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Walker JJ, Meunier E, Garcia S, Messaoudi B, Mouly AM, Veyrac A, Buonviso N, Courtiol E. State-dependent alteration of respiration in a rat model of Parkinson's disease. Exp Neurol 2024; 375:114740. [PMID: 38395215 DOI: 10.1016/j.expneurol.2024.114740] [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: 11/14/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024]
Abstract
Parkinson's disease (PD) is the second most frequent neurodegenerative disorder. Besides major deficits in motor coordination, patients may also display sensory and cognitive impairments, which are often overlooked despite being inherently part of the PD symptomatology. Amongst those symptoms, respiration, a key mechanism involved in the regulation of multiple physiological and neuronal processes, appears to be altered. Importantly, breathing patterns are highly correlated with the animal's behavioral states. This raises the question of the potential impact of behavioral state on respiration deficits in PD. To answer this question, we first characterized the respiratory parameters in a neurotoxin-induced rat model of PD (6-OHDA) across three different vigilance states: sleep, quiet waking and exploration. We noted a significantly higher respiratory frequency in 6-OHDA rats during quiet waking compared to Sham rats. A higher respiratory amplitude was also observed in 6-OHDA rats during both quiet waking and exploration. No effect of the treatment was noted during sleep. Given the relation between respiration and olfaction and the presence of olfactory deficits in PD patients, we then investigated the odor-evoked sniffing response in PD rats, using an odor habituation/cross-habituation paradigm. No substantial differences were observed in olfactory abilities between the two groups, as assessed through sniffing frequency. These results corroborate the hypothesis that respiratory impairments in 6-OHDA rats are vigilance-dependent. Our results also shed light on the importance of considering the behavioral state as an impacting factor when analyzing respiration.
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Affiliation(s)
- Jean Jacques Walker
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, CMO, Centre Hospitalier Le Vinatier, Bâtiment 452, Neurocampus Michel Jouvet - 95 Bd Pinel, 69675 Bron Cedex, France.
| | - Estelle Meunier
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, CMO, Centre Hospitalier Le Vinatier, Bâtiment 452, Neurocampus Michel Jouvet - 95 Bd Pinel, 69675 Bron Cedex, France
| | - Samuel Garcia
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, CMO, Centre Hospitalier Le Vinatier, Bâtiment 452, Neurocampus Michel Jouvet - 95 Bd Pinel, 69675 Bron Cedex, France.
| | - Belkacem Messaoudi
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, CMO, Centre Hospitalier Le Vinatier, Bâtiment 452, Neurocampus Michel Jouvet - 95 Bd Pinel, 69675 Bron Cedex, France.
| | - Anne-Marie Mouly
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, CMO, Centre Hospitalier Le Vinatier, Bâtiment 452, Neurocampus Michel Jouvet - 95 Bd Pinel, 69675 Bron Cedex, France.
| | - Alexandra Veyrac
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, CMO, Centre Hospitalier Le Vinatier, Bâtiment 452, Neurocampus Michel Jouvet - 95 Bd Pinel, 69675 Bron Cedex, France.
| | - Nathalie Buonviso
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, CMO, Centre Hospitalier Le Vinatier, Bâtiment 452, Neurocampus Michel Jouvet - 95 Bd Pinel, 69675 Bron Cedex, France.
| | - Emmanuelle Courtiol
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, CMO, Centre Hospitalier Le Vinatier, Bâtiment 452, Neurocampus Michel Jouvet - 95 Bd Pinel, 69675 Bron Cedex, France.
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Maetzler W, Mirelman A, Pilotto A, Bhidayasiri R. Identifying Subtle Motor Deficits Before Parkinson's Disease is Diagnosed: What to Look for? JOURNAL OF PARKINSON'S DISEASE 2024:JPD230350. [PMID: 38363620 DOI: 10.3233/jpd-230350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Motor deficits typical of Parkinson's disease (PD), such as gait and balance disturbances, tremor, reduced arm swing and finger movement, and voice and breathing changes, are believed to manifest several years prior to clinical diagnosis. Here we describe the evidence for the presence and progression of motor deficits in this pre-diagnostic phase in order to provide suggestions for the design of future observational studies for an effective, quantitatively oriented investigation. On the one hand, these future studies must detect these motor deficits in as large (potentially, population-based) cohorts as possible with high sensitivity and specificity. On the other hand, they must describe the progression of these motor deficits in the pre-diagnostic phase as accurately as possible, to support the testing of the effect of pharmacological and non-pharmacological interventions. Digital technologies and artificial intelligence can substantially accelerate this process.
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Affiliation(s)
- Walter Maetzler
- Department of Neurology University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Anat Mirelman
- Laboratory for Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Laboratory of Digital Neurology and Biosensors, University of Brescia, Brescia, Italy
- Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Brescia Hospital, Brescia, Italy
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
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Oliveira LM, Severs L, Moreira TS, Ramirez JM, Takakura AC. Ampakine CX614 increases respiratory rate in a mouse model of Parkinson's disease. Brain Res 2023; 1815:148448. [PMID: 37301422 DOI: 10.1016/j.brainres.2023.148448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/11/2023] [Accepted: 06/05/2023] [Indexed: 06/12/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by progressive loss of dopaminergic neurons in the substantia nigra compacta (SNpc). In a mouse model of PD induced by the injection of 6-hydroxydopamine (6-OHDA) into the caudate putamen (CPu) dyspnea events are very common. Neuroanatomical and functional studies show that the number of glutamatergic neurons in the pre-Bötzinger Complex (preBötC) are reduced. We hypothesize that the neuronal loss, and consequently loss of glutamatergic connections in the respiratory network previously investigated, are responsible for the breathing impairment in PD. Here, we tested whether ampakines (CX614), a subgroup of AMPA receptor positive allosteric modulators, could stimulate the respiratory activity in PD-induced animals. CX614 (50 µM) injected intraperitoneally or directly into the preBötC region reduced the irregularity pattern and increased the respiratory rate by 37% or 82%, respectively, in PD-induced animals. CX614 also increased the respiratory frequency in healthy animals. These data suggest that ampakine CX614 could become a tool to restore breathing in PD.
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Affiliation(s)
- Luiz M Oliveira
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP 05508, Brazil; Center for Integrative Brain Research, Seattle Children's Research Institute, 1900 9th Avenue, JMB10, Seattle, WA 98101, USA
| | - Liza Severs
- Center for Integrative Brain Research, Seattle Children's Research Institute, 1900 9th Avenue, JMB10, Seattle, WA 98101, USA
| | - Thiago S Moreira
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, 05508, Brazil
| | - Jan-Marino Ramirez
- Center for Integrative Brain Research, Seattle Children's Research Institute, 1900 9th Avenue, JMB10, Seattle, WA 98101, USA; Department of Neurological Surgery, University of Washington, 1900 9th Avenue, JMB10, Seattle, WA 98101, USA; Department of Pediatrics, University of Washington, 1900 9th Avenue, JMB10, Seattle, WA 98101, USA
| | - Ana C Takakura
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP 05508, Brazil.
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Xi C, Bai XC, Li C, Wang WN, Tian S, Tang YL, Shen B, Wang J, Sun YM, Zhu YL. Association between Respiratory Function and Motor Function in Different Stages of Parkinson's Disease. Eur Neurol 2023; 86:242-249. [PMID: 37068470 DOI: 10.1159/000530390] [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: 11/18/2022] [Accepted: 03/19/2023] [Indexed: 04/19/2023]
Abstract
INTRODUCTION Respiratory dysfunction in patients with Parkinson's disease (PD) could present in the early stage and worsen in the late stages. These changes could be a factor affecting the ability of daily living and quality of life of patients with PD. The primary objective of this study was to assess the respiratory function and its association with motor function in patients with different stages of PD. METHODS This was a cross-sectional study conducted at the Huashan Hospital of Fudan University in Shanghai, China. The study included 65 patients diagnosed with PD (the Hoehn and Yahr scale between 1 and 4) and 20 healthy individuals of similar age, gender, weight, and height. The ventilatory function was assessed using the spirometry. Motor function was evaluated using subscale III of the United Parkinson's disease rating scale (UPDRS-III). After confirming the normality of data distribution, we performed one-way ANOVA with a Tukey's post hoc test. RESULTS Compared with the healthy individuals, there was no statistical significance in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) in the H&Y 1 group and H&Y 2 group (p > 0.05) but reduced peak expiratory flow (PEF) in the H&Y 2 group (p = 0.002). Reduced FVC, FEV1, and PEF was seen in the H&Y 3 group (p = 0.002, p = 0.001, and p = 0.0001, respectively). Reduced FVC, FEV1, PEF, and FEF25-75% was seen in the H&Y 4 group (p = 0.001, p = 0.0001, p = 0.0001, and p = 0.025, respectively). The correlation analysis revealed that there was a significant negative correlation between FVC and UPDRS-III scores (r = -0.248, p = 0.046), disease duration (r = -0.276, p = 0.026), H&Y scale (r = -0.415, p = 0.001). FEV1 was negatively correlated with UPDRS-III scores (r = -0.277, p = 0.025), disease duration (r = -0.291, p = 0.019), H&Y scale (r = -0.434, p = 0.0001). FEF25-75% was negatively correlated with disease duration (r = -0.247, p = 0.047), H&Y scale (r = -0.278, p = 0.025). CONCLUSION Our findings revealed that respiratory impairment is present in moderate and advanced PD patients, and directly related to the severity of the disease. It is important to conduct respiratory function test in the clinical practice.
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Affiliation(s)
- Chong Xi
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China,
| | - Xiao-Chen Bai
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ce Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wei-Ning Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shan Tian
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yi-Lin Tang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Bo Shen
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jian Wang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yi-Min Sun
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yu-Lian Zhu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Friedman JH. James Parkinson did NOT describe respiratory changes in The Shaking Palsy. Parkinsonism Relat Disord 2023; 107:105280. [PMID: 36680914 DOI: 10.1016/j.parkreldis.2023.105280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/27/2022] [Accepted: 01/07/2023] [Indexed: 01/11/2023]
Affiliation(s)
- Joseph H Friedman
- Movement Disorders Program Butler Hospital, 345 Blackstone Blvd, Providence, RI, 02906, USA.
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Oliveira RTD, Santos FMD, Ramos AG, Seki KLM, Müller PDT, Christofoletti G. Pulmonary function and medication effect in mild-stage subjects with Parkinson's disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:1233-1238. [PMID: 36580961 PMCID: PMC9800167 DOI: 10.1055/s-0042-1758753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Parkinson's disease (PD) causes a series of movement disorders, many of them starting in the early stage. OBJECTIVE To analyze the pulmonary function of mild-stage subjects with PD and to investigate the effects of levodopa on it. METHODS We included 21 patients with idiopathic PD and 20 healthy control subjects. The participants were submitted to spirometry and impulse oscillometry assessments. The PD patients were evaluated during the "off" and "on" phases of their anti-PD medication, which was was converted to levodopa in an equivalent daily dose. A statistical analysis was performed with cross-sectional (PD patients "off" medication versus controls) and paired (PD patients "off" medication versus PD patients "on" medication) tests. The effect of levodopa was calculated with partial Eta-squared (η2 ρ). Significance was set at 5%. RESULTS The PD patients presented normal values in the impulse oscillometry. Regarding spirometry, the results indicated an incipient obstructive ventilatory disorder in the PD group - confirmed by patients' flow-volume curves. The PD patients received a daily dose of 354.7 ± 148.2 mg of levodopa. The paired analyses showed a small effect of anti-PD medication on pulmonary parameters (η2 ρ = 0.197 for spirometry and η2 ρ= 0.043 for impulse oscillometry). CONCLUSION Patients with PD in the mild stage of the disease present pulmonary compliance and resistance compatible with normal parameters. The differences regarding the spirometric results indicate an incipient obstructive ventilatory disorder in patients with PD. Levodopa had small effect on pulmonary function in the mild stage of the disease.
