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Filippi M, Balestrino R, Basaia S, Agosta F. Neuroimaging in Glucocerebrosidase-Associated Parkinsonism: A Systematic Review. Mov Disord 2022; 37:1375-1393. [PMID: 35521899 PMCID: PMC9546404 DOI: 10.1002/mds.29047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 12/11/2022] Open
Abstract
Background Mutations in the GBA gene cause Gaucher's disease (GD) and constitute the most frequent genetic risk factor for idiopathic Parkinson's disease (iPD). Nonmanifesting carriers of GBA mutations/variants (GBA‐NMC) constitute a potential PD preclinical population, whereas PD patients carrying some GBA mutations/variants (GBA‐PD) have a higher risk of a more aggressive disease course. Different neuroimaging techniques are emerging as potential biomarkers in PD and have been used to study GBA‐associated parkinsonism. Objective The aim is to critically review studies applying neuroimaging to GBA‐associated parkinsonism. Methods Literature search was performed using PubMed and EMBASE databases (last search February 7, 2022). Studies reporting neuroimaging findings in GBA‐PD, GD with and without parkinsonism, and GBA‐NMC were included. Results Thirty‐five studies were included. In longitudinal studies, GBA‐PD patients show a more aggressive disease than iPD at both structural magnetic resonance imaging and 123‐fluoropropylcarbomethoxyiodophenylnortropane single‐photon emission computed tomography. Fluorodeoxyglucose‐positron emission tomography and brain perfusion studies reported a greater cortical involvement in GBA‐PD compared to iPD. Overall, contrasting evidence is available regarding GBA‐NMC for imaging and clinical findings, although subtle differences have been reported compared with healthy controls with no mutations. Conclusions Although results must be interpreted with caution due to limitations of the studies, in line with previous clinical observations, GBA‐PD showed a more aggressive disease progression in neuroimaging longitudinal studies compared to iPD. Cognitive impairment, a “clinical signature” of GBA‐PD, seems to find its neuroimaging correlate in the greater cortical burden displayed by these patients as compared to iPD. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Massimo Filippi
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Roberta Balestrino
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Basaia
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Agosta
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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7
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Chung SJ, Lee PH, Sohn YH, Kim YJ. Glucocerebrosidase Mutations and Motor Reserve in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2021; 11:1715-1724. [PMID: 34459414 DOI: 10.3233/jpd-212758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The concept of motor reserve explains the individual differences in motor deficits despite similar degrees of nigrostriatal dopamine depletion in Parkinson's disease (PD). OBJECTIVE To investigate glucocerebrosidase (GBA) variants as potential determinants of motor reserve for exploratory purposes. METHODS A total of 408 patients with drug-naïve PD were enrolled from the Parkinson's Progression Markers Initiative cohort database. All patients underwent SPECT dopamine transporter (DAT) scans and had results for Sanger sequencing of GBA. Parkinsonian motor deficits were assessed using the Movement Disorders Society Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS-III). We compared MDS-UPDRS-III scores while adjusting for DAT availability in the putamen (i.e., motor reserve) between the PD groups according to the presence of GBA mutations. RESULTS Fifty-four (13.2%) patients carried GBA mutations. PD patients with GBA mutations were younger than those without mutations. There were no significant differences in sex, disease duration, years of education, and striatal DAT availability between the PD groups. PD patients with GBA mutations had higher MDS-UPDRS-III scores for the less affected side than those without mutations, despite similar levels of DAT availability in the contralateral putamen. The MDS-UPDRS-III sub-scores of the more affected side did not differ between the two PD groups. CONCLUSION The results of this study demonstrated the detrimental effect of GBA variants on individual capacity to cope with PD-related pathologies, with different impacts depending on the motor laterality.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yun Joong Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
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8
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David FJ, Munoz MJ, Shils JL, Pauciulo MW, Hale PT, Nichols WC, Afshari M, Sani S, Verhagen Metman L, Corcos DM, Pal GD. Subthalamic Peak Beta Ratio Is Asymmetric in Glucocerebrosidase Mutation Carriers With Parkinson's Disease: A Pilot Study. Front Neurol 2021; 12:723476. [PMID: 34659089 PMCID: PMC8514636 DOI: 10.3389/fneur.2021.723476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/24/2021] [Indexed: 01/18/2023] Open
Abstract
Introduction: Up to 27% of individuals undergoing subthalamic nucleus deep brain stimulation (STN-DBS) have a genetic form of Parkinson's disease (PD). Glucocerebrosidase (GBA) mutation carriers, compared to sporadic PD, present with a more aggressive disease, less asymmetry, and fare worse on cognitive outcomes with STN-DBS. Evaluating STN intra-operative local field potentials provide the opportunity to assess and compare symmetry between GBA and non-GBA mutation carriers with PD; thus, providing insight into genotype and STN physiology, and eligibility for and programming of STN-DBS. The purpose of this pilot study was to test differences in left and right STN resting state beta power in non-GBA and GBA mutation carriers with PD. Materials and Methods: STN (left and right) resting state local field potentials were recorded intraoperatively from 4 GBA and 5 non-GBA patients with PD while off medication. Peak beta power expressed as a ratio to total beta power (peak beta ratio) was compared between STN hemispheres and groups while co-varying for age, age of disease onset, and disease severity. Results: Peak beta ratio was significantly different between the left and the right STN for the GBA group (p < 0.01) but not the non-GBA group (p = 0.56) after co-varying for age, age of disease onset, and disease severity. Discussion: Peak beta ratio in GBA mutation carriers was more asymmetric compared with non-mutation carriers and this corresponded with the degree of clinical asymmetry as measured by rating scales. This finding suggests that GBA mutation carriers have a physiologic signature that is distinct from that found in sporadic PD.
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Affiliation(s)
- Fabian J David
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Miranda J Munoz
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Jay L Shils
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, United States
| | - Michael W Pauciulo
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Philip T Hale
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - William C Nichols
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Mitra Afshari
- Department of Neurological Science, Rush University Medical Center, Chicago, IL, United States
| | - Sepehr Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States
| | - Leo Verhagen Metman
- Department of Neurological Science, Rush University Medical Center, Chicago, IL, United States
| | - Daniel M Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Gian D Pal
- Department of Neurological Science, Rush University Medical Center, Chicago, IL, United States.,Department of Neurology, Rutgers University, New Brunswick, NJ, United States
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9
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Cubo E, Martínez-Martín P, González-Bernal J, Casas E, Arnaiz S, Miranda J, Gámez P, Santos-García D. Effects of Motor Symptom Laterality on Clinical Manifestations and Quality of Life in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 10:1611-1620. [PMID: 32741839 DOI: 10.3233/jpd-202067] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The asymmetry of motor manifestations present in Parkinson's disease (PD) suggests the existence of differences between both hemispheres. As a consequence, this asymmetry might contribute to different PD clinical phenotypes. OBJECTIVE To study the relationship between motor symptom laterality with motor, non-motor symptoms (NMS), freezing of gait (FOG), and quality of life (QoL) impairment in PD. METHODS In this cross-sectional study, we measured motor symptoms severity and complications with the Unified Parkinsons' disease Rating Scale (UPDRS), FOG with the FOG questionnaire, QoL with the 39-item PD Quality of Life Questionnaire Summary Index, and NMS with the NMS, Visual Analogue Scales for Pain and Fatigue, Beck Depression Inventory-II, Impulsive-Compulsive Disorders, and PD Sleep and Cognitive Rating scales. We defined left and right motor laterality using the UPDRS part III. We used comparative, regression, and effect size analyses to evaluate the impact of asymmetry on motor and NMS, FOG, and QoL. RESULTS 342 left (LPD) and 310 right (RPD) patients, with a mean age of 62.0±8.8 years, were included. In multivariate regression analysis, LPD was associated with a greater motor (OR = 1,50, 95% CI 1.02-2.21), FOG (OR = 1.56, 95% CI 1.01-2.41), and overall NMS impairment (OR = 1.43, 95% CI 1.001-2.06), and better QoL (OR = 0.52 95% CI 0.32-0.85). Overall, only a mild effect size was found for all comparisons in which significant differences were present. CONCLUSION In this large multicenter study, motor symptom laterality seems to carry a mild but significant impact on PD clinical manifestations, and QoL.
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Affiliation(s)
- Esther Cubo
- Department of Neurology, Hospital Universitario Burgos, Burgos, Spain
| | - Pablo Martínez-Martín
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain.,Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Elena Casas
- Department of Neurology, Hospital Universitario Burgos, Burgos, Spain
| | - Sandra Arnaiz
- Department of Neurology, Hospital Universitario Burgos, Burgos, Spain
| | - Javier Miranda
- Department of Neurology, Hospital Universitario Burgos, Burgos, Spain
| | - Pedro Gámez
- Department of Neurology, Hospital Universitario Burgos, Burgos, Spain
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10
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Olszewska DA, McCarthy A, Soto-Beasley AI, Walton RL, Ross OA, Lynch T. Dancing Feet Dyskinesia in a Patient with GBA-PD. J Mov Disord 2021; 15:83-85. [PMID: 33915675 PMCID: PMC8820891 DOI: 10.14802/jmd.20169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/04/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Diana A Olszewska
- The Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland.,Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Allan McCarthy
- Department of Neurology, The Adelaide and Meath Hospital, Dublin, Ireland
| | | | - Ronald L Walton
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Owen A Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.,Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL, USA
| | - Tim Lynch
- The Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland.,Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
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11
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Bentivoglio AR, Lo Monaco MR, Liperoti R, Fusco D, Di Stasio E, Tondinelli A, Marzullo D, Maino A, Cipriani MC, Silveri MC. Gender may be related to the side of the motor syndrome and cognition in idiopathic Parkinson's disease. Neurologia 2021; 38:S0213-4853(21)00025-6. [PMID: 33726970 DOI: 10.1016/j.nrl.2021.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/03/2021] [Accepted: 01/10/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND and Sex and cognitive profile may be related to the laterality of motor symptoms in idiopathic Parkinson's disease. INTRODUCTION Parkinson's disease (PD) is well recognised as an inherently asymmetric disease with unilateral onset of motor symptoms. The laterality of motor symptoms may be linked to sex, clinical and demographic variables, and neuropsychological disorders. However, the available data are inconsistent. This study aimed to explore the potential association between the laterality of motor symptoms and clinical and demographic variables and deficits in specific cognitive domains. MATERIAL AND METHODS We retrospectively recruited 97 participants with idiopathic PD without dementia; 60 presented motor symptoms on the left side and 37 on the right side. Both groups were comparable in terms of age, age at disease onset, disease duration, and severity of the neurological deficits according to the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale. RESULTS Participants with left-side motor symptoms scored lower on the Schwab and England Activities of Daily Living scale. Our sample included more men than women (67% vs. 33%). Both sexes were not equally represented in the 2 groups: there were significantly more men than women in the group of patients with left-side motor symptoms (77% vs. 23%), whereas the percentages of men and women in the group of patients with right-side motor symptoms were similar (51% vs. 49%). Both groups performed similarly in all neuropsychological tasks, but women, independently of laterality, performed better than men in the naming task. CONCLUSION We found a clear prevalence of men in the group of patients with left-side motor symptoms; this group also scored lower on the Schwab and England Scale. Female sex was predictive of better performance in the naming task. Sex should always be considered in disorders that cause asymmetric involvement of the brain, such as PD.
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Affiliation(s)
- A R Bentivoglio
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy; Università Cattolica del Sacro Cuore, Institute of Neurology, 00168 Rome, Italy
| | - M R Lo Monaco
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy.
| | - R Liperoti
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy; Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, 00168 Rome, Italy
| | - D Fusco
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy
| | - E Di Stasio
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy; Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie, Università Cattolica del Sacro Cuore, Roma, Italy
| | - A Tondinelli
- Università Cattolica del Sacro Cuore, Department of Psychology, 20123 Milan, Italy
| | - D Marzullo
- Università Cattolica del Sacro Cuore, Institute of Neurology, 00168 Rome, Italy
| | - A Maino
- Università Cattolica del Sacro Cuore, Institute of Neurology, 00168 Rome, Italy
| | - M C Cipriani
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy
| | - M C Silveri
- Fondazione Policlinico Universitario 'Agostino Gemelli' - IRCSS, 00168 Rome, Italy; Università Cattolica del Sacro Cuore, Department of Psychology, 20123 Milan, Italy
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12
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Mullin S, Stokholm MG, Hughes D, Mehta A, Parbo P, Hinz R, Pavese N, Brooks DJ, Schapira AH. Brain Microglial Activation Increased in Glucocerebrosidase (GBA) Mutation Carriers without Parkinson's disease. Mov Disord 2021; 36:774-779. [PMID: 33278043 PMCID: PMC8048428 DOI: 10.1002/mds.28375] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/11/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Glucocerebrosidase gene mutations are a common genetic risk factor for Parkinson's disease. They exhibit incomplete penetrance. The objective of the present study was to measure microglial activation and dopamine integrity in glucocerebrosidase gene mutation carriers without Parkinson's disease compared to controls. METHODS We performed PET scans on 9 glucocerebrosidase gene mutation carriers without Parkinson's disease and 29 age-matched controls. We measured microglial activation as 11 C-(R)-PK11195 binding potentials, and dopamine terminal integrity with 18 F-dopa influx constants. RESULTS The 11 C-(R)-PK11195 binding potential was increased in the substantia nigra of glucocerebrosidase gene carriers compared with controls (Student t test; right, t = -4.45, P = 0.0001). Statistical parametric mapping also localized significantly increased 11 C-(R)-PK11195 binding potential in the occipital and temporal lobes, cerebellum, hippocampus, and mesencephalon. The degree of hyposmia correlated with nigral 11 C-(R)-PK11195 regional binding potentials (Spearman's rank, P = 0.0066). Mean striatal 18 F-dopa uptake was similar to healthy controls. CONCLUSIONS In vivo 11 C-(R)-PK11195 PET imaging detects neuroinflammation in brain regions susceptible to Lewy pathology in glucocerebrosidase gene mutation carriers without Parkinson's. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Stephen Mullin
- Department of Clinical and Movement Neurosciences, Institute of NeurologyUCLLondonUK
- Institute of Health and Care ResearchUniversity of Plymouth Peninsula School of MedicinePlymouthUK
| | | | - Derralyn Hughes
- Department of Haematology, Institute of Immunity and TransplantationUCLLondonUK
| | - Atul Mehta
- Department of Haematology, Institute of Immunity and TransplantationUCLLondonUK
| | - Peter Parbo
- Department of Nuclear Medicine & PET CentreAarhus University HospitalAarhusDenmark
| | - Rainer Hinz
- Wolfson Molecular Imaging CentreUniversity of ManchesterManchesterUK
| | - Nicola Pavese
- Department of Nuclear Medicine & PET CentreAarhus University HospitalAarhusDenmark
- Institute of Translational and Clinical ResearchNewcastle UniversityNewcastleUK
| | - David J. Brooks
- Department of Nuclear Medicine & PET CentreAarhus University HospitalAarhusDenmark
- Institute of Translational and Clinical ResearchNewcastle UniversityNewcastleUK
| | - Anthony H.V. Schapira
- Department of Clinical and Movement Neurosciences, Institute of NeurologyUCLLondonUK
- Lysosomal storage disease unitRoyal Free HospitalLondonUK
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13
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Behl T, Kaur G, Fratila O, Buhas C, Judea-Pusta CT, Negrut N, Bustea C, Bungau S. Cross-talks among GBA mutations, glucocerebrosidase, and α-synuclein in GBA-associated Parkinson's disease and their targeted therapeutic approaches: a comprehensive review. Transl Neurodegener 2021; 10:4. [PMID: 33446243 PMCID: PMC7809876 DOI: 10.1186/s40035-020-00226-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/01/2020] [Indexed: 02/08/2023] Open
Abstract
Current therapies for Parkinson's disease (PD) are palliative, of which the levodopa/carbidopa therapy remains the primary choice but is unable to modulate the progression of neurodegeneration. Due to the complication of such a multifactorial disorder and significant limitations of the therapy, numerous genetic approaches have been proved effective in finding out genes and mechanisms implicated in this disease. Following the observation of a higher frequency of PD in Gaucher's disease (GD), a lysosomal storage condition, mutations of glycosylceramidase beta (GBA) encoding glucocerebrosidase (GCase) have been shown to be involved and have been explored in the context of PD. GBA mutations are the most common genetic risk factor of PD. Various studies have revealed the relationships between PD and GBA gene mutations, facilitating a better understanding of this disorder. Various hypotheses delineate that the pathological mutations of GBA minimize the enzymatic activity of GCase, which affects the proliferation and clearance of α-synuclein; this affects the lysosomal homeostasis, exacerbating the endoplasmic reticulum stress or encouraging the mitochondrial dysfunction. Identification of the pathological mechanisms underlying the GBA-associated parkinsonism (GBA + PD) advances our understanding of PD. This review based on current literature aims to elucidate various genetic and clinical characteristics correlated with GBA mutations and to identify the numerous pathological processes underlying GBA + PD. We also delineate the therapeutic strategies to interfere with the mutant GCase function for further improvement of the related α-synuclein-GCase crosstalks. Moreover, the various therapeutic approaches such as gene therapy, chaperone proteins, and histone deacetylase inhibitors for the treatment of GBA + PD are discussed.
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Affiliation(s)
- Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India.
| | - Gagandeep Kaur
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Ovidiu Fratila
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Camelia Buhas
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Bihor County, Romania
| | - Claudia Teodora Judea-Pusta
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Bihor County, Romania
| | - Nicoleta Negrut
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Cristiana Bustea
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
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14
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Behl T, Kaur G, Fratila O, Buhas C, Judea-Pusta CT, Negrut N, Bustea C, Bungau S. Cross-talks among GBA mutations, glucocerebrosidase, and α-synuclein in GBA-associated Parkinson’s disease and their targeted therapeutic approaches: a comprehensive review. Transl Neurodegener 2021. [DOI: https://doi.org/10.1186/s40035-020-00226-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AbstractCurrent therapies for Parkinson’s disease (PD) are palliative, of which the levodopa/carbidopa therapy remains the primary choice but is unable to modulate the progression of neurodegeneration. Due to the complication of such a multifactorial disorder and significant limitations of the therapy, numerous genetic approaches have been proved effective in finding out genes and mechanisms implicated in this disease. Following the observation of a higher frequency of PD in Gaucher’s disease (GD), a lysosomal storage condition, mutations of glycosylceramidase beta (GBA) encoding glucocerebrosidase (GCase) have been shown to be involved and have been explored in the context of PD. GBA mutations are the most common genetic risk factor of PD. Various studies have revealed the relationships between PD and GBA gene mutations, facilitating a better understanding of this disorder. Various hypotheses delineate that the pathological mutations of GBA minimize the enzymatic activity of GCase, which affects the proliferation and clearance of α-synuclein; this affects the lysosomal homeostasis, exacerbating the endoplasmic reticulum stress or encouraging the mitochondrial dysfunction. Identification of the pathological mechanisms underlying the GBA-associated parkinsonism (GBA + PD) advances our understanding of PD. This review based on current literature aims to elucidate various genetic and clinical characteristics correlated with GBA mutations and to identify the numerous pathological processes underlying GBA + PD. We also delineate the therapeutic strategies to interfere with the mutant GCase function for further improvement of the related α-synuclein–GCase crosstalks. Moreover, the various therapeutic approaches such as gene therapy, chaperone proteins, and histone deacetylase inhibitors for the treatment of GBA + PD are discussed.
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15
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Novel PET Biomarkers to Disentangle Molecular Pathways across Age-Related Neurodegenerative Diseases. Cells 2020; 9:cells9122581. [PMID: 33276490 PMCID: PMC7761606 DOI: 10.3390/cells9122581] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/25/2020] [Accepted: 11/28/2020] [Indexed: 12/11/2022] Open
Abstract
There is a need to disentangle the etiological puzzle of age-related neurodegenerative diseases, whose clinical phenotypes arise from known, and as yet unknown, pathways that can act distinctly or in concert. Enhanced sub-phenotyping and the identification of in vivo biomarker-driven signature profiles could improve the stratification of patients into clinical trials and, potentially, help to drive the treatment landscape towards the precision medicine paradigm. The rapidly growing field of neuroimaging offers valuable tools to investigate disease pathophysiology and molecular pathways in humans, with the potential to capture the whole disease course starting from preclinical stages. Positron emission tomography (PET) combines the advantages of a versatile imaging technique with the ability to quantify, to nanomolar sensitivity, molecular targets in vivo. This review will discuss current research and available imaging biomarkers evaluating dysregulation of the main molecular pathways across age-related neurodegenerative diseases. The molecular pathways focused on in this review involve mitochondrial dysfunction and energy dysregulation; neuroinflammation; protein misfolding; aggregation and the concepts of pathobiology, synaptic dysfunction, neurotransmitter dysregulation and dysfunction of the glymphatic system. The use of PET imaging to dissect these molecular pathways and the potential to aid sub-phenotyping will be discussed, with a focus on novel PET biomarkers.
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16
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Lin W, Zuo CT, Wu JJ, Yang LK, Zhu J, Wang YH. Striatal asymmetry index and its correlation with the Hoehn & Yahr stage in Parkinson's disease. Int J Neurosci 2020; 132:165-170. [PMID: 32883145 DOI: 10.1080/00207454.2020.1806265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Striatal asymmetry is a common feature in Parkinson's disease (PD), which changes with the progression of the disease. However, the correlation between the striatal asymmetry and severity of PD remains unclear. The present study aimed to investigate the characteristics of asymmetry in PD, and analyze the correlation between the striatal asymmetry index (SAI) and disease severity. MATERIALS AND METHODS This retrospective study enrolled 63 patients with idiopathic PD. The severity of PD was classified according to the Hoehn & Yahr (H&Y) staging system. The SAI in the subregions of the striatum was measured using 11C-N-2-carbomethoxy-3-(4-fluorophenyl)-tropane (11C-CFT) positron emission tomography (PET). RESULTS There was a significant difference in the SAI of the posterior putamen among the three groups (H&Y stage I, H&Y stage II, and H&Y stage III-IV; p = 0.001). However, there was no difference in the SAI of the anterior putamen (p = 0.340) or SAI of the caudate nucleus (p = 0.342) among the three groups. The SAI of the posterior putamen in patients with PD was significantly higher than that in patients with multiple system atrophy or progressive supranuclear palsy (p = 0.008). CONCLUSION The SAI of the posterior putamen is associated with the severity of PD, and may be correlated to the loss of dopamine cells in the pars compacta of the ventrolateral substantia nigra projecting to the posterior putamen. The SAI may be a potential indicator for evaluating the severity of PD, and distinguishing PD from other degenerative diseases.