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Affiliation(s)
- Renata Terra de Oliveira
- Universidade Federal de Mato Grosso do Sul, Faculdade de Medicina, Programa de Saúde e Desenvolvimento, Campo Grande MS, Brazil.
| | - Fabiana Maria dos Santos
- Universidade Federal de Mato Grosso do Sul, Faculdade de Medicina, Programa de Saúde e Desenvolvimento, Campo Grande MS, Brazil.
| | | | - Karla Luciana Magnani Seki
- Hospital Universitário Maria Aparecida Pedrossian, Campo Grande MS, Brazil.,Universidade Federal de Mato Grosso do Sul, Instituto de Saúde, Programa em Ciências do Movimento, Campo Grande MS, Brazil.
| | - Paulo de Tarso Müller
- Universidade Federal de Mato Grosso do Sul, Faculdade de Medicina, Programa de Saúde e Desenvolvimento, Campo Grande MS, Brazil.,Universidade Federal de Mato Grosso do Sul, Instituto de Saúde, Programa em Ciências do Movimento, Campo Grande MS, Brazil.
| | - Gustavo Christofoletti
- Universidade Federal de Mato Grosso do Sul, Faculdade de Medicina, Programa de Saúde e Desenvolvimento, Campo Grande MS, Brazil.,Universidade Federal de Mato Grosso do Sul, Instituto de Saúde, Programa em Ciências do Movimento, Campo Grande MS, Brazil.,Address for correspondence Gustavo Christofoletti
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7
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Di Pietro DA, Olivares A, Comini L, Vezzadini G, Luisa A, Petrolati A, Boccola S, Boccali E, Pasotti M, Danna L, Vitacca M. Voice Alterations, Dysarthria, and Respiratory Derangements in Patients With Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3749-3757. [PMID: 36194769 DOI: 10.1044/2022_jslhr-21-00539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Almost 90% of people with Parkinson's disease (PD) develop voice and speech disorders during the course of the disease. Ventilatory dysfunction is one of the main causes. We aimed to evaluate relationships between respiratory impairments and speech/voice changes in PD. METHOD At Day 15 from admission, in consecutive clinically stable PD patients in a neurorehabilitation unit, we collected clinical data as follows: comorbidities, PD severity, motor function and balance, respiratory function at rest (including muscle strength and cough ability), during exercise-induced desaturation and at night, voice function (Voice Handicap Index [VHI] and acoustic analysis [Praat]), speech disorders (Robertson Dysarthria Profile [RDP]), and postural abnormalities. Based on an arbitrary RDP cutoff, two groups with different dysarthria degree were identified-moderate-severe versus no-mild dysarthria-and compared. RESULTS Of 55 patients analyzed (median value Unified Parkinson's Disease Rating Scale Part II 9 and Part III 17), we found significant impairments in inspiratory and expiratory muscle pressure (> 90%, both), exercise tolerance at 6-min walking distance (96%), nocturnal (12.7%) and exercise-induced (21.8%) desaturation, VHI (34%), and Praat Shimmer% (89%). Patients with moderate-severe dysarthria (16% of total sample) had more comorbidities/disabilities and worse respiratory pattern and postural abnormalities (camptocormia) than those with no-mild dysarthria. Moreover, the risk of presenting nocturnal desaturation, reduced peak expiratory flow, and cough ability was about 11, 13, and 8 times higher in the moderate-severe group. CONCLUSIONS Dysarthria and respiratory dysfunction are closely associated in PD patients, particularly nocturnal desaturation and reduced cough ability. In addition, postural condition could be at the base of both respiratory and voice impairments. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21210944.
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Affiliation(s)
- Davide Antonio Di Pietro
- Neurorehabilitation Unit of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - Adriana Olivares
- Scientific Direction of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - Laura Comini
- Scientific Direction of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - Giuliana Vezzadini
- Neurorehabilitation Unit of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, Mantova, Italy
| | - Alberto Luisa
- Neurorehabilitation Unit of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - Anna Petrolati
- Neurorehabilitation Unit of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, Mantova, Italy
| | - Sara Boccola
- Neurorehabilitation Unit of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, Mantova, Italy
| | - Elisa Boccali
- Neurorehabilitation Unit of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - Monica Pasotti
- Neurorehabilitation Unit of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, Mantova, Italy
| | - Laura Danna
- Neurorehabilitation Unit of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - Michele Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
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Yang Y, Yuan Y, Zhang G, Wang H, Chen YC, Liu Y, Tarolli CG, Crepeau D, Bukartyk J, Junna MR, Videnovic A, Ellis TD, Lipford MC, Dorsey R, Katabi D. Artificial intelligence-enabled detection and assessment of Parkinson's disease using nocturnal breathing signals. Nat Med 2022; 28:2207-2215. [PMID: 35995955 PMCID: PMC9556299 DOI: 10.1038/s41591-022-01932-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 07/05/2022] [Indexed: 11/08/2022]
Abstract
There are currently no effective biomarkers for diagnosing Parkinson's disease (PD) or tracking its progression. Here, we developed an artificial intelligence (AI) model to detect PD and track its progression from nocturnal breathing signals. The model was evaluated on a large dataset comprising 7,671 individuals, using data from several hospitals in the United States, as well as multiple public datasets. The AI model can detect PD with an area-under-the-curve of 0.90 and 0.85 on held-out and external test sets, respectively. The AI model can also estimate PD severity and progression in accordance with the Movement Disorder Society Unified Parkinson's Disease Rating Scale (R = 0.94, P = 3.6 × 10-25). The AI model uses an attention layer that allows for interpreting its predictions with respect to sleep and electroencephalogram. Moreover, the model can assess PD in the home setting in a touchless manner, by extracting breathing from radio waves that bounce off a person's body during sleep. Our study demonstrates the feasibility of objective, noninvasive, at-home assessment of PD, and also provides initial evidence that this AI model may be useful for risk assessment before clinical diagnosis.
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Affiliation(s)
- Yuzhe Yang
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Yuan Yuan
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Guo Zhang
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Hao Wang
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Computer Science, Rutgers University, Piscataway, NJ, USA
| | - Ying-Cong Chen
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Yingcheng Liu
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Christopher G Tarolli
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
- Center for Health and Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Daniel Crepeau
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Jan Bukartyk
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Mithri R Junna
- Department of Neurology and Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Aleksandar Videnovic
- Divisions of Sleep Medicine and Movement Disorders, Massachusetts General Hospital, Boston, MA, USA
| | - Terry D Ellis
- Department of Physical Therapy and Athletic Training, Center for Neurorehabilitation, Boston University College of Health and Rehabilitation, Sargent College, Boston, MA, USA
| | - Melissa C Lipford
- Department of Neurology and Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ray Dorsey
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
- Center for Health and Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Dina Katabi
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
- Emerald Innovations, Inc., Cambridge, MA, USA
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9
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Effects of an Aquatic Physical Exercise Program on Ventilatory Parameters in People with Parkinson’s Disease. PARKINSON'S DISEASE 2022; 2022:2073068. [PMID: 36091655 PMCID: PMC9452001 DOI: 10.1155/2022/2073068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
Problems in the respiratory system are the main cause of death in Parkinson’s disease (PD). Ventilatory limitations can also be part of a vicious cycle involving physical-functional limitations (e.g., walking difficulties) and the patients’ perception of fatigue. The objective of this study was to analyze the effects of an aquatic physical exercise intervention program on ventilatory parameters, perception of fatigue, and gait capacity in participants with PD. This quasi-experimental study had a single group with repeated measures in four assessments, proposing an aquatic physical exercise intervention program. The inclusion criteria encompassed being in levels 1 to 4 on the Hoehn and Yahr scale and having a medical certificate for the activities. Assessments took place at 3-month intervals between them—the first period was the control, the second following the intervention, and the third period was the follow-up. The intervention had 25 biweekly sessions over 3 months. A total of 13 people (71.3 ± 5.61 years old) participated in the intervention, without significant differences in the control period. Between the intervention assessments, they had statistically significant differences in MIP, MEP, FVC, Tiffeneau index, MVV, and fatigue. The study demonstrated that the aquatic physical exercise intervention was effective for ventilatory outcomes and fatigue in people with PD.
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10
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de la Rosa T, Calvo VS, Gonçalves VC, Ferreira CB, Cabral LM, Souza FDC, Scerni DA, Scorza FA, Moreira TS, Takakura AC. Respiratory deficits in a female rat model of Parkinson's Disease. Exp Physiol 2022; 107:1349-1359. [PMID: 36030407 DOI: 10.1113/ep090378] [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: 02/14/2022] [Accepted: 08/23/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? How does 6-OHDA-induced Parkinson's Disease model affect the respiratory response in female rats? What effect does ovariectomy have on that response? What is the main finding and its importance? Our results suggest a protective effect of ovarian hormones in maintaining normal neuroanatomical integrity of the medullary respiratory nucleus in females. It was observed that ovariectomy alone reduced NK1r density in preBotc and BotC, and there was an incremental effect of 6-OHDA and ovariectomy on RTN neurons. ABSTRACT Emerging evidence indicates that Parkinson's disease (PD) courses with autonomic and respiratory deficiencies in addition to the classical motor symptoms. The prevalence of PD is lower in women, and it has been hypothesized that neuroprotection by ovarian hormones can explain this difference. While male PD animal models present changes in the central respiratory control areas, as well as ventilatory parameters under normoxia and hypercapnia, little is known about sex differences regarding respiratory deficits in this disease background. This study aimed to explore the neuroanatomical and functional respiratory changes in intact and ovariectomized female rats subjected to chemically induced PD via a bilateral intrastriatal injection of 6-hydroxydopamine (6-OHDA). The respiratory parameters were evaluated by whole-body plethysmography, and the neuroanatomy was monitored using immunohistochemistry. It was found that dopaminergic neurons in the substantia nigra and neurokinin-1 receptor (NK1r) density in the rostral ventrolateral respiratory group, Botzinger and pre-Botzinger complex were reduced in the chemically induced PD animals. Additionally, reduced numbers of Phox2b neurons were only observed in the retrotrapezoid nucleus of PD-ovariectomized rats. Concerning respiratory parameters, in ovariectomized rats, the resting and hypercapnia-induced tidal volume (VT ) is reduced, and ventilation (VE ) changes independently of 6-OHDA administration. Notably, there is a reduction in the number of RTN phox2b neurons and hypercapnia-induced respiratory changes in PD-ovariectomized animals due to a 6-OHDA and OVX interaction. These results suggest a protective effect induced by ovarian hormones in neuroanatomical changes observed in a female experimental PD model. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tomás de la Rosa
- Neurology Department, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil.,Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, University of Cádiz, Cádiz, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Viviam S Calvo
- Neurology Department, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | - Valeria C Gonçalves
- Neurology Department, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | - Caroline B Ferreira
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, São Paulo, Brazil
| | - Lais M Cabral
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, São Paulo, Brazil
| | - Felipe da C Souza
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, São Paulo, Brazil
| | - Débora A Scerni
- Neurology Department, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | - Fúlvio A Scorza
- Neurology Department, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | - Thiago S Moreira
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, São Paulo, Brazil
| | - Ana C Takakura
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, São Paulo, Brazil
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L. F. Nascimento A, O. S. Medeiros P, F. A. T. Pedrão L, Queiroz VC, Oliveira LM, Novaes LS, Caetano AL, Munhoz CD, Takakura AC, Falquetto B. Oxidative stress inhibition via apocynin prevents contributes to medullary respiratory neurodegeneration and respiratory pattern dysfunction in 6-OHDA animal model of Parkinson's disease. Neuroscience 2022; 502:91-106. [DOI: 10.1016/j.neuroscience.2022.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/15/2022]
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van de Wetering-van Dongen VA, Nijkrake MJ, Koenders N, van der Wees PJ, Bloem BR, Kalf JG. Experienced Respiratory Symptoms and the Impact on Daily Life from the Perspective of People with Parkinson's Disease: A Grounded Theory. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1677-1691. [PMID: 35634852 PMCID: PMC9398081 DOI: 10.3233/jpd-213121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Abnormal respiratory function tests can be observed early in the course of Parkinson's disease (PD). A better understanding of the impact of respiratory dysfunction on daily life in PD is needed to prevent later occurring complications as a (aspiration) pneumonia. OBJECTIVE To explain which respiratory symptoms people with PD or a form of atypical parkinsonism experience and how these symptoms impact on their daily lives. METHODS This qualitative study used a grounded theory approach. A purposeful sample strategy was used to capture information-rich cases. Data were collected in semi-structured interviews with participants diagnosed with either PD (n = 11) or atypical parkinsonism (n = 3), all of whom had confirmed respiratory symptoms. Data were analyzed using grounded theory analysis by creating codes, categories, theoretical themes, and, ultimately, a conceptual model. RESULTS Four respiratory profiles emerged, describing different types of respiratory dysfunction, with various positive and negative influencing factors. First, a loss of breathing automatism was experienced. Second, episodes of breathlessness or a rapid, shallow breathing pattern were triggered by either physical exertion, fatigue, or postural deformities. Third, stress and anxiety also triggered episodes of breathlessness. Fourth, a decreased cough strength and frequent coughing. Based on these findings, we constructed a conceptual model that visualizes the relations between these four types of respiratory dysfunction and their impact on daily life, with 'discomfort' and 'avoidance of social activities' as crucial elements. CONCLUSION A tailored approach for each profile of respiratory dysfunction is recommended to improve respiratory dysfunction and to reduce its social impact in people with PD.