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Affiliation(s)
- Wei Lin
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,The Department of Neurosurgery, Joint Logistics Support Unit No. 904 Hospital, Anhui Medical University, Wuxi, Jiangsu, China
| | - Chuan-Tao Zuo
- Positron Emission Tomography (PET) Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jian-Jun Wu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Li-Kun Yang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,The Department of Neurosurgery, Joint Logistics Support Unit No. 904 Hospital, Anhui Medical University, Wuxi, Jiangsu, China
| | - Jie Zhu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,The Department of Neurosurgery, Joint Logistics Support Unit No. 904 Hospital, Anhui Medical University, Wuxi, Jiangsu, China
| | - Yu-Hai Wang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,The Department of Neurosurgery, Joint Logistics Support Unit No. 904 Hospital, Anhui Medical University, Wuxi, Jiangsu, China
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17
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Abstract
PURPOSE OF REVIEW GBA1 mutations, which result in the lysosomal disorder Gaucher disease, are the most common known genetic risk factor for Parkinson disease and Dementia with Lewy Bodies (DLB). The pathogenesis of this association is not fully understood, but further elucidation of this link could lead to new therapeutic options. RECENT FINDINGS The characteristic clinical phenotype of GBA1-PD resembles sporadic Parkinson disease, but with an earlier onset and more severe course. Many different GBA1 mutations increase the risk of Parkinson disease, some primarily detected in specific populations. Glucocerebrosidase deficiency appears to be associated with increased α-synuclein aggregation and accumulation, mitochondrial dysfunction because of impaired autophagy, and increased endoplasmic reticulum stress. SUMMARY As our understanding of GBA1-associated Parkinson disease increases, new treatment opportunities emerge. MicroRNA profiles are providing examples of both up-regulated and down-regulated proteins related to GBA1 and may provide new therapeutic targets. Chaperone therapy, directed at either misfolded glucocerebrosidase or α-synuclein aggregation, is currently under development and there are several early clinical trials ongoing. Substrate reduction therapy, aimed at lowering the accumulation of metabolic by-products, especially glucosylsphingosine, is also being explored. Basic science insights from the rare disorder Gaucher disease are serving to catapult drug discovery for parkinsonism.
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18
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Gera A, O’Keefe JA, Ouyang B, Liu Y, Ruehl S, Buder M, Joyce J, Purcell N, Pal G. Gait asymmetry in glucocerebrosidase mutation carriers with Parkinson's disease. PLoS One 2020; 15:e0226494. [PMID: 31978134 PMCID: PMC6980620 DOI: 10.1371/journal.pone.0226494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/27/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND GBA mutation carriers with PD (PD-GBA) are at higher risk of cognitive decline, but there is limited data regarding whether there are differences in gait dysfunction between GBA mutation and non-mutation carriers with PD. OBJECTIVES/METHODS The primary aim of this study was to use quantitative inertial sensor-based gait analysis to compare gait asymmetry in 17 PD-GBA subjects, 17 non-mutation carriers with PD, and 15 healthy control subjects using parameters that had gait laterality and were markers of bradykinesia, in particular arm swing velocity and arm swing range of motion and stride length. RESULTS Arm swing velocity was more symmetric in PD-GBA subjects vs. non-mutation carriers in the OFF state (12.5 +/- 8.3 vs. 22.9 +/- 11.8%, respectively, p = 0.018). In the ON-medication state, non-mutation carriers with PD, but not PD-GBA subjects, exhibited arm swing velocity (16.8 +/- 8.6 vs. 22.9 +/- 11.8%, p = 0.006) and arm range of motion (26.7 +/- 16.3 vs. 33.4 +/- 18.6%, p = 0.02) that was more asymmetric compared with the OFF-medication state. CONCLUSIONS In the OFF medication state, arm swing velocity asymmetry may be a useful parameter in helping to distinguish GBA mutation carriers with PD from non-mutation carriers.
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Affiliation(s)
- Anjali Gera
- Department of Neurological Sciences, Rush University, Chicago, Illinois, United States of America
| | - Joan A. O’Keefe
- Cell & Molecular Medicine, Rush University, Chicago, Illinois, United States of America
| | - Bichun Ouyang
- Department of Neurological Sciences, Rush University, Chicago, Illinois, United States of America
| | - Yuanqing Liu
- Department of Neurological Sciences, Rush University, Chicago, Illinois, United States of America
| | - Samantha Ruehl
- Department of Neurological Sciences, Rush University, Chicago, Illinois, United States of America
| | - Mark Buder
- Department of Neurological Sciences, Rush University, Chicago, Illinois, United States of America
| | - Jessica Joyce
- Cell & Molecular Medicine, Rush University, Chicago, Illinois, United States of America
| | - Nicolette Purcell
- Cell & Molecular Medicine, Rush University, Chicago, Illinois, United States of America
| | - Gian Pal
- Department of Neurological Sciences, Rush University, Chicago, Illinois, United States of America
- * E-mail:
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19
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Amaral CEDM, Lopes PF, Ferreira JCC, Alves EAC, Montenegro MVB, Costa ETD, Yamada ES, Cavalcante FOQ, Santana-da-Silva LC. GBA mutations p.N370S and p.L444P are associated with Parkinson's disease in patients from Northern Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 77:73-79. [PMID: 30810589 DOI: 10.1590/0004-282x20190006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/21/2018] [Indexed: 01/03/2023]
Abstract
Mutations of the GBA gene have been reported in patients with Parkinson's disease (PD) from a number of different countries, including Brazil. In order to confirm this pattern in a sample of PD patients from northern Brazil, we conducted a case-control study of the occurrence of the two most common mutations of the GBA gene (c.1226A>G; p.N370S and c.1448T>C; p.L444P) in a group of 81 PD patients and 81 control individuals, using PCR-RFLP, confirmed by the direct sequencing of the PCR products. In the patient group, three patients (3.7%) were heterozygous for the GBA c.1226A>G; p.N370S mutation, and three (3.7%) for GBA c.1448T>C; p.L444P Neither mutation was detected in the control group (p =0.0284). Patients with the c.1448T>C; p.L444P mutation showed a tendency to have an earlier disease onset, but a larger sample number is required to confirm this observation. Our results suggest an association between the GBA c.1226A>G; p.N370S and c.1448T>C; p.L444P mutations and the development of PD in the population of patients from the Northern Brazil.
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Affiliation(s)
| | - Patrick Farias Lopes
- Universidade Federal do Pará, Laboratório de Erros Inatos de Metabolismo, Belém PA, Brasil
| | | | | | | | - Edmar Tavares da Costa
- Universidade Federal do Pará, Laboratório de Neuropatologia Experimental, Belém PA, Brasil
| | - Elizabeth Sumi Yamada
- Universidade Federal do Pará, Laboratório de Neuropatologia Experimental, Belém PA, Brasil
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20
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Niemann N, Jankovic J. Juvenile parkinsonism: Differential diagnosis, genetics, and treatment. Parkinsonism Relat Disord 2019; 67:74-89. [DOI: 10.1016/j.parkreldis.2019.06.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/24/2019] [Accepted: 06/28/2019] [Indexed: 12/12/2022]
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21
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Huang YY, Poniger S, Tsai CL, Tochon-Danguy HJ, Ackermann U, Yen RF. Three-step two-pot automated production of NCA [ 18F]FDOPA with FlexLab module. Appl Radiat Isot 2019; 158:108871. [PMID: 32113705 DOI: 10.1016/j.apradiso.2019.108871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 08/05/2019] [Accepted: 08/21/2019] [Indexed: 01/12/2023]
Abstract
Automated three-step two-pot production of no-carrier-added (NCA) [18F]FDOPA was first implemented in the iPHASE FlexLab module. Decay-corrected radiochemical yield (RCY) of [18F]FDOPA synthesized by this method was 10~14% (n = 7) with a synthesis time of ~110 min [18F]FDOPA was obtained in > 95% of radiochemical purity with a molar activity of ~431 GBq/μmol. With the method successfully implementing on the commercial FlexLab module and its built-in step-by-step activity monitoring, further processes optimization would be achieved.
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Affiliation(s)
- Ya-Yao Huang
- PET Center, Department of Nuclear Medicine, National Taiwan University Hospital, 7, Chung-Shan S. Road, Taipei, 100, Taiwan.
| | - Stan Poniger
- Department of Molecular Imaging and Therapy, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia; iPHASE Technologies, 3 Cypress Ave, Glen Waverley, Victoria, 3150, Australia
| | - Chia-Ling Tsai
- PET Center, Department of Nuclear Medicine, National Taiwan University Hospital, 7, Chung-Shan S. Road, Taipei, 100, Taiwan
| | - Henri J Tochon-Danguy
- Department of Molecular Imaging and Therapy, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia; iPHASE Technologies, 3 Cypress Ave, Glen Waverley, Victoria, 3150, Australia
| | - Uwe Ackermann
- Department of Molecular Imaging and Therapy, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia
| | - Ruoh-Fang Yen
- PET Center, Department of Nuclear Medicine, National Taiwan University Hospital, 7, Chung-Shan S. Road, Taipei, 100, Taiwan; Molecular Imaging Center, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 106, Taiwan
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22
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Riederer P, Berg D, Casadei N, Cheng F, Classen J, Dresel C, Jost W, Krüger R, Müller T, Reichmann H, Rieß O, Storch A, Strobel S, van Eimeren T, Völker HU, Winkler J, Winklhofer KF, Wüllner U, Zunke F, Monoranu CM. α-Synuclein in Parkinson's disease: causal or bystander? J Neural Transm (Vienna) 2019; 126:815-840. [PMID: 31240402 DOI: 10.1007/s00702-019-02025-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/29/2019] [Indexed: 12/13/2022]
Abstract
Parkinson's disease (PD) comprises a spectrum of disorders with differing subtypes, the vast majority of which share Lewy bodies (LB) as a characteristic pathological hallmark. The process(es) underlying LB generation and its causal trigger molecules are not yet fully understood. α-Synuclein (α-syn) is a major component of LB and SNCA gene missense mutations or duplications/triplications are causal for rare hereditary forms of PD. As typical sporadic PD is associated with LB pathology, a factor of major importance is the study of the α-syn protein and its pathology. α-Syn pathology is, however, also evident in multiple system atrophy (MSA) and Lewy body disease (LBD), making it non-specific for PD. In addition, there is an overlap of these α-synucleinopathies with other protein-misfolding diseases. It has been proven that α-syn, phosphorylated tau protein (pτ), amyloid beta (Aβ) and other proteins show synergistic effects in the underlying pathogenic mechanisms. Multiple cell death mechanisms can induce pathological protein-cascades, but this can also be a reverse process. This holds true for the early phases of the disease process and especially for the progression of PD. In conclusion, while rare SNCA gene mutations are causal for a minority of familial PD patients, in sporadic PD (where common SNCA polymorphisms are the most consistent genetic risk factor across populations worldwide, accounting for 95% of PD patients) α-syn pathology is an important feature. Conversely, with regard to the etiopathogenesis of α-synucleinopathies PD, MSA and LBD, α-syn is rather a bystander contributing to multiple neurodegenerative processes, which overlap in their composition and individual strength. Therapeutic developments aiming to impact on α-syn pathology should take this fact into consideration.
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Affiliation(s)
- Peter Riederer
- Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, University of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany. .,Department of Psychiatry, University of South Denmark, Odense, Denmark.
| | - Daniela Berg
- Department of Neurology, UKHS, Christian-Albrechts-Universität, Campus Kiel, Kiel, Germany
| | - Nicolas Casadei
- NGS Competence Center Tübingen, Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Fubo Cheng
- NGS Competence Center Tübingen, Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Joseph Classen
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Christian Dresel
- Department of Neurology, Center for Movement Disorders, Neuroimaging Center Mainz, Clinical Neurophysiology, Forschungszentrum Translationale Neurowissenschaften (FTN), Rhein-Main-Neuronetz, Mainz, Germany
| | | | - Rejko Krüger
- Clinical and Experimental Neuroscience, LCSB (Luxembourg Centre for Systems, Biomedicine), University of Luxembourg, Esch-sur-Alzette and Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg.,National Center for Excellence in Research, Parkinson's disease (NCER-PD), Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Thomas Müller
- Department of Neurology, Alexianer St. Joseph Berlin-Weißensee, Berlin, Germany
| | - Heinz Reichmann
- Department of Neurology, University of Dresden, Dresden, Germany
| | - Olaf Rieß
- Institute of Medical Genetics and Applied Genomics, Tübingen, Germany
| | - Alexander Storch
- Department of Neurology, University of Rostock, Rostock, Germany.,German Centre for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany
| | - Sabrina Strobel
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Thilo van Eimeren
- Department of Neurology, University Hospital of Cologne, Cologne, Germany
| | | | - Jürgen Winkler
- Department Kopfkliniken, Molekulare Neurologie, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Konstanze F Winklhofer
- Institute of Biochemistry and Pathobiochemistry, Ruhr-Universität Bochum, Bochum, Germany
| | - Ullrich Wüllner
- Department of Neurology, University of Bonn, German Center for Neurodegenerative Diseases (DZNE Bonn), Bonn, Germany
| | - Friederike Zunke
- Department of Biochemistry, Medical Faculty, University of Kiel, Kiel, Germany
| | - Camelia-Maria Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Würzburg, Germany
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23
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Shin S, Kim K, Lee JM, Kim EJ, Kim SJ, Kim IJ, Pak K, Lee MJ. Effect of Single-Nucleotide Polymorphisms on Decline of Dopamine Transporter Availability in Parkinson's Disease. J Clin Neurol 2019; 15:102-107. [PMID: 30618224 PMCID: PMC6325373 DOI: 10.3988/jcn.2019.15.1.102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/24/2018] [Accepted: 09/28/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND AND PURPOSE We aimed to determine the association between the annual changes in dopamine transporter (DAT) availability as measured by ¹²³I-ioflupane (¹²³I-FP-CIT) single-photon-emission computed tomography and single-nucleotide polymorphisms (SNPs) known to be risk factors in Parkinson's disease (PD). METHODS In total, 150 PD patients were included from the Parkinson's Progression Markers Initiative database. Specific SNPs that are associated with PD were selected for genotyping. SNPs that were not in Hardy-Weinberg equilibrium or whose minor allele frequency was less than 0.05 were excluded. Twenty-three SNPs met the inclusion criteria for this study. The Kruskal-Wallis test was used to compare annual percentage changes in DAT availability for three subgroups of SNP. RESULTS None of the 23 SNPs exerted a statistically significant effect (p<0.0022) on the decline of DAT availability in PD patients. However, we observed trends of association (p<0.05) between three SNPs of two genes with the annual percentage change in DAT availability: 1) rs199347 on the putamen (p=0.0138), 2) rs356181 on the caudate nucleus (p=0.0105), and 3) rs3910105 on the caudate nucleus (p=0.0374). A post-hoc analysis revealed that DAT availability was reduced the most for 1) the putamen in the CC genotype of rs199347 (vs. CT, p=0.0199; vs. TT, p=0.0164), 2) the caudate nucleus in the TT genotype of rs356181 (vs. CC, p=0.0081), and 3) the caudate nucleus in the CC genotype of rs3910105 (vs. TT, p=0.0317). CONCLUSIONS Significant trends in the associations between three SNPs and decline of DAT availability in PD patients have been discovered.
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Affiliation(s)
- Seunghyeon Shin
- Department of Nuclear Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jae Meen Lee
- Department of Neurosurgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Eun Joo Kim
- Department of Neurology, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Seong Jang Kim
- Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - In Joo Kim
- Department of Nuclear Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - Kyoungjune Pak
- Department of Nuclear Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - Myung Jun Lee
- Department of Neurology, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
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24
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Blandini F, Cilia R, Cerri S, Pezzoli G, Schapira AHV, Mullin S, Lanciego JL. Glucocerebrosidase mutations and synucleinopathies: Toward a model of precision medicine. Mov Disord 2018; 34:9-21. [PMID: 30589955 DOI: 10.1002/mds.27583] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 10/24/2018] [Accepted: 11/01/2018] [Indexed: 12/21/2022] Open
Abstract
Glucocerebrosidase is a lysosomal enzyme. The characterization of a direct link between mutations in the gene coding for glucocerebrosidase (GBA1) with the development of Parkinson's disease and dementia with Lewy bodies has heightened interest in this enzyme. Although the mechanisms through which glucocerebrosidase regulates the homeostasis of α-synuclein remains poorly understood, the identification of reduced glucocerebrosidase activity in the brains of patients with PD and dementia with Lewy bodies has paved the way for the development of novel therapeutic strategies directed at enhancing glucocerebrosidase activity and reducing α-synuclein burden, thereby slowing down or even preventing neuronal death. Here we reviewed the current literature relating to the mechanisms underlying the cross talk between glucocerebrosidase and α-synuclein, the GBA1 mutation-associated clinical phenotypes, and ongoing therapeutic approaches targeting glucocerebrosidase. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Fabio Blandini
- Laboratory of Functional Neurochemistry, IRCCS Mondino Foundation, Pavia, Italy
| | - Roberto Cilia
- Parkinson Institute, ASST Gaetano Pini-CTO, Milan, Italy
| | - Silvia Cerri
- Laboratory of Functional Neurochemistry, IRCCS Mondino Foundation, Pavia, Italy
| | - Gianni Pezzoli
- Parkinson Institute, ASST Gaetano Pini-CTO, Milan, Italy
| | - Anthony H V Schapira
- Department of Clinical Neurosciences, Institute of Neurology, University College London, Hampstead, UK
| | - Stephen Mullin
- Department of Clinical Neurosciences, Institute of Neurology, University College London, Hampstead, UK.,Institute of Translational and Stratified Medicine, Plymouth University Peninsula School of Medicine, Plymouth, UK
| | - José L Lanciego
- Programa de Neurociencias, Fundación para la Investigación Médica Aplicada (FIMA), Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CiberNed), Madrid, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
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25
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Varrone A, Pellecchia MT. SPECT Molecular Imaging in Familial Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 142:225-260. [PMID: 30409254 DOI: 10.1016/bs.irn.2018.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dopamine transporter (DAT) imaging with single-photon emission computed tomography (SPECT) is a diagnostic tool to study the integrity of the dopaminergic system in patients with parkinsonism and uncertain diagnosis. DAT SPECT enables to detect the presence of nigrostriatal deficit even in the early or pre-symptomatic stages of the disease and to quantify the DAT loss with the progression of nigrostriatal degeneration. For these reasons, DAT SPECT has been also used as a tool to study genetic conditions that are associated with parkinsonism in order to examine the degree and patterns of dopaminergic deficits that are present in at risk subjects and in affected patients carrying the mutations. Studies included subjects with sporadic mutations of common genes associated with Parkinson's disease (PD) and families with both affected patients and asymptomatic carriers. For obvious reasons, the majority of the studies have included a limited number of subjects. Therefore, because of the heterogeneity and the size of the cohorts examined, in many cases the findings can be merely descriptive and general conclusions on the patterns of dopaminergic deficit in different genetic conditions need to take into account some exceptions.
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Affiliation(s)
- Andrea Varrone
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden.
| | - Maria Teresa Pellecchia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Salerno, Italy
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26
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Thaler A. Structural and Functional MRI in Familial Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 142:261-287. [PMID: 30409255 DOI: 10.1016/bs.irn.2018.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Between 10 and 15% of Parkinson disease (PD) cases can be traced to a genetically identified causative mutation which currently number over 40. This enables the study of both "at risk" populations for future development of PD and a unique sub-group of genetically determined patient population. Structural and functional magnetic imaging has the potential of assisting diagnosis, early detection and disease progression as it is relatively cheap and easy to implement. However, the large variety of imaging options and different analytical approaches hamper the pursuit of a unified imaging biomarker. This chapter details the current imaging options and summarizes the findings among both genetically determined patients with PD and their non-manifesting first degree relatives, speculating on possible compensational mechanisms while mapping future directions in order to better utilize MRI in the research of genetic PD.
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Affiliation(s)
- Avner Thaler
- Movement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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27
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Koros C, Simitsi A, Prentakis A, Beratis I, Papadimitriou D, Kontaxopoulou D, Fragkiadaki S, Papagiannakis N, Seibyl J, Marek K, Papageorgiou SG, Trapali XG, Stamelou M, Stefanis L. 123I-FP-CIT SPECT [(123) I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography] Imaging in a p.A53T α-synuclein Parkinson's disease cohort versus Parkinson's disease. Mov Disord 2018; 33:1734-1739. [PMID: 30288781 DOI: 10.1002/mds.27451] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 05/03/2018] [Accepted: 05/09/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The p.A53T point mutation in the α-synuclein gene (SNCA) is a rare but highly relevant cause of autosomal dominant Parkinson's disease (PD). OBJECTIVES The objective of this study was to assess striatal dopaminergic denervation in a cohort of symptomatic carriers of the p.A53T SNCA mutation as compared to PD patients. METHODS Data from the Parkinson's Progression Markers Initiative database of 11 symptomatic p.A53T SNCA mutation carriers who underwent 123I-FP-CIT SPECT [(123) I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography] imaging at our site were compared with those of 33 age-, sex-, and disease duration-matched PD patients. RESULTS The p.A53T mutation carriers had significantly lower caudate nucleus binding ratio both contralaterally and ipsilaterally to the most affected side (P = .002 and P = .006) and a decreased contralateral caudate/putamen signal ratio (P = .007) as compared to PD. A similar degree of striatal asymmetry was observed in both subgroups. No correlation between scores in neuropsychological tests and caudate nucleus dopaminergic denervation could be demonstrated. CONCLUSIONS PD patients harboring the p.A53T SNCA mutation show evidence of a more severe nigrostriatal denervation, especially evident in the caudate nucleus. The lack of significant differences in the putaminal binding ratios may reflect a floor effect or a true preferential targeting of the caudate terminals in p.A53T SNCA-associated PD. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Christos Koros
- 1st Neurology Clinic, Eginition Hospital, Athens University Medical School, Athens, Greece.,2nd Neurology Clinic, Attikon Hospital, Athens University Medical School, Athens, Greece
| | - Athina Simitsi
- 1st Neurology Clinic, Eginition Hospital, Athens University Medical School, Athens, Greece.,2nd Neurology Clinic, Attikon Hospital, Athens University Medical School, Athens, Greece
| | | | - Ion Beratis
- 2nd Neurology Clinic, Attikon Hospital, Athens University Medical School, Athens, Greece
| | | | - Dionysia Kontaxopoulou
- 2nd Neurology Clinic, Attikon Hospital, Athens University Medical School, Athens, Greece
| | - Stella Fragkiadaki
- 2nd Neurology Clinic, Attikon Hospital, Athens University Medical School, Athens, Greece
| | - Nikolaos Papagiannakis
- 2nd Neurology Clinic, Attikon Hospital, Athens University Medical School, Athens, Greece
| | - John Seibyl
- Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA
| | - Kenneth Marek
- Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA
| | | | | | - Maria Stamelou
- 1st Neurology Clinic, Eginition Hospital, Athens University Medical School, Athens, Greece.,Neurology Clinic, Philipps University, Marburg, Germany.,Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece
| | - Leonidas Stefanis
- 1st Neurology Clinic, Eginition Hospital, Athens University Medical School, Athens, Greece.,2nd Neurology Clinic, Attikon Hospital, Athens University Medical School, Athens, Greece
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28
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O'Regan G, deSouza RM, Balestrino R, Schapira AH. Glucocerebrosidase Mutations in Parkinson Disease. JOURNAL OF PARKINSONS DISEASE 2018; 7:411-422. [PMID: 28598856 DOI: 10.3233/jpd-171092] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Following the discovery of a higher than expected incidence of Parkinson Disease (PD) in Gaucher disease, a lysosomal storage disorder, mutations in the glucocerebrocidase (GBA) gene, which encodes a lysosomal enzyme involved in sphingolipid degradation were explored in the context of idiopathic PD. GBA mutations are now known to be the single largest risk factor for development of idiopathic PD. Clinically, on imaging and pharmacologically, GBA PD is almost identical to idiopathic PD, other than certain features that can be identified in the specialist research setting but not in routine clinical practice. In patients with a known GBA mutation, it is possible to monitor for prodromal signs of PD. The clinical similarity with idiopathic PD and the chance to identify PD at a pre-clinical stage provides a unique opportunity to research therapeutic options for early PD, before major irreversible neurodegeneration occurs. However, to date, the molecular mechanisms which lead to this increased PD risk in GBA mutation carriers are not fully elucidated. Experimental models to define the molecular mechanisms and test therapeutic options include cell culture, transgenic mice and other in vivo models amenable to genetic manipulation, such as drosophilia. Some key pathological pathways of interest in the context of GBA mutations include alpha synuclein aggregation, lysosomal-autophagy axis changes and endoplasmic reticulum stress. Therapeutic agents that exploit these pathways are being developed and include the small molecule chaperone Ambroxol. This review aims to summarise the main features of GBA-PD and provide insights into the pathological relevance of GBA mutations on molecular pathways and the therapeutic implications for PD resulting from investigation of the role of GBA in PD.