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Affiliation(s)
- Veerle A van de Wetering-van Dongen
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Nijmegen, the Netherlands
| | - Maarten J Nijkrake
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Nijmegen, the Netherlands
| | - Niek Koenders
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Rehabilitation, Nijmegen, the Netherlands
| | - Philip J van der Wees
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Rehabilitation and IQ Healthcare, Nijmegen, the Netherlands
| | - Bastiaan R Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - Johanna G Kalf
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Nijmegen, the Netherlands
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13
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Cho S, Agmon G, Shellikeri S, Cousins KAQ, Ash S, Irwin DJ, Spindler M, Deik AF, Elman LB, Quinn C, Liberman M, Grossman M, Nevler N. Prosodic characteristics of prepausal words produced by patients with neurodegenerative disease. SPEECH PROSODY (URBANA, ILL.) 2022; 2022:120-124. [PMID: 36444200 PMCID: PMC9701527 DOI: 10.21437/speechprosody.2022-25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Prosody of patients with neurodegenerative disease is often impaired. We investigated changes to two prosodic cues in patients: the pitch contour and the duration of prepausal words. We analyzed recordings of picture descriptions produced by patients with neurodegenerative conditions that included either cognitive (n=223), motor (n=68), or mixed cognitive and motor impairments (n=109), and by healthy controls (n=28; HC). A speech activity detector identified pauses. Words were aligned to the acoustic signal; pitch values were normalized in scale and duration. Analyses of pitch showed that the ending (90th-100th percentile) of prepausal words had a lower pitch in the mixed and motor groups than the cognitive group and HC. The pitch contour from the midpoint of words to the end showed a steep rising slope for HC, but patients showed a gentle rising or flat slope. This suggests that HC signaled the continuation of their description after the pause with rising contour; patients either failed to keep describing the picture due to cognitive impairment or could not raise pitch due to motor impairments. Prepausal words showed longer duration relative to non-prepausal words with no significant differences between the groups. This suggests that prepausal lengthening is preserved in patients.
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Affiliation(s)
- Sunghye Cho
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA
| | - Galit Agmon
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Sanjana Shellikeri
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Katheryn A Q Cousins
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon Ash
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Meredith Spindler
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Andres F Deik
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Lauren B Elman
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Colin Quinn
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Liberman
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Naomi Nevler
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
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Kaczyńska K, Orłowska ME, Andrzejewski K. Respiratory Abnormalities in Parkinson's Disease: What Do We Know from Studies in Humans and Animal Models? Int J Mol Sci 2022; 23:ijms23073499. [PMID: 35408858 PMCID: PMC8998219 DOI: 10.3390/ijms23073499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 12/12/2022] Open
Abstract
Parkinson’s disease (PD) is the second most common progressive neurodegenerative disease characterized by movement disorders due to the progressive loss of dopaminergic neurons in the ventrolateral region of the substantia nigra pars compacta (SNpc). Apart from the cardinal motor symptoms such as rigidity and bradykinesia, non-motor symptoms including those associated with respiratory dysfunction are of increasing interest. Not only can they impair the patients’ quality of life but they also can cause aspiration pneumonia, which is the leading cause of death among PD patients. This narrative review attempts to summarize the existing literature on respiratory impairments reported in human studies, as well as what is newly known from studies in animal models of the disease. Discussed are not only respiratory muscle dysfunction, apnea, and dyspnea, but also altered central respiratory control, responses to hypercapnia and hypoxia, and how they are affected by the pharmacological treatment of PD.
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15
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Oguz S, Gurses HN, Kuran Aslan G, Demir R, Ozyilmaz S, Karantay Mutluay F, Apaydin H. Walking training augments the effects of expiratory muscle training in Parkinson's disease. Acta Neurol Scand 2022; 145:79-86. [PMID: 34459496 DOI: 10.1111/ane.13524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the effects of walking training combined with respiratory muscle training (RMT) on pulmonary function, respiratory muscle strength, and functional exercise capacity in patients with Parkinson's disease. MATERIALS & METHODS Thirty patients with Parkinson's disease were included in the study. Patients were randomly divided into two groups: the walking and RMT group (W + RMT, n = 15) and the RMT (n = 15) group. Spirometry, respiratory muscle strength, and a 6-min walking test were measured before and after the eighth week of the study. RMT was performed using inspiratory and expiratory threshold loading methods. Walking training intensity was adjusted according to the 6-min walking test. Patients performed 15 min of inspiratory muscle training and 15 min of expiratory muscle training in both groups, and 15 min of walking training in the W + RMT group in addition to RMT, twice per day, 5 days/week, for a total of 8 weeks at home. Training intensity was adjusted once per week for the groups at the hospital. RESULTS Respiratory muscle strength and 6-min walking distance were significantly increased (p = .001), and UPDRS-III scores were significantly improved (W + RMT: p = .008 and RMT: p = .01) in the two groups. The increase in maximal expiratory pressure was significantly higher in the W + RMT group than in the RMT group (p = .007). CONCLUSION Walking training increases the effect of expiratory muscle training in patients with Parkinson's disease.
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Affiliation(s)
- Semra Oguz
- Faculty of Health Sciences Division of Physiotherapy and Rehabilitation Marmara University Istanbul Turkey
| | - Hulya Nilgun Gurses
- Faculty of Health Sciences Division of Physiotherapy and Rehabilitation Department of Cardiopulmonary Physiotherapy and Rehabilitation Bezmialem Vakif University Istanbul Turkey
| | - Goksen Kuran Aslan
- Faculty of Health Sciences Division of Physiotherapy and Rehabilitation Istanbul University–Cerrahpasa Istanbul Turkey
| | - Rengin Demir
- Institute of Cardiology Department of Cardiology Istanbul University–Cerrahpasa Istanbul Turkey
| | - Semiramis Ozyilmaz
- Faculty of Health Sciences Division of Physiotherapy and Rehabilitation Bezmialem Vakif University Istanbul Turkey
| | - Fatma Karantay Mutluay
- Faculty of Health Sciences Division of Physiotherapy and Rehabilitation Istanbul Medipol University Istanbul Turkey
| | - Hulya Apaydin
- Cerrahpasa Faculty of Medicine Department of Neurology Istanbul University‐Cerrahpasa Istanbul Turkey
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16
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Ghosh S. Breathing disorders in neurodegenerative diseases. HANDBOOK OF CLINICAL NEUROLOGY 2022; 189:223-239. [PMID: 36031306 DOI: 10.1016/b978-0-323-91532-8.00008-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Neurodegenerative disorders are a diverse group of conditions caused by progressive degeneration of neurons resulting in cognitive, motor, sensory, and autonomic dysfunction, leading to severe disability and death. Pulmonary dysfunction is relatively common in these conditions, may be present early in the disease, and is less well recognized and treated than other symptoms. There are variable disorders of upper and lower airways, central control of ventilation, strength of respiratory muscles, and breathing during sleep which further impact daily activities and quality of life and have the potential to injure vulnerable neurons. Laryngopharyngeal dysfunction affects speech, swallowing, and clearance of secretions, increases the risk of aspiration pneumonia, and can cause stridor and sudden death. In Parkinson's disease, L-Dopa benefits some pulmonary symptoms but there are limited pharmacological treatment options for pulmonary dysfunction. Targeted treatments include strengthening of respiratory muscles, positive airway pressure in sleep and techniques to improve cough efficacy. Well-designed clinical trials are needed to evaluate the long-term benefits of these interventions. Challenges for the future include earlier identification of pulmonary dysfunction in the clinic, institution of the most effective treatments (based on clinical trials that measure long-term meaningful outcomes) and the development of neuroprotective treatment.
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Affiliation(s)
- Soumya Ghosh
- Perron Institute for Neurological and Translational Science, University of Western Australia and Department of Neurology, Sir Charles Gairdner and Perth Children's Hospitals, Nedlands, WA, Australia.
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17
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Batista LA, Cabral LM, Moreira TS, Takakura AC. Inhibition of anandamide hydrolysis does not rescue respiratory abnormalities observed in an animal model of Parkinson's disease. Exp Physiol 2021; 107:161-174. [PMID: 34907627 DOI: 10.1113/ep089249] [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: 11/05/2020] [Accepted: 12/08/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? The respiratory frequency to hypercapnia is attenuated in an animal model of Parkinson's disease (PD): what is the therapeutic potential of inhibition of anandamide hydrolysis for this respiratory deficit? What is the main finding and its importance? In an animal model of PD there is an increased variability in resting respiratory frequency and an impaired tachypnoeic response to hypercapnia, which is accompanied by diminished expression of Phox2b immunoreactivity in the retrotrapezoid nucleus (RTN). Inhibition of anandamide hydrolysis also impaired the response to hypercapnia and decreased the number of Phox2b immunoreactive cells in the RTN. This strategy does not reverse the respiratory deficits observed in an animal model of PD. ABSTRACT Parkinson's disease (PD) is characterized by severe classic motor symptoms along with various non-classic symptoms. Among the non-classic symptoms, respiratory dysfunctions are increasingly recognized as contributory factors to complications in PD. The endocannabinoid system has been proposed as a target to treat PD and other neurodegenerative disorders. Since symptom management of PD is mainly focused on the classic motor symptoms, in this work we aimed to test the hypothesis that increasing the actions of the endocannabinoid anandamide by inhibiting its hydrolysis with URB597 reverses the respiratory deficits observed in an animal model of PD. Results show that bilateral injection of 6-hydroxydopamine hydrochloride (6-OHDA) in the dorsal striatum leads to neurodegeneration of the substantia nigra, accompanied by reduced expression of Phox2b in the retrotrapezoid nucleus (RTN), an increase in resting respiratory frequency variability and an impaired tachypnoeic response to hypercapnia. URB597 treatment in control animals was associated with an impaired tachypnoeic response to hypercapnia and a reduced expression of Phox2b in the RTN, whereas treatment of 6-OHDA-lesioned animals with URB597 was not able to reverse the deficits observed. These results suggest that targeting anandamide may not be a suitable strategy to treat PD since this treatment mimics the respiratory deficits observed in the 6-OHDA model of PD.