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Affiliation(s)
- Grace O'Regan
- Department of Clinical Neurosciences, UCL Institute of Neurology, Royal Free Campus, London, UK
| | - Ruth-Mary deSouza
- Department of Clinical Neurosciences, UCL Institute of Neurology, Royal Free Campus, London, UK
| | | | - Anthony H Schapira
- Department of Clinical Neurosciences, UCL Institute of Neurology, Royal Free Campus, London, UK
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29
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Riederer P, Jellinger KA, Kolber P, Hipp G, Sian-Hülsmann J, Krüger R. Lateralisation in Parkinson disease. Cell Tissue Res 2018; 373:297-312. [PMID: 29656343 DOI: 10.1007/s00441-018-2832-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 03/21/2018] [Indexed: 01/11/2023]
Abstract
Asymmetry of dopaminergic neurodegeneration and subsequent lateralisation of motor symptoms are distinctive features of Parkinson's disease compared to other forms of neurodegenerative or symptomatic parkinsonism. Even 200 years after the first description of the disease, the underlying causes for this striking clinicopathological feature are not yet fully understood. There is increasing evidence that lateralisation of disease is due to a complex interplay of hereditary and environmental factors that are reflected not only in the concept of dominant hemispheres and handedness but also in specific susceptibilities of neuronal subpopulations within the substantia nigra. As a consequence, not only the obvious lateralisation of motor symptoms occurs but also patterns of associated non-motor signs are defined, which include cognitive functions, sleep behaviour or olfaction. Better understanding of the mechanisms contributing to lateralisation of neurodegeneration and the resulting patterns of clinical phenotypes based on bilateral post-mortem brain analyses and clinical studies focusing on right/left hemispheric symptom origin will help to develop more targeted therapeutic approaches, taking into account subtypes of PD as a heterogeneous disorder.
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Affiliation(s)
- P Riederer
- Center of Mental Health, Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany. .,Psychiatry Department of Clinical Research, University of Southern Denmark, Odense University Hospital, J.B. Winsløws Vej 18, Indgang 220 A, DK-5000, Odense C, Denmark.
| | - K A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, A-1150, Vienna, Austria
| | - P Kolber
- Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - G Hipp
- Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - J Sian-Hülsmann
- Department of Medical Physiology, University of Nairobi, PO Box 30197, Nairobi, 00100, Kenya
| | - R Krüger
- Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
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30
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Imbriani P, Schirinzi T, Meringolo M, Mercuri NB, Pisani A. Centrality of Early Synaptopathy in Parkinson's Disease. Front Neurol 2018; 9:103. [PMID: 29545770 PMCID: PMC5837972 DOI: 10.3389/fneur.2018.00103] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 02/13/2018] [Indexed: 12/16/2022] Open
Abstract
Significant advances have been made in the understanding of the numerous mechanisms involved in Parkinson’s disease (PD) pathogenesis. The identification of PD pathogenic mutations and the use of different animal models have contributed to better elucidate the processes underlying the disease. Here, we report a brief survey of some relevant cellular mechanisms, including autophagic–lysosomal dysfunction, endoplasmic reticulum stress, and mitochondrial impairment, with the main aim to focus on their potential convergent roles in determining early alterations at the synaptic level, mainly consisting in a decrease in dopamine release at nigrostriatal terminals and loss of synaptic plasticity at corticostriatal synapses. In a number of experimental models, this synaptopathy has been shown to be an initial, central event in PD pathogenesis, preceding neuronal damage, thereby representing a valuable tool for testing potential disease-modifying treatments.
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Affiliation(s)
- Paola Imbriani
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Laboratory of Neurophysiology and Plasticity, Fondazione Santa Lucia (IRCCS), Rome, Italy
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Laboratory of Neurophysiology and Plasticity, Fondazione Santa Lucia (IRCCS), Rome, Italy
| | - Maria Meringolo
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Laboratory of Neurophysiology and Plasticity, Fondazione Santa Lucia (IRCCS), Rome, Italy
| | - Nicola B Mercuri
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Laboratory of Neurophysiology and Plasticity, Fondazione Santa Lucia (IRCCS), Rome, Italy
| | - Antonio Pisani
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Laboratory of Neurophysiology and Plasticity, Fondazione Santa Lucia (IRCCS), Rome, Italy
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31
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Balestrino R, Schapira AHV. Glucocerebrosidase and Parkinson Disease: Molecular, Clinical, and Therapeutic Implications. Neuroscientist 2018; 24:540-559. [PMID: 29400127 DOI: 10.1177/1073858417748875] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Parkinson disease (PD) is a complex neurodegenerative disease characterised by multiple motor and non-motor symptoms. In the last 20 years, more than 20 genes have been identified as causes of parkinsonism. Following the observation of higher risk of PD in patients affected by Gaucher disease, a lysosomal disorder caused by mutations in the glucocerebrosidase (GBA) gene, it was discovered that mutations in this gene constitute the single largest risk factor for development of idiopathic PD. Patients with PD and GBA mutations are clinically indistinguishable from patients with idiopathic PD, although some characteristics emerge depending on the specific mutation, such as slightly earlier onset. The molecular mechanisms which lead to this increased PD risk in GBA mutation carriers are multiple and not yet fully elucidated, they include alpha-synuclein aggregation, lysosomal-autophagy dysfunction and endoplasmic reticulum stress. Moreover, dysfunction of glucocerebrosidase has also been demonstrated in non-GBA PD, suggesting its interaction with other pathogenic mechanisms. Therefore, GBA enzyme function represents an interesting pharmacological target for PD. Cell and animal models suggest that increasing GBA enzyme activity can reduce alpha-synuclein levels. Clinical trials of ambroxol, a glucocerebrosidase chaperone, are currently ongoing in PD and PD dementia, as is a trial of substrate reduction therapy. The aim of this review is to summarise the main features of GBA-PD and discuss the implications of glucocerebrosidase modulation on PD pathogenesis.
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Affiliation(s)
| | - Anthony H V Schapira
- 2 Department of Clinical Neurosciences, UCL Institute of Neurology, Royal Free Campus, London, UK
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32
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Matarazzo M, Wile D, Mackenzie M, Stoessl AJ. PET Molecular Imaging in Familial Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 142:177-223. [DOI: 10.1016/bs.irn.2018.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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33
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Wang Y, Wu JJ, Liu FT, Chen K, Chen C, Luo SS, Wang YX, Li DK, Guan RY, Yang YJ, An Y, Wang J, Sun YM. Olfaction in Parkin carriers in Chinese patients with Parkinson disease. Brain Behav 2017; 7:e00680. [PMID: 28523222 PMCID: PMC5434185 DOI: 10.1002/brb3.680] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/10/2017] [Accepted: 02/13/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Olfactory identification was reported to be better among PD (Parkinson disease) patients with Parkin mutations, but previous studies didn't eliminate the interference of other PD related genes on olfaction, and whether olfaction of Parkin mutations patients was better in Chinese population was still unknown. OBJECTIVE To assess olfaction function among PD patients with Parkin mutations in Chinese population. MATERIALS AND METHODS A total of 226 PD patients with a positive family history or an early-onset age (<50 years) were enrolled for genetic testing of PD related genes by target sequencing and multiple ligation-dependent probe amplification. The clinical data including olfactory function test were investigated. Linear regression was performed to adjust for the covariates between all groups. RESULTS There were 68 patients found having a negative result in PD genetic testing and 43 patients carrying homozygous or compound heterozygous Parkin mutations. Among them, 49 PD panel negative patients and 33 PD-Parkin patients had results of olfactory assessment. PD -Parkin patients performed significantly better on the Sniffin' Sticks tests than panel negative patients (8.0 ± 1.7 vs. 5.7 ± 1.9, p < .001), but still worse compared to healthy controls (9.4 ± 1.5, p = .003). These differences persisted after adjusting for confounders. CONCLUSIONS Among Chinese population, PD -Parkin patients had relatively preserved olfaction compared to PD panel negative patients after eliminating the interference of other PD related genes, but were still worse than healthy controls.
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Affiliation(s)
- Ying Wang
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
| | - Jian-Jun Wu
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China.,Department of Neurology Jing'an District Center Hospital of Shanghai Shanghai China
| | - Feng-Tao Liu
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
| | - Kui Chen
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
| | - Chen Chen
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
| | - Su-Shan Luo
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
| | - Yi-Xuan Wang
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
| | - Da-Ke Li
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
| | - Rong-Yuan Guan
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
| | - Yu-Jie Yang
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
| | - Yu An
- Institute of Biomedical Sciences Medical School Fudan University Shanghai China
| | - Jian Wang
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
| | - Yi-Min Sun
- Department and Institute of Neurology Huashan Hospital Fudan University Shanghai China
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34
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Huang CS, Wang GH, Tai CH, Hu CC, Yang YC. Antiarrhythmics cure brain arrhythmia: The imperativeness of subthalamic ERG K + channels in parkinsonian discharges. SCIENCE ADVANCES 2017; 3:e1602272. [PMID: 28508055 PMCID: PMC5425237 DOI: 10.1126/sciadv.1602272] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 03/15/2017] [Indexed: 06/07/2023]
Abstract
ERG K+ channels have long been known to play a crucial role in shaping cardiac action potentials and, thus, appropriate heart rhythms. The functional role of ERG channels in the central nervous system, however, remains elusive. We demonstrated that ERG channels exist in subthalamic neurons and have similar gating characteristics to those in the heart. ERG channels contribute crucially not only to the setting of membrane potential and, consequently, the firing modes, but also to the configuration of burst discharges and, consequently, the firing frequency and automaticity of the subthalamic neurons. Moreover, modulation of subthalamic discharges via ERG channels effectively modulates locomotor behaviors. ERG channel inhibitors ameliorate parkinsonian symptoms, whereas enhancers render normal animals hypokinetic. Thus, ERG K+ channels could be vital to the regulation of both cardiac and neuronal rhythms and may constitute an important pathophysiological basis and pharmacotherapeutic target for the growing list of neurological disorders related to "brain arrhythmias."
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Affiliation(s)
- Chen-Syuan Huang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Guan-Hsun Wang
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Chun-Hwei Tai
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Chang Hu
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Ya-Chin Yang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Tao-Yuan, Taiwan
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Barber TR, Klein JC, Mackay CE, Hu MTM. Neuroimaging in pre-motor Parkinson's disease. Neuroimage Clin 2017; 15:215-227. [PMID: 28529878 PMCID: PMC5429242 DOI: 10.1016/j.nicl.2017.04.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/10/2017] [Accepted: 04/15/2017] [Indexed: 12/23/2022]
Abstract
The process of neurodegeneration in Parkinson's disease begins long before the onset of clinical motor symptoms, resulting in substantial cell loss by the time a diagnosis can be made. The period between the onset of neurodegeneration and the development of motoric disease would be the ideal time to intervene with disease modifying therapies. This pre-motor phase can last many years, but the lack of a specific clinical phenotype means that objective biomarkers are needed to reliably detect prodromal disease. In recent years, recognition that patients with REM sleep behaviour disorder (RBD) are at particularly high risk of future parkinsonism has enabled the development of large prodromal cohorts in which to investigate novel biomarkers, and neuroimaging has generated some of the most promising results to date. Here we review investigations undertaken in RBD and other pre-clinical cohorts, including modalities that are well established in clinical Parkinson's as well as novel imaging methods. Techniques such as high resolution MRI of the substantia nigra and functional imaging of Parkinsonian brain networks have great potential to facilitate early diagnosis. Further longitudinal studies will establish their true value in quantifying prodromal neurodegeneration and predicting future Parkinson's.