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Affiliation(s)
- Luara A Batista
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, Brazil
| | - Laís M Cabral
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, Brazil
| | - Thiago S Moreira
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, Brazil
| | - Ana C Takakura
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, Brazil
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Danilenko V, Devyatkin A, Marsova M, Shibilova M, Ilyasov R, Shmyrev V. Common Inflammatory Mechanisms in COVID-19 and Parkinson's Diseases: The Role of Microbiome, Pharmabiotics and Postbiotics in Their Prevention. J Inflamm Res 2021; 14:6349-6381. [PMID: 34876830 PMCID: PMC8643201 DOI: 10.2147/jir.s333887] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/29/2021] [Indexed: 12/14/2022] Open
Abstract
In the last decade, metagenomic studies have shown the key role of the gut microbiome in maintaining immune and neuroendocrine systems. Malfunction of the gut microbiome can induce inflammatory processes, oxidative stress, and cytokine storm. Dysfunction of the gut microbiome can be caused by short-term (virus infection and other infectious diseases) or long-term (environment, nutrition, and stress) factors. Here, we reviewed the inflammation and oxidative stress in neurodegenerative diseases and coronavirus infection (COVID-19). Here, we reviewed the renin-angiotensin-aldosterone system (RAAS) involved in the processes of formation of oxidative stress and inflammation in viral and neurodegenerative diseases. Moreover, the coronavirus uses ACE2 receptors of the RAAS to penetrate human cells. The coronavirus infection can be the trigger for neurodegenerative diseases by dysfunction of the RAAS. Pharmabiotics, postbiotics, and next-generation probiotics, are considered as a means to prevent oxidative stress, inflammatory processes, neurodegenerative and viral diseases through gut microbiome regulation.
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Affiliation(s)
- Valery Danilenko
- Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia
| | - Andrey Devyatkin
- Central Clinical Hospital with a Polyclinic CMP RF, Moscow, Russia
| | - Mariya Marsova
- Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia
| | | | - Rustem Ilyasov
- Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia
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Wei J, Ho G, Takamatsu Y, Masliah E, Hashimoto M. Therapeutic Potential of α-Synuclein Evolvability for Autosomal Recessive Parkinson's Disease. PARKINSON'S DISEASE 2021; 2021:6318067. [PMID: 34858569 PMCID: PMC8632460 DOI: 10.1155/2021/6318067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/20/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
The majority of Parkinson's disease (PD) is sporadic in elderly and is characterized by α-synuclein (αS) aggregation and other alterations involving mitochondria, ubiquitin-proteasome, and autophagy. The remaining are familial PD associated with gene mutations of either autosomal dominant or recessive inheritances. However, the former ones are similar to sporadic PD, and the latter ones are accompanied by impaired mitophagy during the reproductive stage. Since no radical therapies are available for PD, the objective of this paper is to discuss a mechanistic role for amyloidogenic evolvability, a putative physiological function of αS, among PD subtypes, and the potential relevance to therapy. Presumably, αS evolvability might benefit familial PD due to autosomal dominant genes and also sporadic PD during reproduction, which may manifest as neurodegenerative diseases through antagonistic pleiotropy mechanism in aging. Indeed, there are some reports describing that αS prevents apoptosis and mitochondrial alteration under the oxidative stress conditions, notwithstanding myriads of papers on the neuropathology of αS. Importantly, β-synuclein (βS), the nonamyloidogenic homologue of αS, might buffer against evolvability of αS protofibrils associated with neurotoxicity. Finally, it is intriguing to predict that increased αS evolvability through suppression of βS expression might protect against autosomal recessive PD. Collectively, further studies are warranted to better understand αS evolvability in PD pathogenesis, leading to rational therapy development.
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Affiliation(s)
- Jianshe Wei
- Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Gilbert Ho
- PCND Neuroscience Research Institute, Poway 92064, CA, USA
| | - Yoshiki Takamatsu
- Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Eliezer Masliah
- Division of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Makoto Hashimoto
- Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
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Vitacca M, Olivares A, Comini L, Vezzadini G, Langella A, Luisa A, Petrolati A, Frigo G, Paneroni M. Exercise Intolerance and Oxygen Desaturation in Patients with Parkinson's Disease: Triggers for Respiratory Rehabilitation? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312298. [PMID: 34886018 PMCID: PMC8656612 DOI: 10.3390/ijerph182312298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022]
Abstract
The role that oxygen desaturation plays in exercise tolerance and its rehabilitative implications in patients with Parkinson's disease (PD) are unclear. We aimed to test exercise tolerance and oxygen saturation levels both during exercise and at night in PD patients to better define their rehabilitative needs. In clinically stable PD patients, undergoing inpatient rehabilitation, and in "ON" phase, we prospectively assessed clinical data, sleepiness, comorbidities, PD severity (Hoehn&Yahr, HY), motor function (ADLs, UPDRSII and UPDRSIII, Barthel Index, Functional Independence Measure), balance, spirometry, respiratory muscles (MIP/MEP), peak cough expiratory flow (PCEF), continuous night oxygen monitoring, and meters at 6MWT. Of 55 patients analyzed (28 with moderate-severe PD, HY ≥ 2.5), 37% and 23% showed moderate-severe impairment on UPDRSII and UPDRSIII, respectively; 96% had reduced exercise tolerance and severe respiratory muscles impairment (MIP/MEP < 45% pred.); 21.8% showed desaturations during exercise; and 12.7% showed nocturnal desaturations. At multiple regression, low exercise tolerance and low mean nocturnal and exercise-induced saturation correlated with several respiratory and motor function and disability indices (all p < 0.03). Exercise tolerance, exercise-induced desaturations, and nocturnal desaturations were extremely frequent in PD patients and were worse in more severe PD patients. This suggests considering a combined role for motor and respiratory rehabilitation in these patients.
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Affiliation(s)
- Michele Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy;
- Correspondence:
| | - Adriana Olivares
- Scientific Direction of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy; (A.O.); (L.C.)
| | - Laura Comini
- Scientific Direction of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy; (A.O.); (L.C.)
| | - Giuliana Vezzadini
- Neurorehabilitation of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, 46042 Castel Goffredo, Italy; (G.V.); (A.P.); (G.F.)
| | - Annamaria Langella
- Neurorehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy; (A.L.); (A.L.)
| | - Alberto Luisa
- Neurorehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy; (A.L.); (A.L.)
| | - Anna Petrolati
- Neurorehabilitation of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, 46042 Castel Goffredo, Italy; (G.V.); (A.P.); (G.F.)
| | - Gianluigi Frigo
- Neurorehabilitation of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, 46042 Castel Goffredo, Italy; (G.V.); (A.P.); (G.F.)
| | - Mara Paneroni
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy;
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Johnson RA, Kelm-Nelson CA, Ciucci MR. Changes to Ventilation, Vocalization, and Thermal Nociception in the Pink1-/- Rat Model of Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 10:489-504. [PMID: 32065805 DOI: 10.3233/jpd-191853] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Individuals with Parkinson's disease (PD) experience significant vocal communication deficits. Findings in the Pink1-/- rat model of early-onset PD suggest that ultrasonic vocal communication is impaired early, progressively worsens prior to nigrostriatal dopamine depletion, and is associated with loss of locus coeruleus neurons, brainstem α-synuclein, and larynx pathology. Individuals with PD also demonstrate ventilatory deficits and altered sensory processing, which may contribute to vocal deficits. OBJECTIVE The central hypothesis is that ventilatory and sensory deficits are present in the early disease stages when limb and vocal motor deficits also present. METHODS Pink1-/- rats were compared to wildtype (WT) controls at longitudinal timepoints. Whole-body flow through plethysmography was used to measure ventilation in the following conditions: baseline, hypoxia, and maximal chemoreceptor stimulation. Plantar thermal nociception, and as a follow up to previous work, limb gait and vocalization were analyzed. Serotonin density (5-HT) in the dorsal raphe was quantified post-mortem. RESULTS Baseline breathing frequencies were consistently higher in Pink1-/- rats at all time points. In hypoxic conditions, there were no significant changes between genotypes. With hypercapnia, Pink1-/- rats had decreased breathing frequencies with age. Thermal withdrawal latencies were significantly faster in Pink1-/- compared with WT rats across time. No differences in 5-HT were found between genotypes. Vocal peak frequency was negatively correlated to tidal volume and minute ventilation in Pink1-/- rats. CONCLUSION This work suggests that abnormal nociceptive responses in Pink1-/- rats and ventilatory abnormalities may be associated with abnormal sensorimotor processing to chemosensory stimuli during disease manifestation.
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Affiliation(s)
- Rebecca A Johnson
- Department of Surgical Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Cynthia A Kelm-Nelson
- Division of Otolaryngology, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA
| | - Michelle R Ciucci
- Division of Otolaryngology, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA.,Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA.,Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
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22
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Oliveira LM, Baertsch NA, Moreira TS, Ramirez JM, Takakura AC. Unraveling the Mechanisms Underlying Irregularities in Inspiratory Rhythm Generation in a Mouse Model of Parkinson's Disease. J Neurosci 2021; 41:4732-4747. [PMID: 33863785 PMCID: PMC8260248 DOI: 10.1523/jneurosci.2114-20.2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 12/15/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder anatomically characterized by a progressive loss of dopaminergic neurons in the substantia nigra compacta (SNpc). Much less known, yet clinically very important, are the detrimental effects on breathing associated with this disease. Consistent with the human pathophysiology, the 6-hydroxydopamine hydrochloride (6-OHDA) rodent model of PD shows reduced respiratory frequency (fR) and NK1r-immunoreactivity in the pre-Bötzinger complex (preBötC) and PHOX2B+ neurons in the retrotrapezoid nucleus (RTN). To unravel mechanisms that underlie bradypnea in PD, we employed a transgenic approach to label or stimulate specific neuron populations in various respiratory-related brainstem regions. PD mice were characterized by a pronounced decreased number of putatively rhythmically active excitatory neurons in the preBötC and adjacent ventral respiratory column (VRC). Specifically, the number of Dbx1 and Vglut2 neurons was reduced by 47.6% and 17.3%, respectively. By contrast, inhibitory Vgat+ neurons in the VRC, as well as neurons in other respiratory-related brainstem regions, showed relatively minimal or no signs of neuronal loss. Consistent with these anatomic observations, optogenetic experiments identified deficits in respiratory function that were specific to manipulations of excitatory (Dbx1/Vglut2) neurons in the preBötC. We conclude that the decreased number of this critical population of respiratory neurons is an important contributor to the development of irregularities in inspiratory rhythm generation in this mouse model of PD.SIGNIFICANCE STATEMENT We found a decreased number of a specific population of medullary neurons which contributes to breathing abnormalities in a mouse model of Parkinson's disease (PD).
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Affiliation(s)
- Luiz M Oliveira
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de São Paulo, São Paulo 05508, Brazil
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington 98101
| | - Nathan A Baertsch
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington 98101
- Department of Pediatrics, University of Washington, Seattle, Washington 98101
| | - Thiago S Moreira
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas, Universidade de São Paulo, São Paulo 05508, Brazil
| | - Jan-Marino Ramirez
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington 98101
- Department of Neurological Surgery, University of Washington, Seattle, Washington 98101
- Department of Pediatrics, University of Washington, Seattle, Washington 98101
| | - Ana C Takakura
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de São Paulo, São Paulo 05508, Brazil
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Na + leak-current channel (NALCN) at the junction of motor and neuropsychiatric symptoms in Parkinson's disease. J Neural Transm (Vienna) 2021; 128:749-762. [PMID: 33961117 DOI: 10.1007/s00702-021-02348-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/30/2021] [Indexed: 12/27/2022]
Abstract
Parkinson's disease (PD) is a debilitating movement disorder often accompanied by neuropsychiatric symptoms that stem from the loss of dopaminergic function in the basal ganglia and altered neurotransmission more generally. Akinesia, postural instability, tremors and frozen gait constitute the major motor disturbances, whereas neuropsychiatric symptoms include altered circadian rhythms, disordered sleep, depression, psychosis and cognitive impairment. Evidence is emerging that the motor and neuropsychiatric symptoms may share etiologic factors. Calcium/ion channels (CACNA1C, NALCN), synaptic proteins (SYNJ1) and neuronal RNA-binding proteins (RBFOX1) are among the risk genes that are common to PD and various psychiatric disorders. The Na+ leak-current channel (NALCN) is the focus of this review because it has been implicated in dystonia, regulation of movement, cognitive impairment, sleep and circadian rhythms. It regulates the resting membrane potential in neurons, mediates pace-making activity, participates in synaptic vesicle recycling and is functionally co-localized to the endoplasmic reticulum (ER)-several of the major processes adversely affected in PD. Here, we summarize the literature on mechanisms and pathways that connect the motor and neuropsychiatric symptoms of PD with a focus on recurring relationships to the NALCN. It is hoped that the various connections outlined here will stimulate further discussion, suggest additional areas for exploration and ultimately inspire novel treatment strategies.
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Kaminsky DA, Grosset DG, Kegler-Ebo DM, Cangiamilla S, Klingler M, Zhao P, Oh C. Natural history of lung function over one year in patients with Parkinson's disease. Respir Med 2021; 182:106396. [PMID: 33866196 DOI: 10.1016/j.rmed.2021.106396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/03/2021] [Accepted: 04/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Little is known about decline in lung function in Parkinson's disease (PD). To assess these changes, we assessed the changes in lung function that occurred over 12 months in patients on standard PD therapy as part of the observational cohort of an open-label study of inhaled levodopa (CVT-301) in PD. METHODS PD patients on stable oral PD therapy and no chronic respiratory disease had spirometry and diffusing capacity of the lungs for carbon monoxide (DLCO) measured at 3, 6, 9, and 12 months. RESULTS 106 patients (81.5%) in the observational cohort on no investigational therapy completed the study. Mean FEV1 declined at 12 months from 2.88L at baseline with a mean change of -0.11L, greater than the -0.030-0.045L/year observed in healthy, non-smokers aged 60-70 years. FVC declined from 3.77L (mean change -0.19L); FEV1/FVC ratio remained relatively constant. DLCO mean change was -0.48 mL/min/mmHg from a baseline of 24.24 mL/min/mmHg. This change in DLCO, while not significant, was similar to that seen in non-smokers aged 60-70 years (DLCO -0.42-0.63 mL/min/mmHg/year). Decreases in alveolar volume (VA) and inspiratory vital capacity (IVC) rather than the transfer coefficient (DLCO/VA) were observed. CONCLUSIONS PD patients had greater declines in FEV1, and FVC, but not in DLCO, compared to healthy non-smokers of similar age. Declines in FEV1 and FVC with little change in FEV1/FVC, and decline in VA and IVC with little change in DLCO/VA, suggest these changes were due to decreases in lung volume and are compatible with progressive PD-associated respiratory muscle weakness. TRIAL REGISTRATION ClinicalTrials.gov (NCT02352363 Registered January 26, 2015 [https://clinicaltrials.gov/ct2/show/NCT02352363]) and EudraCT (2014-003799-22).
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Affiliation(s)
- David A Kaminsky
- Larner College of Medicine, University of Vermont, Burlington, VT, USA.
| | - Donald G Grosset
- Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
| | | | | | | | - Ping Zhao
- Acorda Therapeutics, Inc., Ardsley, NY, USA
| | - Charles Oh
- Acorda Therapeutics, Inc., Ardsley, NY, USA
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Deficiency of Biogenic Amines Modulates the Activity of Hypoglossal Nerve in the Reserpine Model of Parkinson's Disease. Cells 2021; 10:cells10030531. [PMID: 33801475 PMCID: PMC8001069 DOI: 10.3390/cells10030531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 02/01/2023] Open
Abstract
The underlying cause of respiratory impairments appearing in Parkinson's disease (PD) is still far from being elucidated. To better understand the pathogenesis of respiratory disorders appearing in PD, we studied hypoglossal (HG) and phrenic (PHR) motoneuron dysfunction in a rat model evoked with reserpine administration. After reserpine, a decrease in the baseline amplitude and minute HG activity was noted, and no depressive phase of the hypoxic ventilatory response was observed. The pre-inspiratory time of HG activity along with the ratio of pre-inspiratory time to total respiratory cycle time and the ratio of pre-inspiratory to inspiratory amplitude were significantly reduced during normoxia, hypoxia, and recovery compared to sham rats. We suggest that the massive depletion of not only dopamine, but above all noradrenaline and serotonin in the brainstem observed in our study, has an impact on the pre-inspiratory activity of the HG. The shortening of the pre-inspiratory activity of the HG in the reserpine model may indicate a serious problem with maintaining the correct diameter of the upper airways in the preparation phase for inspiratory effort and explain the development of obstructive sleep apnea in some PD patients. Therapies involving the supplementation of amine depletion other than dopamine should be considered.
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Mancini JD, Yao S, Martinez LR, Shakil H, Li TS. Gut Microbiome Changes with Osteopathic Treatment of Constipation in Parkinson's Disease: A Pilot Study. NEUROLOGY (E-CRONICON) 2021; 13:19-33. [PMID: 33899052 PMCID: PMC8061899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The gut microbiome appears to be predictive of Parkinson's disease (PD) with constipation. Chronic constipation frequently manifests prior to motor symptoms and impairs quality of life. An osteopathic manipulative medicine (OMM) sequence used physical exam assessment and manual treatment of neuromusculoskeletal dysfunctions pertinent to constipation in PD for this prospective ABA-design study, IRB-NYITBHS1065. The effects of 4 weekly treatments on the gut microbiome among men and women over 40 years old with chronic constipation and PD were investigated. Severity of PD was rated with the Movement Disorders Society-Unified PD rating scale (UPDRS) in six subjects with constipation. Also, the Bristol stool scale and questionnaires validated for constipation were administered for diagnosis, symptom severity, and quality of life during a 4-week control-period (A), 4-weekly OMM-treatments (B), and 2-weeks no-intervention (A). Biweekly stool samples were assessed for normalized microbiota abundance. RESULTS The mean Bristol rating improved from type 2 (± 1) Pre-OMM to 3 (± 1; p = .167; d = 0.677) Post-OMM. Mean constipation severity significantly decreased (p = .010; d = 1.508) Post-OMM. Mean quality of life significantly improved (p = .041; d = 1.072) Post-OMM. The Pre-OMM mean number of families within the phylum Firmicutes decreased by 3 (p = .043; d = 1.177) Post-OMM. There were significant changes in the normalized abundance of phyla Actinobacteria (p = .040; d = 0.845) and Verrucomicrobia (p = .024; d = 0.675) as well as in genus Roseburia (p = .033; d = 1.109), Intestinimonas (p = .035; d = 0.627) and Anaerotruncus (p = .004) Post-OMM. CONCLUSION The gut microbiome shifted among individuals with constipation and PD after four weekly treatments with the OMM-sequence. Changes in the gut microbiome Post-OMM were associated with UPDRS results and constipation measures. Clinical trials and studies to develop the gut microbiome into a validated biomarker for PD are necessary to understand the impact of OMM in patients with PD and constipation.
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Affiliation(s)
- Jayme D Mancini
- New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, NY, USA
| | - Sheldon Yao
- New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, NY, USA
| | - Luis R Martinez
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Haque Shakil
- New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, NY, USA
| | - To Shan Li
- New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, NY, USA
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Chang TC, Chen YC, Huang YC, Lin WC, Lu CH. Systemic oxidative stress and cognitive function in Parkinson's disease with different PWMH or DWMH lesions. BMC Neurol 2021; 21:16. [PMID: 33430806 PMCID: PMC7798238 DOI: 10.1186/s12883-020-02037-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/26/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD), frequently accompanied by cognitive impairments, is associated with systemic oxidative stress and abnormal structural changes on brain images. We aimed to identify the correlation between systemic oxidative stress and cognitive function in PD patients with different periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH). METHODS A total of 146 participants with idiopathic PD underwent brain MRI, which revealed PWMH and DWMH. The number of lesions were evaluated using the Fazekas criteria. Systemic oxidative stress was determined as early or late phase changes in leukocyte apoptosis and its subsets by flow cytometry. Cognitive functions, including attention, executive function, memory, language, and visual space, were assessed. RESULTS For different DWMH, the leukocyte apoptosis and its subsets were significantly different.. However, there were no significant differences in oxidative stress biomarkers in PD patients with different PWMH. Attention and memory were significantly decreased in patients with more advanced DWMH injuries. Attention, memory, and language were significantly impaired in patients with worse PWMH lesions. CONCLUSION Significant oxidative stress biomarker alternations in PD patients with DWMH, but not PWMH, might be associated with white matter injury. Systemic inflammatory responses may contribute to deep white matter damage in PD. Further, more cognitive deficits were seen in PD patients with worse deep white matter lesions, especially in moderate to severe periventricular white matter injury. TRIAL REGISTRATION Retrospective study.
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Affiliation(s)
- Ta-Chih Chang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Cun Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Chi Huang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Hoit JD, Lansing RW, Brown VP, Nitido H. Speaking dyspnea in Parkinson's disease: Preliminary findings. JOURNAL OF COMMUNICATION DISORDERS 2020; 88:106050. [PMID: 33190067 DOI: 10.1016/j.jcomdis.2020.106050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/16/2020] [Accepted: 08/29/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE To determine if people with Parkinson's disease (PD) experience dyspnea (breathing discomfort) during speaking. METHOD The participants were 11 adults with PD and 22 healthy adults (11 young, 11 old). Participants were asked to recall experiences of breathing discomfort across different speaking contexts and provide ratings of those experiences (Retrospective ratings); then they rated the breathing discomfort experienced while performing speaking tasks that were designed to differ in respiratory demands (immediate Post-Speaking ratings). RESULTS Participants with PD reported experiencing breathing discomfort during speaking significantly more frequently (approximately 60 % of the time) than did healthy participants (less than 20 % of the time). Retrospective ratings did not differ significantly from Post-Speaking ratings. Breathing discomfort was experienced by the fewest number of participants with PD for Conversation (two) and Extemporaneous Speaking (three) and by the greatest number for Extended Reading (ten) and Long Counting (nine), although the magnitude of the ratings generally reflected only "Slight" discomfort. Breathing discomfort was most frequently described as air hunger and breathing work, less frequently as mental effort, and very rarely as lung tightness. A few participants with PD reported experiencing emotions associated with their breathing discomfort and most reported using strategies to avoid breathing discomfort in their daily lives. CONCLUSIONS Individuals with PD are more apt to experience speaking dyspnea than healthy individuals, especially when speaking for extended periods or when using long breath groups. Such dyspnea may contribute to a tendency to avoid speaking situations and thereby impair quality of life.
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Affiliation(s)
- Jeannette D Hoit
- University of Arizona, Department of Speech, Language, and Hearing Sciences, United States.
| | | | - Valerie Phan Brown
- University of Arizona, Department of Speech, Language, and Hearing Sciences, United States
| | - Hallie Nitido
- University of Arizona, Department of Speech, Language, and Hearing Sciences, United States
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Chaudhry ZL, Klenja D, Janjua N, Cami-Kobeci G, Ahmed BY. COVID-19 and Parkinson's Disease: Shared Inflammatory Pathways Under Oxidative Stress. Brain Sci 2020; 10:brainsci10110807. [PMID: 33142819 PMCID: PMC7693814 DOI: 10.3390/brainsci10110807] [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: 09/22/2020] [Revised: 10/25/2020] [Accepted: 10/26/2020] [Indexed: 12/20/2022] Open
Abstract
The current coronavirus pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a serious global health crisis. It is a major concern for individuals living with chronic disorders such as Parkinson’s disease (PD). Increasing evidence suggests an involvement of oxidative stress and contribution of NFκB in the development of both COVID-19 and PD. Although, it is early to identify if SARS-CoV-2 led infection enhances PD complications, it is likely that oxidative stress may exacerbate PD progression in COVID-19 affected individuals and/or vice versa. In the current study, we sought to investigate whether NFκB-associated inflammatory pathways following oxidative stress in SARS-CoV-2 and PD patients are correlated. Toward this goal, we have integrated bioinformatics analysis obtained from Basic Local Alignment Search Tool of Protein Database (BLASTP) search for similarities of SARS-CoV-2 proteins against human proteome, literature review, and laboratory data obtained in a human cell model of PD. A Parkinson’s like state was created in 6-hydroxydopamine (6OHDA)-induced differentiated dopamine-containing neurons (dDCNs) obtained from an immortalized human neural progenitor cell line derived from the ventral mesencephalon region of the brain (ReNVM). The results indicated that SARS-CoV-2 infection and 6OHDA-induced toxicity triggered stimulation of caspases-2, -3 and -8 via the NFκB pathway resulting in the death of dDCNs. Furthermore, specific inhibitors for NFκB and studied caspases reduced the death of stressed dDCNs. The findings suggest that knowledge of the selective inhibition of caspases and NFκB activation may contribute to the development of potential therapeutic approaches for the treatment of COVID-19 and PD.