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Affiliation(s)
- Thomas R Barber
- Oxford Parkinson's Disease Centre (OPDC), University of Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, UK.
| | - Johannes C Klein
- Oxford Parkinson's Disease Centre (OPDC), University of Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Clare E Mackay
- Oxford Parkinson's Disease Centre (OPDC), University of Oxford, UK; Department of Psychiatry, University of Oxford, UK; Oxford Centre for Human Brain Activity (OHBA), University of Oxford, UK
| | - Michele T M Hu
- Oxford Parkinson's Disease Centre (OPDC), University of Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, UK.
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Genetic factors influencing frontostriatal dysfunction and the development of dementia in Parkinson's disease. PLoS One 2017; 12:e0175560. [PMID: 28399184 PMCID: PMC5388496 DOI: 10.1371/journal.pone.0175560] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/28/2017] [Indexed: 02/07/2023] Open
Abstract
The dual syndrome hypothesis for cognitive impairment in Parkinson's disease (PD) establishes a dichotomy between a frontrostriatal dopamine-mediated syndrome, which leads to executive deficits, and a posterior cortical syndrome, which leads to dementia. Certain genes have been linked to these syndromes although the exact contribution is still controversial. The study's objective was to investigate the role of APOE, MAPT, COMT, SNCA and GBA genes in the dual syndromes. We genotyped APOE (rs429358 and rs7412), MAPT (rs9468), COMT (rs4680) and SNCA (rs356219) risk polymorphisms and sequenced GBA in a cohort of 298 PD patients. The degree of dopaminergic depletion was investigated with [123I]FP-CIT SPECTs and the presence of dementia was ascertained with a long-term review based on established criteria. The association between genetic and imaging parameters was studied with linear regression, and the relationship with dementia onset with Cox regression. We found that APOE2 allele (Pput = 0.002; Pcau = 0.01), the minor allele 'G' in SNCA polymorphism (Pput = 0.02; Pcau = 0.006) and GBA deleterious variants in (Pput = 0.01; Pcau = 0.001) had a detrimental effect on striatal [123I]FP-CIT uptake in PD. Conversely, Met/Met carriers in COMT polymorphism had increased caudate uptake (Pcau = 0.03). The development of dementia was influenced by APOE4 allele (HR = 1.90; P = 0.03) and GBA deleterious variants (HR = 2.44; P = 0.01). Finally, we observed no role of MAPT locus in any of the syndromes. As a conclusion, APOE2, SNCA, COMT and GBA influence frontostriatal dysfunction whereas APOE4 and GBA influence the development of dementia, suggesting a double-edged role of GBA. The dichotomy of the dual syndromes may be driven by a broad dichotomy in these genetic factors.
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Strafella AP, Bohnen NI, Perlmutter JS, Eidelberg D, Pavese N, Van Eimeren T, Piccini P, Politis M, Thobois S, Ceravolo R, Higuchi M, Kaasinen V, Masellis M, Peralta MC, Obeso I, Pineda-Pardo JÁ, Cilia R, Ballanger B, Niethammer M, Stoessl JA. Molecular imaging to track Parkinson's disease and atypical parkinsonisms: New imaging frontiers. Mov Disord 2017; 32:181-192. [DOI: 10.1002/mds.26907] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/21/2016] [Accepted: 11/27/2016] [Indexed: 12/23/2022] Open
Affiliation(s)
- Antonio P. Strafella
- Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Parkinson Disease Program, Neurology Div/Dept. Medicine, Toronto Western Hospital, UHN; Krembil Research Institute, UHN; Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH; University of Toronto; Ontario Canada
| | - Nicolaas I. Bohnen
- University of Michigan & Veterans Administration Medical Center; Ann Arbor Michigan USA
| | - Joel S. Perlmutter
- Neurology, Radiology, Neuroscience, Physical Therapy & Occupational Therapy; Washington University in St. Louis; St. Louis Missouri USA
| | - David Eidelberg
- Center for Neurosciences; The Feinstein Institute for Medical Research; Manhasset New York USA
| | - Nicola Pavese
- Newcastle Magnetic Resonance Centre & Positron Emission Tomography Centre; Newcastle University; Campus for Ageing & Vitality Newcastle upon Tyne United Kingdom
| | - Thilo Van Eimeren
- Multimodal Neuroimaging Group-Department of Nuclear Medicine Department of Neurology-University of Cologne; Institute of Neuroscience and Medicine, Jülich Research Center, German Center for Neurodegenerative Diseases (DZNE); Germany
| | - Paola Piccini
- Neurology Imaging Unit, Centre of Neuroinflammation and Neurodegeneration, Division of Brain Sciences, Hammersmith Campus; Imperial College London; United Kingdom
| | - Marios Politis
- Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry; Psychology and Neuroscience, King's College London; London United Kingdom
| | - Stephane Thobois
- Hospices Civils de Lyon, Hopital Neurologique Pierre Wertheimer; Université Lyon 1; CNRS, Centre de Neurosciences Cognitives; UMR 5229 Lyon France
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, Movement Disorders and Parkinson Center; University of Pisa; Italy
| | - Makoto Higuchi
- National Institute of Radiological Sciences; National Institutes for Quantum and Radiological Science and Technology; Chiba Japan
| | - Valtteri Kaasinen
- Division of Clinical Neurosciences, Turku University Hospital; Department of Neurology; University of Turku; Turku PET Centre, University of Turku; Turku Finland
| | - Mario Masellis
- Cognitive & Movement Disorders Clinic, Sunnybrook Health Sciences Centre; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute; University of Toronto; Toronto Ontario Canada
| | - M. Cecilia Peralta
- Movement Disorder and Parkinson's Disease Program; CEMIC University Hospital; Buenos Aires Argentina
| | - Ignacio Obeso
- Centro Integral de Neurociencias (CINAC), Hospitales Madrid Puerta del Sur & Centro de Investigación Biomédica en Red; Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
| | - Jose Ángel Pineda-Pardo
- Centro Integral de Neurociencias (CINAC), Hospitales Madrid Puerta del Sur & Centro de Investigación Biomédica en Red; Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
| | - Roberto Cilia
- Parkinson Institute; ASST Gaetano Pini-CTO; Milan Italy
| | - Benedicte Ballanger
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Neuroplasticity & Neuropathology of Olfactory Perception Team; University Lyon; France
| | - Martin Niethammer
- Center for Neurosciences; The Feinstein Institute for Medical Research; Manhasset New York USA
| | - Jon A. Stoessl
- Pacific Parkinson's Research Centre & National Parkinson Foundation Centre of Excellence; University of British Columbia & Vancouver Coastal Health; Vancouver British Columbia Canada
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Malek N, Swallow DMA, Grosset KA, Lawton MA, Smith CR, Bajaj NP, Barker RA, Ben-Shlomo Y, Bresner C, Burn DJ, Foltynie T, Morris HR, Williams N, Wood NW, Grosset DG. Olfaction in Parkin single and compound heterozygotes in a cohort of young onset Parkinson's disease patients. Acta Neurol Scand 2016; 134:271-6. [PMID: 26626018 DOI: 10.1111/ane.12538] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Parkin related Parkinson's disease (PD) is differentiated from idiopathic PD by absent or sparse Lewy bodies, and preserved olfaction. The significance of single Parkin mutations in the pathogenesis of PD is debated. OBJECTIVES To assess olfaction results according to Parkin mutation status. To compare the prevalence of Parkin single heterozygous mutations in patients diagnosed with PD to the rate in healthy controls in order to establish whether these single mutations could be a risk factor for developing PD. METHODS Parkin gene mutation testing was performed in young onset PD (diagnosed <50 years old) to identify three groups: Parkin homozygous or compound heterozygote mutation carriers, Parkin single heterozygote mutation carriers, and non-carriers of Parkin mutations. Olfaction was tested using the 40-item British version of the University of Pennsylvania smell identification test (UPSIT). RESULTS Of 344 young onset PD cases tested, 8 (2.3%) were Parkin compound heterozygotes and 13 (3.8%) were Parkin single heterozygotes. Olfaction results were available in 282 cases (eight compound heterozygotes, nine single heterozygotes, and 265 non-carriers). In Parkin compound heterozygotes, the median UPSIT score was 33, interquartile range (IQR) 28.5-36.5, which was significantly better than in single Parkin heterozygotes (median 19, IQR 18-28) and non-carriers (median score 22, IQR 16-28) (ANOVA P < 0.001). These differences persisted after adjusting for age, disease duration, gender, and smoking (P < 0.001). There was no significant difference in UPSIT scores between single heterozygotes and non-carriers (P = 0.90). CONCLUSIONS Patients with Parkin compound heterozygous mutations have relatively preserved olfaction compared to Parkin single heterozygotes and non-carriers. The prevalence of Parkin single heterozygosity is similar to the 3.7% rate reported in healthy controls.
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Affiliation(s)
- N. Malek
- Institute of Neurological Sciences; Queen Elizabeth University Hospital; Glasgow UK
| | - D. M. A. Swallow
- Institute of Neurological Sciences; Queen Elizabeth University Hospital; Glasgow UK
| | - K. A. Grosset
- Institute of Neurological Sciences; Queen Elizabeth University Hospital; Glasgow UK
| | - M. A. Lawton
- School of Social & Community Medicine; University of Bristol; UK
| | - C. R. Smith
- Institute of Neurological Sciences; Queen Elizabeth University Hospital; Glasgow UK
| | | | - R. A. Barker
- Clinical Neurosciences; John van Geest Centre for Brain Repair; Cambridge UK
| | - Y. Ben-Shlomo
- School of Social & Community Medicine; University of Bristol; UK
| | - C. Bresner
- Institute of Psychological Medicine and Clinical Neurosciences; Cardiff University; UK
| | - D. J. Burn
- Institute of Neuroscience; University of Newcastle; Newcastle upon Tyne UK
| | - T. Foltynie
- Sobell Department of Motor Neuroscience; UCL Institute of Neurology; London UK
| | - H. R. Morris
- Department of Clinical Neurosciences; University College London; UK
| | - N. Williams
- Institute of Psychological Medicine and Clinical Neurosciences; Cardiff University; UK
| | - N. W. Wood
- Department of Molecular Neuroscience; University College London; UK
| | - D. G. Grosset
- Institute of Neurological Sciences; Queen Elizabeth University Hospital; Glasgow UK
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Schapira AH, Chiasserini D, Beccari T, Parnetti L. Glucocerebrosidase in Parkinson's disease: Insights into pathogenesis and prospects for treatment. Mov Disord 2016; 31:830-5. [DOI: 10.1002/mds.26616] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/05/2016] [Accepted: 02/12/2016] [Indexed: 12/22/2022] Open
Affiliation(s)
- Anthony H.V. Schapira
- University Department of Clinical Neurosciences; UCL Institute of Neurology; London United Kingdom
| | - Davide Chiasserini
- Department of Medicine, section of Neurology; University of Perugia; Perugia Italy
| | - Tommaso Beccari
- Department of Pharmaceutical Sciences; University of Perugia; Perugia Italy
| | - Lucilla Parnetti
- Department of Medicine, section of Neurology; University of Perugia; Perugia Italy
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Feligioni M, Mango D, Piccinin S, Imbriani P, Iannuzzi F, Caruso A, De Angelis F, Blandini F, Mercuri NB, Pisani A, Nisticò R. Subtle alterations of excitatory transmission are linked to presynaptic changes in the hippocampus of PINK1-deficient mice. Synapse 2016; 70:223-30. [PMID: 26850695 DOI: 10.1002/syn.21894] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/01/2016] [Accepted: 02/02/2016] [Indexed: 12/13/2022]
Abstract
Homozygous or heterozygous mutations in the PTEN-induced kinase 1 (PINK1) gene have been linked to early-onset Parkinson's disease (PD). Several neurophysiological studies have demonstrated alterations in striatal synaptic plasticity along with impaired dopamine release in PINK1-deficient mice. Using electrophysiological methods, here we show that PINK1 loss of function causes a progressive increase of spontaneous glutamate-mediated synaptic events in the hippocampus, without influencing long-term potentiation. Moreover, fluorescence analysis reveals increased neurotrasmitter release although our biochemical results failed to detect which presynaptic proteins might be engaged. This study provides a novel role for PINK1 beyond the physiology of nigrostriatal dopaminergic circuit. Specifically, PINK1 might contribute to preserve synaptic function and glutamatergic homeostasis in the hippocampus, a brain region underlying cognition. The subtle changes in excitatory transmission here observed might be a pathogenic precursor to excitotoxic neurodegeneration and cognitive decline often observed in PD. Using electrophysiological and fluorescence techniques, we demonstrate that lack of PINK1 causes increased excitatory transmission and neurotransmitter release in the hippocampus, which might lead to the cognitive decline often observed in Parkinson's disease.
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Affiliation(s)
- Marco Feligioni
- EBRI-European Brain Research Institute, Rome, Italy.,Casa Cura Policlinico, Milan, Italy
| | - Dalila Mango
- EBRI-European Brain Research Institute, Rome, Italy
| | | | | | | | | | | | - Fabio Blandini
- IRCSS "C. Mondino", National Neurological Institute, Pavia, Italy
| | - Nicola B Mercuri
- University of Rome "Tor Vergata", Rome, Italy.,IRCSS Santa Lucia Foundation, Rome, Italy
| | | | - Robert Nisticò
- EBRI-European Brain Research Institute, Rome, Italy.,University of Rome "Tor Vergata", Rome, Italy
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41
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Sensitive analysis of α-synuclein by nonlinear laser wave mixing coupled with capillary electrophoresis. Anal Biochem 2016; 500:51-9. [PMID: 26874019 DOI: 10.1016/j.ab.2016.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 12/31/2015] [Accepted: 01/13/2016] [Indexed: 01/07/2023]
Abstract
Multi-photon nonlinear laser wave-mixing spectroscopy is a novel absorption-based technique that offers excellent detection sensitivity for biomedical applications, including early diagnosis and investigation of neurodegenerative diseases. α-Synuclein is linked to Parkinson's disease (PD), and characterization of its oligomers and quantification of the protein may contribute to understanding PD. The laser wave-mixing signal has a quadratic dependence on analyte concentration, and hence the technique is effective in monitoring small changes in concentration within biofluids. A wide variety of labels can be employed for laser wave-mixing detection due to its ability to detect both chromophores and fluorophores. In this investigation, two fluorophores and a chromophore are studied and used as labels for the detection of α-synuclein. Wave-mixing detection limits of PD-related protein conjugated with fluorescein isothiocyanate, QSY 35 acetic acid, succinimidyl ester, and Chromeo P503 were determined to be 1.4 × 10(-13) M, 1.4 × 10(-10) M, and 1.9 × 10(-13) M, respectively. Based on the laser probe volume used, the corresponding mass detection limits were determined to be 1.1 × 10(-23) mol, 1.1 × 10(-20) mol, and 1.5 × 10(-23) mol. This study also presents molecular-based separation and quantification of α-synuclein by laser wave mixing coupled with capillary electrophoresis.
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42
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Migdalska-Richards A, Schapira AHV. The relationship between glucocerebrosidase mutations and Parkinson disease. J Neurochem 2016; 139 Suppl 1:77-90. [PMID: 26860875 PMCID: PMC5111601 DOI: 10.1111/jnc.13385] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/08/2015] [Accepted: 10/02/2015] [Indexed: 01/12/2023]
Abstract
Parkinson disease (PD) is the second most common neurodegenerative disorder after Alzheimer disease, whereas Gaucher disease (GD) is the most frequent lysosomal storage disorder caused by homozygous mutations in the glucocerebrosidase (GBA1) gene. Increased risk of developing PD has been observed in both GD patients and carriers. It has been estimated that GBA1 mutations confer a 20‐ to 30‐fold increased risk for the development of PD, and that at least 7–10% of PD patients have a GBA1 mutation. To date, mutations in the GBA1 gene constitute numerically the most important risk factor for PD. The type of PD associated with GBA1 mutations (PD‐GBA1) is almost identical to idiopathic PD, except for a slightly younger age of onset and a tendency to more cognitive impairment. Importantly, the pathology of PD‐GBA1 is identical to idiopathic PD, with nigral dopamine cell loss, Lewy bodies, and neurites containing alpha‐synuclein. The mechanism by which GBA1 mutations increase the risk for PD is still unknown. However, given that clinical manifestation and pathological findings in PD‐GBA1 patients are almost identical to those in idiopathic PD individuals, it is likely that, as in idiopathic PD, alpha‐synuclein accumulation, mitochondrial dysfunction, autophagic impairment, oxidative and endoplasmic reticulum stress may contribute to the development and progression of PD‐GBA1. Here, we review the GBA1 gene, its role in GD, and its link with PD.
The impact of glucocerebrosidase 1 (GBA1) mutations on functioning of endoplasmic reticulum (ER), lysosomes, and mitochondria. GBA1 mutations resulting in production of misfolded glucocerebrosidase (GCase) significantly affect the ER functioning. Misfolded GCase trapped in the ER leads to both an increase in the ubiquitin–proteasome system (UPS) and the ER stress. The presence of ER stress triggers the unfolded protein response (UPR) and/or endoplasmic reticulum‐associated degradation (ERAD). The prolonged activation of UPR and ERAD subsequently leads to increased apoptosis. The presence of misfolded GCase in the lysosomes together with a reduction in wild‐type GCase levels lead to a retardation of alpha‐synuclein degradation via chaperone‐mediated autophagy (CMA), which subsequently results in alpha‐synuclein accumulation and aggregation. Impaired lysosomal functioning also causes a decrease in the clearance of autophagosomes, and so their accumulation. GBA1 mutations perturb normal mitochondria functioning by increasing generation of free radical species (ROS) and decreasing adenosine triphosphate (ATP) production, oxygen consumption, and membrane potential. GBA1 mutations also lead to accumulation of dysfunctional and fragmented mitochondria.
This article is part of a special issue on Parkinson disease.
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Barkhuizen M, Anderson DG, Grobler AF. Advances in GBA-associated Parkinson's disease--Pathology, presentation and therapies. Neurochem Int 2015; 93:6-25. [PMID: 26743617 DOI: 10.1016/j.neuint.2015.12.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/29/2015] [Accepted: 12/04/2015] [Indexed: 12/27/2022]
Abstract
GBA mutations are to date the most common genetic risk factor for Parkinson's disease. The GBA gene encodes the lysomal hydrolase glucocerebrosidase. Whilst bi-allelic GBA mutations cause Gaucher disease, both mono- and bi-allelic mutations confer risk for Parkinson's disease. Clinically, Parkinson's disease patients with GBA mutations resemble idiopathic Parkinson's disease patients. However, these patients have a modest reduction in age-of-onset of disease and a greater incidence of cognitive decline. In some cases, GBA mutations are also responsible for familial Parkinson's disease. The accumulation of α-synuclein into Lewy bodies is the central neuropathological hallmark of Parkinson's disease. Pathologic GBA mutations reduce enzymatic function. A reduction in glucocerebrosidase function increases α-synuclein levels and propagation, which in turn inhibits glucocerebrosidase in a feed-forward cascade. This cascade is central to the neuropathology of GBA-associated Parkinson's disease. The lysosomal integral membrane protein type-2 is necessary for normal glucocerebrosidase function. Glucocerebrosidase dysfunction also increases in the accumulation of β-amyloid and amyloid-precursor protein, oxidative stress, neuronal susceptibility to metal ions, microglial and immune activation. These factors contribute to neuronal death. The Mendelian Parkinson's disease genes, Parkin and ATP13A2, intersect with glucocerebrosidase. These factors sketch a complex circuit of GBA-associated neuropathology. To clinically interfere with this circuit, central glucocerebrosidase function must be improved. Strategies based on reducing breakdown of mutant glucocerebrosidase and increasing the fraction that reaches the lysosome has shown promise. Breakdown can be reduced by interfering with the ability of heat-shock proteins to recognize mutant glucocerebrosidase. This underlies the therapeutic efficacy of certain pharmacological chaperones and histone deacetylase inhibitors. These therapies are promising for Parkinson's disease, regardless of mutation status. Recently, there has been a boom in studies investigating the role of glucocerebrosidase in the pathology of Parkinson's disease. This merits a comprehensive review of the current cell biological processes and pathological pictures involving Parkinson's disease associated with GBA mutations.
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Affiliation(s)
- Melinda Barkhuizen
- DST/NWU Preclinical Drug Development Platform, North-West University, Potchefstroom, 2520, South Africa; Department of Paediatrics, School for Mental Health and Neuroscience, Maastricht University, Maastricht, 6229, The Netherlands.
| | - David G Anderson
- Department of Neurology, Witwatersrand University Donald Gordon Medical Centre, Parktown, Johannesburg, 2193, South Africa
| | - Anne F Grobler
- DST/NWU Preclinical Drug Development Platform, North-West University, Potchefstroom, 2520, South Africa
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Weingarten CP, Sundman MH, Hickey P, Chen NK. Neuroimaging of Parkinson's disease: Expanding views. Neurosci Biobehav Rev 2015; 59:16-52. [PMID: 26409344 PMCID: PMC4763948 DOI: 10.1016/j.neubiorev.2015.09.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 09/07/2015] [Accepted: 09/15/2015] [Indexed: 12/14/2022]
Abstract
Advances in molecular and structural and functional neuroimaging are rapidly expanding the complexity of neurobiological understanding of Parkinson's disease (PD). This review article begins with an introduction to PD neurobiology as a foundation for interpreting neuroimaging findings that may further lead to more integrated and comprehensive understanding of PD. Diverse areas of PD neuroimaging are then reviewed and summarized, including positron emission tomography, single photon emission computed tomography, magnetic resonance spectroscopy and imaging, transcranial sonography, magnetoencephalography, and multimodal imaging, with focus on human studies published over the last five years. These included studies on differential diagnosis, co-morbidity, genetic and prodromal PD, and treatments from L-DOPA to brain stimulation approaches, transplantation and gene therapies. Overall, neuroimaging has shown that PD is a neurodegenerative disorder involving many neurotransmitters, brain regions, structural and functional connections, and neurocognitive systems. A broad neurobiological understanding of PD will be essential for translational efforts to develop better treatments and preventive strategies. Many questions remain and we conclude with some suggestions for future directions of neuroimaging of PD.