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Affiliation(s)
- Zahara L. Chaudhry
- Institute of Biomedical & Environmental Science and Technology, School of Life Sciences, Faculty of Creative Arts, Technologies & Science, University Square, University of Bedfordshire, Luton LU1 3JU, UK; (Z.L.C.); (G.C.-K.)
| | - Donika Klenja
- School of Cellular and Molecular Medicine, University of Bristol, University Walk, Bristol BS8 1TD, UK;
| | - Najma Janjua
- Faculty of Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan;
| | - Gerta Cami-Kobeci
- Institute of Biomedical & Environmental Science and Technology, School of Life Sciences, Faculty of Creative Arts, Technologies & Science, University Square, University of Bedfordshire, Luton LU1 3JU, UK; (Z.L.C.); (G.C.-K.)
| | - Bushra Y. Ahmed
- Institute of Biomedical & Environmental Science and Technology, School of Life Sciences, Faculty of Creative Arts, Technologies & Science, University Square, University of Bedfordshire, Luton LU1 3JU, UK; (Z.L.C.); (G.C.-K.)
- Correspondence:
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Baille G, Perez T, Devos D, Machuron F, Dujardin K, Chenivesse C, Defebvre L, Moreau C. Dyspnea Is a Specific Symptom in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2020; 9:785-791. [PMID: 31476170 DOI: 10.3233/jpd-191713] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Dyspnea is a multidimensional sensation that is reported in Parkinson's disease (PD). The multidimensional dyspnea profile (MDP) questionnaire can help to distinguish the perceptive dimension and the emotion response. OBJECTIVE The aim was to assess the clinical features associated with dyspnea using the MDP questionnaire in order to determine which aspects of the symptom was linked with anxiety, depression or motor severity of the disease. METHODS Non-demented patients were asked whether they experienced shortness of breath in the last month. In case of positive answer, dyspnea was assessed by the MDP. MDS-UPDRS, global cognitive performance, non-motor symptoms and quality of life were assessed. RESULTS 60/163 patients were dyspneic since 4.6±2.4 years. The most frequent best sensory quality (SQ) described were: hyperpnoea (35%), physical breathing effort (25%) and air hunger (20%). Hyperpnoea and air hunger had the highest SQ intensity. Anxiety had the highest intensity in the emotional domain. CONCLUSION Dyspnea is a frequent symptom in PD, with specific presentations and two main aspects: one related with anxiety and another with ventilation control impairment.
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Affiliation(s)
- Guillaume Baille
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN center, Lille, France
| | - Thierry Perez
- CHU Lille, Lung Function Department, Univ Lille, INSERM 1019, CNRS UMR 8204, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - David Devos
- CHU Lille, Department of Allergy and Respiratory Medicine, Competence Center for rare lung diseases, Univ. Lille, CNRS, INSERM, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Center for Infection and Immunity of Lille, Lille, France
| | - François Machuron
- Univ. Lille, CHU Lille, EA 2694 - Santé Publique: Épidémiologie et Qualité des Soins, Department of Biostatistics, Lille, France
| | - Kathy Dujardin
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN center, Lille, France
| | - Cécile Chenivesse
- CHU Lille, Lung Function Department, Univ Lille, INSERM 1019, CNRS UMR 8204, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - Luc Defebvre
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN center, Lille, France
| | - Caroline Moreau
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN center, Lille, France
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Green AL, Paterson DJ. Using Deep Brain Stimulation to Unravel the Mysteries of Cardiorespiratory Control. Compr Physiol 2020; 10:1085-1104. [PMID: 32941690 DOI: 10.1002/cphy.c190039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This article charts the history of deep brain stimulation (DBS) as applied to alleviate a number of neurological disorders, while in parallel mapping the electrophysiological circuits involved in generating and integrating neural signals driving the cardiorespiratory system during exercise. With the advent of improved neuroimaging techniques, neurosurgeons can place small electrodes into deep brain structures with a high degree accuracy to treat a number of neurological disorders, such as movement impairment associated with Parkinson's disease and neuropathic pain. As well as stimulating discrete nuclei and monitoring autonomic outflow, local field potentials can also assess how the neurocircuitry responds to exercise. This technique has provided an opportunity to validate in humans putative circuits previously identified in animal models. The central autonomic network consists of multiple sites from the spinal cord to the cortex involved in autonomic control. Important areas exist at multiple evolutionary levels, which include the anterior cingulate cortex (telencephalon), hypothalamus (diencephalon), periaqueductal grey (midbrain), parabrachial nucleus and nucleus of the tractus solitaries (brainstem), and the intermediolateral column of the spinal cord. These areas receive afferent input from all over the body and provide a site for integration, resulting in a coordinated efferent autonomic (sympathetic and parasympathetic) response. In particular, emerging evidence from DBS studies have identified the basal ganglia as a major sub-cortical cognitive integrator of both higher center and peripheral afferent feedback. These circuits in the basal ganglia appear to be central in coupling movement to the cardiorespiratory motor program. © 2020 American Physiological Society. Compr Physiol 10:1085-1104, 2020.
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Affiliation(s)
- Alexander L Green
- Division of Medical Sciences, Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - David J Paterson
- Department of Physiology Anatomy and Genetics, University of Oxford, Oxford, UK
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Fasano A, Cereda E, Barichella M, Cassani E, Ferri V, Zecchinelli AL, Pezzoli G. COVID-19 in Parkinson's Disease Patients Living in Lombardy, Italy. Mov Disord 2020; 35:1089-1093. [PMID: 32484584 PMCID: PMC7300944 DOI: 10.1002/mds.28176] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 12/16/2022] Open
Abstract
Background It is unknown whether patients with PD are at greater risk of COVID‐19, what their risk factors are, and whether their clinical manifestations differ from the general population. Objectives The study aimed to address all these issues. Methods In a case‐controlled survey, we interviewed 1,486 PD patients attending a single tertiary center in Lombardy, Italy and 1,207 family members (controls). Results One hundred five (7.1%) and 92 controls (7.6%) were identified as COVID‐19 cases. COVID‐19 patients were younger, more likely to suffer from chronic obstructive pulmonary disease, to be obese, and vitamin D nonsupplemented than unaffected patients. Six patients (5.7%) and 7 family members (7.6%) died from COVID‐19. Patients were less likely to report shortness of breath and require hospitalization. Conclusions In an unselected large cohort of nonadvanced PD patients, COVID‐19 risk and mortality did not differ from the general population, but symptoms appeared to be milder. The possible protective role of vitamin D supplementation warrants future studies. © 2020 International Parkinson and Movement Disorder Society
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Affiliation(s)
- Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.,Krembil Brain Institute, Toronto, Ontario, Canada
| | | | - Michela Barichella
- UOS Clinical Nutrition, Pini-CTO, Milan, Italy.,Fondazione Grigioni per il Morbo di Parkinson, Italy
| | - Erica Cassani
- Fondazione Grigioni per il Morbo di Parkinson, Italy.,Parkinson Institute, Pini-CTO, Milan, Italy
| | - Valentina Ferri
- Fondazione Grigioni per il Morbo di Parkinson, Italy.,Parkinson Institute, Pini-CTO, Milan, Italy
| | | | - Gianni Pezzoli
- Fondazione Grigioni per il Morbo di Parkinson, Italy.,Parkinson Institute, Pini-CTO, Milan, Italy
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Vijayan S, Singh B, Ghosh S, Stell R, Mastaglia FL. Dyspnea in Parkinson's disease: an approach to diagnosis and management. Expert Rev Neurother 2020; 20:619-626. [PMID: 32419523 DOI: 10.1080/14737175.2020.1763795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Dyspnea is a complex and debilitating non-motor symptom experienced by a significant proportion of PD patients which results in limitations to physical ability and a reduction in quality of life. AREAS COVERED The authors highlight the underlying pathophysiological mechanisms that can contribute to dyspnea in PD patients, and provide the clinician with a practical working algorithm for the management of such patients. The authors further highlight important clinical red flags that should be heeded in dyspneic PD patients and discuss therapeutic strategies for managing dyspnea. EXPERT OPINION Although awareness of dyspnea in PD is increasing, further studies of its prevalence and natural history at different stages of the disease are needed. In particular, it is important to determine whether dyspnea could be an early or prodromal disease manifestation. Although peripheral mechanisms are likely to play a major role in the pathophysiology of dyspnea, the possibility that central changes in brainstem ventilatory control may also play a part warrants further investigation.
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Affiliation(s)
- Srimathy Vijayan
- The Perron Institute for Neurological and Translational sciences, QEII Medical Centre , Nedlands, Perth, Australia.,Faculty of Health and Medical Sciences, University of Western Australia , Nedlands, Perth, Australia
| | - Bhajan Singh
- Department of Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital , Nedlands, Perth, Australia.,School of Human Sciences, University of Western Australia , Crawley, Perth, Australia.,West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands , Perth, Australia
| | - Soumya Ghosh
- The Perron Institute for Neurological and Translational sciences, QEII Medical Centre , Nedlands, Perth, Australia
| | - Rick Stell
- The Perron Institute for Neurological and Translational sciences, QEII Medical Centre , Nedlands, Perth, Australia
| | - Frank L Mastaglia
- The Perron Institute for Neurological and Translational sciences, QEII Medical Centre , Nedlands, Perth, Australia
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Garg D, Dhamija RK. The Challenge of Managing Parkinson's Disease Patients during the COVID-19 Pandemic. Ann Indian Acad Neurol 2020; 23:S24-S27. [PMID: 32419750 PMCID: PMC7213030 DOI: 10.4103/aian.aian_295_20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 01/13/2023] Open
Abstract
The 2019 novel coronavirus (nCoV) pandemic is rapidly developing across the globe and new information is emerging expeditiously and constantly, particularly in relation to neurological illnesses. Both central and peripheral nervous system involvement has been reported including headache, dizziness, hyposmia/anosmia, taste disturbances, seizures, stroke, alteration of the sensorium, and even acute hemorrhagic necrotizing leukoencephalopathy. Varying degrees of olfactory disturbances may pre-empt the diagnosis of COVID-19. Although no direct effect of 2019 nCoV has been reported yet on Parkinson's disease, there are enormous possible indirect effects and implications. We examine the potential effects and challenges posed by this pandemic to individuals with Parkinson's disease, particularly in the Indian context where telecommunication access or support group access may be lacking for these patients. Additionally, lockdown and social distancing may pose hurdles in the provision of optimum medical therapy, particularly if patients experience motor and non-motor deteriorations due to diverse reasons.
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Affiliation(s)
- Divyani Garg
- Department of Neurology, Lady Hardinge Medical College, New Delhi, India
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Andrzejewski K, Jampolska M, Zaremba M, Joniec-Maciejak I, Boguszewski PM, Kaczyńska K. Respiratory pattern and phrenic and hypoglossal nerve activity during normoxia and hypoxia in 6-OHDA-induced bilateral model of Parkinson's disease. J Physiol Sci 2020; 70:16. [PMID: 32160868 PMCID: PMC7066294 DOI: 10.1186/s12576-020-00743-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 03/02/2020] [Indexed: 12/03/2022]
Abstract
Respiratory disturbances present in Parkinson's disease (PD) are not well understood. Thus, studies in animal models aimed to link brain dopamine (DA) deficits with respiratory impairment are needed. Adult Wistar rats were lesioned with injection of 6-hydroxydopamine (6-OHDA) into the third cerebral ventricle. Two weeks after hypoxic test was performed in whole-body plethysmography chamber, phrenic (PHR) and hypoglossal (HG) nerve activities were recorded in normoxic and hypoxic conditions in anesthetized, vagotomized, paralyzed and mechanically ventilated rats. The effects of activation and blockade of dopaminergic carotid body receptors were investigated during normoxia in anesthetized spontaneously breathing rats. 6-OHDA injection affected resting respiratory pattern in awake animals: an increase in tidal volume and a decrease in respiratory rate had no effect on minute ventilation. Hypoxia magnified the amplitude and minute activity of the PHR and HG nerve of 6-OHDA rats. The ratio of pre-inspiratory to inspiratory HG burst amplitude was reduced in normoxic breathing. Yet, the ratio of pre-inspiratory time to total time of the respiratory cycle was increased during normoxia. 6-OHDA lesion had no impact on DA and domperidone effects on the respiratory pattern, which indicate that peripheral DA receptors are not affected in this model. Analysis of monoamines confirmed substantial striatal depletion of dopamine, serotonin and noradrenaline (NA) and reduction of NA content in the brainstem. In bilateral 6-OHDA model changes in activity of both nerves: HG (linked with increased apnea episodes) and PHR are present. Demonstrated respiratory effects could be related to specific depletion of DA and NA.
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Affiliation(s)
- Kryspin Andrzejewski
- Department of Respiration Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawińskiego 5, 02-106, Warsaw, Poland
| | - Monika Jampolska
- Department of Respiration Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawińskiego 5, 02-106, Warsaw, Poland
| | - Małgorzata Zaremba
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Ilona Joniec-Maciejak
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Paweł M Boguszewski
- Laboratory of Animal Models, Neurobiology Centre, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
| | - Katarzyna Kaczyńska
- Department of Respiration Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawińskiego 5, 02-106, Warsaw, Poland.
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Vijayan S, Singh B, Ghosh S, Stell R, Mastaglia FL. Brainstem Ventilatory Dysfunction: A Plausible Mechanism for Dyspnea in Parkinson's Disease? Mov Disord 2020; 35:379-388. [DOI: 10.1002/mds.27932] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
- Srimathy Vijayan
- Perron Institute for Neurological and Translational Sciences Nedlands Perth, Western Australia Australia
| | - Bhajan Singh
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital Nedlands Perth, Western Australia Australia
- School of Human Sciences, University of Western Australia Crawley Western Australia Australia
| | - Soumya Ghosh
- Perron Institute for Neurological and Translational Sciences Nedlands Perth, Western Australia Australia
| | - Rick Stell
- Perron Institute for Neurological and Translational Sciences Nedlands Perth, Western Australia Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Sciences Nedlands Perth, Western Australia Australia
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Rodríguez MÁ, Crespo I, del Valle M, Olmedillas H. Should respiratory muscle training be part of the treatment of Parkinson’s disease? A systematic review of randomized controlled trials. Clin Rehabil 2019; 34:429-437. [DOI: 10.1177/0269215519896054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective: To determine the effectiveness of respiratory muscle training in persons with Parkinson’s disease. Data sources: PubMed/MEDLINE, EMBASE, Web of Science, Scopus and PEDro electronic databases were searched until 15 November 2019. Reference lists of included studies were hand-searched. Methods: Randomized controlled trials assessing the effects of respiratory muscle training programmes (both inspiratory and expiratory) in patients with Parkinson’s disease were included. Two reviewers independently identified eligible studies and extracted data. Method quality was appraised with the PEDro scale. Results: Five papers including three randomized controlled trials with a total of 111 patients were identified. Method appraisal showed a mean score of 5 in the PEDro scale. One study analysed inspiratory muscle training, one expiratory muscle training and two established a comparison between both of them. Statistically positive results were found in maximal inspiratory pressure ( P < 0.05 and d = 0.76), maximal expiratory pressure ( P < 0.01 and d = 1.40), perception of dyspnoea ( P < 0.01), swallowing function ( d = 0.55) and phonatory measures, without significant differences in spirometric indices. Conclusions: Respiratory muscle training may be an effective alternative for improving respiratory muscle strength, swallowing function and phonatory parameters in subjects with Parkinson’s disease. Nevertheless, the lack of primary studies about this type of training prevents obtaining robust evidence.
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Affiliation(s)
| | - Irene Crespo
- Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain
- Institute of Biomedicine, Universidad de León, León, Spain
| | - Miguel del Valle
- Department of Cellular Morphology and Biology, Universidad de Oviedo, Oviedo, Spain
| | - Hugo Olmedillas
- Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain
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Racca F, Vianello A, Mongini T, Ruggeri P, Versaci A, Vita GL, Vita G. Practical approach to respiratory emergencies in neurological diseases. Neurol Sci 2019; 41:497-508. [PMID: 31792719 PMCID: PMC7224095 DOI: 10.1007/s10072-019-04163-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/15/2019] [Indexed: 02/06/2023]
Abstract
Many neurological diseases may cause acute respiratory failure (ARF) due to involvement of bulbar respiratory center, spinal cord, motoneurons, peripheral nerves, neuromuscular junction, or skeletal muscles. In this context, respiratory emergencies are often a challenge at home, in a neurology ward, or even in an intensive care unit, influencing morbidity and mortality. More commonly, patients develop primarily ventilatory impairment causing hypercapnia. Moreover, inadequate bulbar and expiratory muscle function may cause retained secretions, frequently complicated by pneumonia, atelectasis, and, ultimately, hypoxemic ARF. On the basis of the clinical onset, two main categories of ARF can be identified: (i) acute exacerbation of chronic respiratory failure, which is common in slowly progressive neurological diseases, such as movement disorders and most neuromuscular diseases, and (ii) sudden-onset respiratory failure which may develop in rapidly progressive neurological disorders including stroke, convulsive status epilepticus, traumatic brain injury, spinal cord injury, phrenic neuropathy, myasthenia gravis, and Guillain-Barré syndrome. A tailored assistance may include manual and mechanical cough assistance, noninvasive ventilation, endotracheal intubation, invasive mechanical ventilation, or tracheotomy. This review provides practical recommendations for prevention, recognition, management, and treatment of respiratory emergencies in neurological diseases, mostly in teenagers and adults, according to type and severity of baseline disease.
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Affiliation(s)
- Fabrizio Racca
- Department of Anaesthesia and Intensive Care, Sant'Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Andrea Vianello
- Respiratory Pathophysiology Division, University of Padua, Padua, Italy
| | - Tiziana Mongini
- Neuromuscular Center, Department of Neurosciences, University of Turin, Turin, Italy
| | - Paolo Ruggeri
- Unit of Pneumology, Department BIOMORF, University of Messina, Messina, Italy
| | - Antonio Versaci
- Intensive Care Unit, AOU Policlinico "G. Martino", Messina, Italy
| | - Gian Luca Vita
- Nemo Sud Clinical Centre for Neuromuscular Disorders, Messina, Italy
| | - Giuseppe Vita
- Nemo Sud Clinical Centre for Neuromuscular Disorders, Messina, Italy. .,Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
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Montero Ferro A, P Basso-Vanelli R, Moreira Mello RL, Sanches Garcia-Araujo A, Gonçalves Mendes R, Costa D, Gianlorenço AC. Effects of inspiratory muscle training on respiratory muscle strength, lung function, functional capacity and cardiac autonomic function in Parkinson's disease: Randomized controlled clinical trial protocol. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 24:e1777. [PMID: 31090181 DOI: 10.1002/pri.1777] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 02/04/2019] [Accepted: 03/17/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Individuals with Parkinson's disease (PD), in addition to motor impairment, may evolve with respiratory and autonomic nervous system disorders. Currently, there are few studies with emphasis on muscle and pulmonary dysfunction and that verify the benefits of inspiratory muscle training (IMT) in this population. AIM The aim of this study was to evaluate whether IMT is effective for the improvement of respiratory muscle strength, lung function, thoracic mobility, functional capacity and cardiac autonomic function in PD. METHODS A randomized and controlled trial will be conducted with 26 participants with idiopathic PD, with aged between 50 and 65 years, in the Stages I to III by the Modified Hoehn and Yahr Scale. Respiratory muscle strength will be performed by manovacuometry and lung function by spirometry. Functional capacity will be evaluated by the 6-min walk test and autonomic cardiac function by heart rate variability. In addition, thoracic mobility measurement will also be performed. After the evaluations, these participants will be randomly assigned to two groups: the IMT group with Powerbreathe® , which will perform the eight series of 2 min each, with 1 min of rest between them, totaling 30 min, at 60% of the maximum inspiratory pressure and the control group, who will perform the same training protocol but with the load maintained at 9 cmH2 O. All participants will be submitted to the same motor training protocol. CONCLUSION It is expected that IMT increases the inspiratory muscle strength, contributing to the improved expiratory muscle strength, lung function, thoracic mobility, functional capacity and cardiac autonomic function in individuals with mild to moderate PD.
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Affiliation(s)
- Alyne Montero Ferro
- Post Graduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos-UFSCar, São Carlos, Brazil
| | - Renata P Basso-Vanelli
- Post Graduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos-UFSCar, São Carlos, Brazil
| | - Roberta Lorena Moreira Mello
- Post Graduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos-UFSCar, São Carlos, Brazil
| | - Adriana Sanches Garcia-Araujo
- Post Graduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos-UFSCar, São Carlos, Brazil
| | - Renata Gonçalves Mendes
- Post Graduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos-UFSCar, São Carlos, Brazil
| | - Dirceu Costa
- Physiotherapy Graduation and Rehabilitation Sciences Post Graduation Program, Nove de Julho University-UNINOVE, São Paulo, Brazil
| | - Anna Carolyna Gianlorenço
- Post Graduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos-UFSCar, São Carlos, Brazil
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Oliveira LM, Oliveira MA, Moriya HT, Moreira TS, Takakura AC. Respiratory disturbances in a mouse model of Parkinson's disease. Exp Physiol 2019; 104:729-739. [PMID: 30758090 DOI: 10.1113/ep087507] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 02/08/2019] [Indexed: 12/13/2022]
Abstract
NEW FINDINGS What is the central question of this study? Clinical reports have described and suggested central and peripheral respiratory abnormalities in Parkinson's disease (PD) patients; however, these reports have never addressed the occurrence of these abnormalities in an animal model. What is the main finding and its importance? A mouse model of PD has reduced neurokinin-1 receptor immunoreactivity in the pre-Bӧtzinger complex and Phox2b-expressing neurons in the retrotrapezoid nucleus. The PD mouse has impairments of respiratory frequency and the hypercapnic ventilatory response. Lung collagen deposition and ribcage stiffness appear in PD mice. ABSTRACT Parkinson's disease (PD) is a neurodegenerative motor disorder characterized by dopaminergic deficits in the brain. Parkinson's disease patients may experience shortness of breath, dyspnoea, breathing difficulties and pneumonia, which can be linked as a cause of morbidity and mortality of those patients. The aim of the present study was to clarify whether a mouse model of PD could develop central brainstem and lung respiratory abnormalities. Adult male C57BL/6 mice received bilateral injections of 6-hydroxydopamine (10 μg μl-1 ; 0.5 μl) or vehicle into the striatum. Ventilatory parameters were assessed in the 40 days after induction of PD, by whole-body plethysmography. In addition, measurements of respiratory input impedance (closed and opened thorax) were performed. 6-Hydroxydopamine reduced the number of tyrosine hydroxylase neurons in the substantia nigra pars compacta, the density of neurokinin-1 receptor immunoreactivity in the pre-Bӧtzinger complex and the number of Phox2b neurons in the retrotrapezoid nucleus. Physiological experiments revealed a reduction in resting respiratory frequency in PD animals, owing to an increase in expiratory time and a blunted hypercapnic ventilatory response. Measurements of respiratory input impedance showed that only PD animals with the thorax preserved had increased viscance, indicating that the ribcage could be stiff in this animal model of PD. Consistent with stiffened ribcage mechanics, abnormal collagen deposits in alveolar septa and airways were observed in PD animals. Our data showed that our mouse model of PD presented with neurodegeneration in respiratory brainstem centres and disruption of lung mechanical properties, suggesting that both central and peripheral deficiencies contribute to PD-related respiratory pathologies.