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Affiliation(s)
- Carol P Weingarten
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States.
| | - Mark H Sundman
- Brain Imaging and Analysis Center, Duke University Medical Center, United States
| | - Patrick Hickey
- Department of Neurology, Duke University School of Medicine, United States
| | - Nan-kuei Chen
- Brain Imaging and Analysis Center, Duke University Medical Center, United States; Department of Radiology, Duke University School of Medicine, United States
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45
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Kiferle L, Giuntini M, Bonuccelli U, Ceravolo R. Imaging in Glucocerebrosidase-Associated Parkinsonism: Current Status and Implications for Pathophysiology. NEURODEGENER DIS 2015; 15:271-80. [PMID: 26227893 DOI: 10.1159/000433438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 05/12/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Glucocerebrosidase (GBA) mutations have been described as the most prevalent in Parkinson's disease (PD) and in Lewy body dementia, accounting for up to 7 and 13.8% of cases, respectively. To elucidate the pathophysiology of idiopathic Parkinson's disease (iPD), the pathogenic mechanisms leading to Lewy body accumulation in GBA-associated parkinsonism (GBA-PD) are a matter of current research. However, only few imaging studies, conducted on small GBA-PD patient cohorts, exist. METHODS We provide an overview of current structural and functional imaging studies in patients with Gaucher's disease and parkinsonism and in GBA-PD patients, underlining the main differences compared to iPD. RESULTS A limited number of PET studies have been conducted in GBA-PD, exploring brain metabolism and dopaminergic presynaptic and postsynaptic function. Moreover, structural MRI and spectroscopy studies recently evidenced the differences with iPD, aiding to understand of some peculiar aspects of iPD. Finally, new evidence from transcranial sonography confirms the technique's role in the study of GBA-PD and highlights the additional involvement of the raphe nucleus. CONCLUSIONS Further imaging studies conducted in a broader population of early GBA-PD are warranted to characterize the disease and elucidate the pathophysiological mechanisms underlying GBA-PD and to understand GBA implications in iPD.
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Affiliation(s)
- Lorenzo Kiferle
- Neurology Unit, Department of Clinical and Experimental Neurology, University of Pisa, Pisa, Italy
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46
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Cox TM, Rosenbloom BE, Barker RA. Gaucher disease and comorbidities: B-cell malignancy and parkinsonism. Am J Hematol 2015; 90 Suppl 1:S25-8. [PMID: 26096744 DOI: 10.1002/ajh.24057] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Data emerging from the International Collaborative Gaucher Group (ICGG) Gaucher Registry together with other contemporary clinical surveys have revealed a close association between Gaucher disease and non-Hodgkin's B-cell lymphoma and myeloma and Gaucher disease and Parkinson's disease. Several possible explanations for increased B-cell proliferation and neoplasia in Gaucher disease have been proposed, including the possible influence of sphingosine (derived from the extra lysosomal metabolism of glucosylceramide), gene modifiers, splenectomy and immune system deregulation induced by cytokines, chemokines, and hydrolases released from Gaucher cells. Parkinson's disease is frequently seen in the otherwise-healthy relatives of Gaucher disease patients leading to the finding that GBA mutations represent a genetic risk factor for Parkinson's disease. The mechanism of the association between GBA mutations and Parkinson's disease has yet to be elucidated but the pathogenesis appears distinct from that of Gaucher disease. Several pathogenic pathways have been proposed including lysosomal and/or mitochondrial dysfunction. The effect of Gaucher disease specific therapies on the incidence of cancer or Parkinson's disease are not clear and will likely be evaluated in future ICGG Gaucher Registry studies.
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Affiliation(s)
- Timothy M. Cox
- Department of Medicine; University of Cambridge; United Kingdom
| | | | - Roger A. Barker
- Department of Clinical Neurosciences; University of Cambridge; United Kingdom
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47
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Abstract
BACKGROUND Parkinson's disease (PD) was previously described as the prototypical sporadic disease; however, rapid advances in population and molecular genetics have revealed the existence of a significant number genetic risk factors, prompting its redefinition as a primarily genetic disorder. SOURCES OF DATA Data for this review have been gathered from the published literature. AREAS OF AGREEMENT Multiple haplotypes conveying variable but quantifiable genetic risk, acting concurrently and possibly interacting with one another, provide the basis for a new model of PD. The beginning of this revolution in our understanding came from the clinical observation of parkinsonism with a Mendelian pattern of inheritance in a number of families. The functional work that followed elucidated multiple disease pathways leading to the degeneration of the substantia nigra that characterizes PD. It is however only in recent years, with the emergence of large cohort genome-wide association studies (GWAS), that the relevance of these pathways to so-called sporadic PD has become apparent. AREAS OF CONTROVERSY A substantial portion of the presumed genetic inheritance of PD remains at present undefined. Although it is likely that so-called intermediate risk genetic risk factors are the principal component of this 'missing heritability', this is yet to be proved. GROWING POINTS Although the picture is by now means complete, the beginnings of rational basis for genetic screening of PD risk have begun to emerge. Equally, this enhanced understanding of the various genetic and in turn biochemical pathways shows promising signs of producing fruitful therapeutic strategies. Technological advances promise to reduce the costs associated with and further increase our capability to understand the complex influence of genetics on the pathogenesis of PD. AREAS TIMELY FOR DEVELOPING RESEARCH The coming years will require the enhancement of current techniques and the development of new ones to define PD's missing heritability. It will also require functional work to define better and in turn potentially reverse the mechanisms that contribute with large effect sizes to the risk of sporadic PD.
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Affiliation(s)
- Stephen Mullin
- Leonard Wolfson Clinical Research Fellow, UCL, Institute of Neurology, Rowland Hill Street, Hampstead, London NW3 2PF, UK
| | - Anthony Schapira
- Department of Clinical Neurosciences, UCL, Institute of Neurology, Hampstead, London, UK
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Schapira AHV. Glucocerebrosidase and Parkinson disease: Recent advances. Mol Cell Neurosci 2015; 66:37-42. [PMID: 25802027 PMCID: PMC4471139 DOI: 10.1016/j.mcn.2015.03.013] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/10/2015] [Accepted: 03/12/2015] [Indexed: 12/13/2022] Open
Abstract
Mutations of the glucocerebrosidase (GBA) gene are the most important risk factor yet discovered for Parkinson disease (PD). Homozygous GBA mutations result in Gaucher disease (GD), a lysosomal storage disorder. Heterozygous mutations have not until recently been thought to be associated with any pathological process. However, it is clear that the presence of a GBA mutation in homozygous or heterozygous form is associated with an approximately 20-fold increase in the risk for PD, with little if any difference in risk burden related to gene dose. Most studies suggest that 5-10% of PD patients have GBA mutations, although this figure is greater in the Ashkenazi population and may be an underestimate overall if the entire exome is not sequenced. GBA-associated PD is clinically indistinguishable from idiopathic PD, except for slightly earlier age of onset and a greater frequency of cognitive impairment. Pathological and imaging features, and response to pharmacotherapy are identical to idiopathic PD. GBA mutations result in reduced enzyme activity and mutant protein may become trapped in the endoplasmic reticulum (ER) leading to unfolded protein response and ER associated degradation and stress. Both mechanisms may be relevant in GD and PD pathogenesis and lead to impaired lysosomal function. Of particular relevance to PD is the interaction of glucocerebrosidase enzyme (GCase) with alpha-synuclein (SNCA). There appears to be a bi-directional reciprocal relationship between GCase levels and those of SNCA. Thus reduced GCase in GBA mutation PD brain is associated with increased SNCA, and increased SNCA deposition is associated with reduced GCase even in GBA wild-type PD brains. It is noteworthy that GBA mutations are also associated with an increase in risk for dementia with Lewy bodies, another synucleinopathy. It has been suggested that the relationship between GCase and SNCA may be leveraged to reduce SNCA levels in PD by enhancing GCase levels and activity. This hypothesis has been confirmed in GBA mutant mice, PD patient fibroblasts and cells with SNCA overexpression, and offers an important target pathway for future neuroprotection therapy in PD. This article is part of a Special Issue entitled 'Neuronal Protein'.
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Affiliation(s)
- Anthony H V Schapira
- Department of Clinical Neurosciences, UCL Institute of Neurology, UCL Royal Free Campus, Rowland Hill Street, London NW3 2PF, United Kingdom.
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49
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Castellanos G, Fernández-Seara MA, Lorenzo-Betancor O, Ortega-Cubero S, Puigvert M, Uranga J, Vidorreta M, Irigoyen J, Lorenzo E, Muñoz-Barrutia A, Ortiz-de-Solorzano C, Pastor P, Pastor MA. Automated neuromelanin imaging as a diagnostic biomarker for Parkinson's disease. Mov Disord 2015; 30:945-52. [PMID: 25772492 DOI: 10.1002/mds.26201] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 01/20/2015] [Accepted: 02/09/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We aimed to analyze the diagnostic accuracy of an automated segmentation and quantification method of the SNc and locus coeruleus (LC) volumes based on neuromelanin (NM)-sensitive MRI (NM-MRI) in patients with idiopathic (iPD) and monogenic (iPD) Parkinson's disease (PD). METHODS Thirty-six patients (23 idiopathic and 13 monogenic PARKIN or LRRK2 mutations) and 37 age-matched healthy controls underwent 3T-NM-MRI. SNc and LC volumetry were performed using fully automated multi-image atlas segmentation. The diagnostic performance to differentiate PD from controls was measured using the area under the curve (AUC) and likelihood ratios based on receiver operating characteristic (ROC) analyses. RESULTS We found a significant reduction of SNc and LC volumes in patients, when compared to controls. ROC analysis showed better diagnostic accuracy when using SNc volume than LC volume. Significant differences between ipsilateral and contralateral SNc volumes, in relation to the more clinically affected side, were found in patients with iPD (P = 0.007). Contralateral atrophy in the SNc showed the highest power to discriminate PD subjects from controls (AUC, 0.93-0.94; sensitivity, 91%-92%; specificity, 89%; positive likelihood ratio: 8.4-8.5; negative likelihood ratio: 0.09-0.1 at a single cut-off point). Interval likelihood ratios for contralateral SNc volume improved the diagnostic accuracy of volumetric measurements. CONCLUSION SNc and LC volumetry based on NM-MRI resulting from the automated segmentation and quantification technique can yield high diagnostic accuracy for differentiating PD from health and might be an unbiased disease biomarker. © 2015 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Gabriel Castellanos
- Neuroimaging Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - María A Fernández-Seara
- Neuroimaging Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Oswaldo Lorenzo-Betancor
- Neurogenetics Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Sara Ortega-Cubero
- Neurogenetics Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Marc Puigvert
- Pulmonary Department, Clínica Universidad de Navarra, University of Navarra School of Medicine, Pamplona, Spain
| | - Javier Uranga
- Cancer Imaging Laboratory, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain
| | - Marta Vidorreta
- Neuroimaging Laboratory, University of Navarra, Pamplona, Spain
| | - Jaione Irigoyen
- Neuroimaging Laboratory, University of Navarra, Pamplona, Spain.,Neurogenetics Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain.,Department of Neurology, Clínica Universidad de Navarra, University of Navarra School of Medicine, Pamplona, Spain
| | - Elena Lorenzo
- Neurogenetics Laboratory, University of Navarra, Pamplona, Spain
| | - Arrate Muñoz-Barrutia
- Cancer Imaging Laboratory, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain.,Bioengineering and Aerospace Engineering Department, University Carlos III of Madrid and Gregorio Marañon Health Research Institute, Madrid, Spain
| | - Carlos Ortiz-de-Solorzano
- Cancer Imaging Laboratory, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain
| | - Pau Pastor
- Neurogenetics Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain.,Department of Neurology, Clínica Universidad de Navarra, University of Navarra School of Medicine, Pamplona, Spain.,Department of Neurology, Hospital Universitari Mutua de Terrassa, University of Barcelona, Barcelona, Spain
| | - María A Pastor
- Neuroimaging Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain.,Department of Neurology, Clínica Universidad de Navarra, University of Navarra School of Medicine, Pamplona, Spain
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50
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Ba F, Martin WW. Dopamine transporter imaging as a diagnostic tool for parkinsonism and related disorders in clinical practice. Parkinsonism Relat Disord 2015; 21:87-94. [PMID: 25487733 DOI: 10.1016/j.parkreldis.2014.11.007] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/12/2014] [Accepted: 11/12/2014] [Indexed: 01/22/2023]
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