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Affiliation(s)
- Luiz M Oliveira
- Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, SP, Brazil
| | - Maria A Oliveira
- Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, SP, Brazil
| | - Henrique T Moriya
- Biomedical Engineering Laboratory, University of São Paulo, São Paulo, Brazil
| | - Thiago S Moreira
- Department of Physiology and Biophysics, Institute of Biomedical Science, University of São Paulo, São Paulo, SP, Brazil
| | - Ana C Takakura
- Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, SP, Brazil
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Prasad S, Pal PK. When time is of the essence: Managing care in emergency situations in Parkinson's disease. Parkinsonism Relat Disord 2019; 59:49-56. [DOI: 10.1016/j.parkreldis.2018.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 12/13/2022]
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Radder DLM, de Vries NM, Riksen NP, Diamond SJ, Gross D, Gold DR, Heesakkers J, Henderson E, Hommel ALAJ, Lennaerts HH, Busch J, Dorsey RE, Andrejack J, Bloem BR. Multidisciplinary care for people with Parkinson’s disease: the new kids on the block! Expert Rev Neurother 2019; 19:145-157. [DOI: 10.1080/14737175.2019.1561285] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Danique L. M. Radder
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nienke M. de Vries
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Niels P. Riksen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sarah J. Diamond
- Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, OR, USA
| | - Ditza Gross
- Pulmonary Rehabilitation Clinic, Top Ichelov, Tel-Aviv, Israel
| | - Daniel R. Gold
- Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology – Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - John Heesakkers
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Emily Henderson
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Older People’s Unit, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Adrianus L. A. J. Hommel
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Groenhuysen, Elderly Care Organisation, Roosendaal, The Netherlands
| | - Herma H. Lennaerts
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Anesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jane Busch
- American Dental Association, , Chicago, Illinois, USA
- Wisconsin Dental Association, Dane County Dental Society, Cross Plains, Wisconsin, USA
| | - Ray E. Dorsey
- Center for Health + Technology, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - John Andrejack
- Parkinson’s Foundation Patient Advocate in Research, New York City, New York, USA
| | - Bastiaan R. Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Su CM, Kung CT, Chen FC, Cheng HH, Hsiao SY, Lai YR, Huang CC, Tsai NW, Lu CH. Manifestations and Outcomes of Patients with Parkinson's Disease and Serious Infection in the Emergency Department. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6014896. [PMID: 30417011 PMCID: PMC6207881 DOI: 10.1155/2018/6014896] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/01/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Several comorbidities contribute to an increased risk of infections in Parkinson's disease (PD) as the disease progresses. However, few studies have examined the correlation between sepsis and PD. AIM The aim of this study is to disclose the presentation and outcome of serious infection in patients with PD in the emergency department. METHODS This retrospective cohort study enrolled patients with PD who had serious infection and were admitted to the emergency department between January 2007 and December 2013. For clinical comparison, we compared the clinical features, laboratory data, and outcomes with those of age- and sex-matched patients who had serious infection but not PD. RESULTS There were a total of 1,200 episodes of infected PD patients and 2,400 age- and sex-matched infected patients without PD as disease controls. PD patients had fewer comorbidities and lower severity of infectious disease but longer hospital stays than control group patients. The incidences of respiratory tract and urinary tract infections were higher in PD patients. The levels of inflammatory and organ dysfunction biomarkers in PD were lower and compatible with the severity of infectious disease. A total of 86 (7.2%) infected PD patients died during the 28-day admission compared to 339 (14.1%) in non-PD patients. Serum C-reactive protein, bandemia, and lactate could be used to predict mortality in infected PD patients. CONCLUSIONS In infected patients with PD, respiratory and urinary tract infections were the two most common infectious sources. Empiric therapy based on experience could treat both respiratory and urinary tract infections. Early diagnosis and treatment are essential for survival.
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Affiliation(s)
- Chih-Min Su
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Chung Shan Medical University, School of Medicine, Taiwan
| | - Chia-Te Kung
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Cheng Chen
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsien-Hung Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Chung Shan Medical University, School of Medicine, Taiwan
| | - Sheng-Yuan Hsiao
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Yun-Ru Lai
- Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chin-Cheng Huang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Nai-Wen Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Department of Neurology, Xiamen Chang Gung Memorial Hospital, Xiamen, Fujian, China
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Baille G, Chenivesse C, Perez T, Machuron F, Dujardin K, Devos D, Defebvre L, Moreau C. Dyspnea: An underestimated symptom in Parkinson's disease. Parkinsonism Relat Disord 2018; 60:162-166. [PMID: 30224267 DOI: 10.1016/j.parkreldis.2018.09.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/29/2018] [Accepted: 09/02/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Dyspnea is one of the least well-characterized non-motor symptoms (NMS) associated with Parkinson's disease (PD). OBJECTIVE To determine the frequency of dyspnea in a large, single-center cohort of consecutive PD patients with no history of lung or heart disease, and to compare clinical features in dyspneic vs. non-dyspneic patients. METHODS Patients with abnormal cardiovascular and pulmonary results in a clinical examination were excluded. A positive response to at least one question ("In the last month, have you suffered from breathlessness?" and "In the last month, have you had trouble breathing normally?") was considered to signify the experience of dyspnea. MDS-UPDRS, global cognitive performance, non-motor symptoms and quality of life were assessed. RESULTS In the cohort of 153 non-demented PD patients (mean age ± standard deviation: 63.9 ± 7.4; mean disease duration: 9.2 ± 6.1 years), the mean [95% confidence interval (CI)] frequency of dyspnea was 39.2% (31.5-47). After adjustment for disease severity, PD patients with dyspnea had a significantly higher Movement Disorders Society Unified Parkinson's Disease Rating Scale part I, II and IV scores, a higher HAD anxiety and depression scores and a significantly higher 8-item Parkinson's Disease Questionnaire. CONCLUSION Dyspnea is a frequent NMS in PD. Its pathophysiology and prognostic value need more investigation.
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Affiliation(s)
- Guillaume Baille
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN Center, Lille, F-59000 France.
| | - Cécile Chenivesse
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Univ. Lille, INSERM U1019, CIIL, Institut Pasteur de Lille, F-59000 Lille, France
| | - Thierry Perez
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Univ. Lille, INSERM U1019, CIIL, Institut Pasteur de Lille, F-59000 Lille, France
| | - François Machuron
- Univ. Lille, CHU Lille, EA 2694 - Santé Publique: Épidémiologie et Qualité des Soins, Department of Biostatistics, F-59000 Lille, France
| | - Kathy Dujardin
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN Center, Lille, F-59000 France
| | - David Devos
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN Center, Lille, F-59000 France
| | - Luc Defebvre
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN Center, Lille, F-59000 France
| | - Caroline Moreau
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN Center, Lille, F-59000 France
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Johnson BP, Westlake KP. Link Between Parkinson Disease and Rapid Eye Movement Sleep Behavior Disorder With Dream Enactment: Possible Implications for Early Rehabilitation. Arch Phys Med Rehabil 2017; 99:411-415. [PMID: 28890381 DOI: 10.1016/j.apmr.2017.08.468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/04/2017] [Accepted: 08/06/2017] [Indexed: 12/11/2022]
Abstract
The purpose of this article is 2-fold: first, to inform readers of the link between the loss of motor inhibition during rapid eye movement (REM) sleep dreaming, diagnosed as REM sleep behavior disorder, and the future onset of neurodegenerative disorders, such as Parkinson disease and dementia with Lewy bodies; it has been reported that motor disinhibition during REM sleep often precedes the onset of these disorders by years or even decades; second, to consider that the identification of REM sleep behavior disorder and the early involvement of rehabilitation and/or development of home exercise plans may aid in prolonging and even increasing function, independence, and quality of life, should such neurodegenerative disorders develop later in life.
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Affiliation(s)
- Brian P Johnson
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD
| | - Kelly P Westlake
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD.
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Abstract
Ventilatory inhibition is considered an undesirable pharmacological side effect of pharmacotherapy in neurodegenerative conditions underlain by brain dopamine deficiency. In this context, oleic derivatives of dopamine or N-acyl-dopamines are novel substances that may be of high therapeutic interest as having the ability to cross the blood-brain barrier and acting in dopamine-like manner. In the present study we seek to define the influence of N-acyl-dopamines on lung ventilation and its hypoxic responses in the rat. We found that N-oleoyl-dopamine decreased both normoxic and peak hypoxic ventilation in response to 8% acute hypoxia, on average, by 31% and 41%, respectively. Its metabolite, 3'-O-methyl-N-oleoyl-dopamine, caused a 15% ventilatory decrease each, whereas an oleic ester derivative, 3'-O-oleoyl-N-oleoyl-dopamine, caused 11% and 19% ventilatory decreases, respectively. All three N-acyl-dopamines investigated displayed an inhibitory effect on ventilation. The findings indicate that 3'-O-methyl-N-oleoyl-dopamine and 3'-O-oleoyl-N-oleoyl-dopamine performed better than N-oleoyl-dopamine in term of less ventilatory suppression, albeit the differences among the three compounds were modest. We conclude that N-acyl-dopamines are worthy of intensified explorations as potential carriers of dopamine molecule in view of the lack of clinically effective methods of dopamine delivery into the brain in neurodegenerative conditions.
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Phrenic and hypoglossal nerve activity during respiratory response to hypoxia in 6-OHDA unilateral model of Parkinson's disease. Life Sci 2017; 180:143-150. [PMID: 28527784 DOI: 10.1016/j.lfs.2017.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/12/2017] [Accepted: 05/16/2017] [Indexed: 02/07/2023]
Abstract
AIMS Parkinson's disease (PD) patients apart from motor dysfunctions exhibit respiratory disturbances. Their mechanism is still unknown and requires investigation. Our research was designed to examine the activity of phrenic (PHR) and hypoglossal (HG) nerves activity during a hypoxic respiratory response in the 6-hydroxydopamine (6-OHDA) model of PD. MAIN METHODS Male adult Wistar rats were injected unilaterally with 6-OHDA (20μg) or the vehicle into the right medial forebrain bundle (MFB). Two weeks after the surgery the activity of the phrenic and hypoglossal nerve was registered in anesthetized, vagotomized, paralyzed, and mechanically ventilated rats under normoxic and hypoxic conditions. Lesion effectiveness was confirmed by the cylinder test, performed before the MFB injection and 14days after, before the respiratory experiment. KEY FINDINGS 6-OHDA lesioned animals showed a significant increase in normoxic inspiratory time. Expiratory time and total time of the respiratory cycle were prolonged in PD rats after hypoxia. The amplitude of the PHR activity and its minute activity were increased in comparison to the sham group at recovery time and during 30s of hypoxia. The amplitude of the HG activity was increased in response to hypoxia in 6-OHDA lesioned animals. The degeneration of dopaminergic neurons decreased the pre-inspiratory/inspiratory ratio of the hypoglossal burst amplitude during and after hypoxia. SIGNIFICANCE Unilateral MFB lesion changed the activity of the phrenic and hypoglossal nerves. The altered pre-inspiratory hypoglossal nerve activity indicates modifications to the central mechanisms controlling the activity of the HG nerve and may explain respiratory disorders seen in PD, i.e. apnea.
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