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Yong Y, Dong H, Zhou Z, Zhu Y, Gu M, Li W. Serum 25-hydroxyvitamin D concentrations and their impact on all-cause mortality in Parkinson's disease: insights from National Health and Nutrition Examination Survey 1999-2020 data. Front Nutr 2024; 11:1423651. [PMID: 39183989 PMCID: PMC11341485 DOI: 10.3389/fnut.2024.1423651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/25/2024] [Indexed: 08/27/2024] Open
Abstract
Background and purpose This study explores the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and mortality among Parkinson's disease (PD) patients, providing evidence for the potential benefits of vitamin D (VD) supplementation. Methods PD patients were collected from the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2020. These patients were categorized based on their serum 25(OH)D levels: deficiency, insufficiency, and sufficiency. We compared demographic information and analyzed mortality data from the National Death Index. A restricted cubic spline model assessed the nonlinear association between 25(OH)D levels and mortality, complemented by multivariable Cox regression analysis. Consistency of results was checked through subgroup analysis. Results The study included 364 PD patients: 87 (23.9%) with VD deficiency, 121 (33.2%) with insufficiency, and 156 (42.9%) with sufficiency. Demographically, 46.4% were male, and 56% were over 65 years. The deficiency group predominantly consisted of Mexican Americans (53.1%), had lower income levels, a higher unmarried rate, and increased liver disease incidence. The analysis showed a U-shaped curve between 25(OH)D levels and mortality risk, with the lowest risk at 78.68 nmol/L (p-non-linear = 0.007, p-overall = 0.008). Kaplan-Meier analysis found the highest survival rates in patients with 25(OH)D levels between 75-100 nmol/L (p = 0.039). Compared to this group, patients with levels below 50 nmol/L had a 3.52-fold increased mortality risk (95% CI = 1.58-7.86, p = 0.002), and those above 100 nmol/L had a 2.92-fold increase (95% CI = 1.06-8.05, p = 0.038). Age-specific subgroup analysis (p = 0.009) revealed that both very low (<50 nmol/L) and high (>100 nmol/L) levels increased mortality risk in patients under 65, while levels below 75 nmol/L raised mortality risk in older patients. Conclusion Serum 25(OH)D levels are nonlinearly linked to mortality in PD patients, with optimal survival rates occurring at 75-100 nmol/L. Deviations from this range increase the risk of death.
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Affiliation(s)
- Yufei Yong
- Department of Health Management Center, The Affiliated Hospital of Qingdao University, Qingdao, China
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Ryu DW, Park J, Lee MJ, Yoo D, Cheon SM. Trends in Physiotherapy Interventions and Medical Costs for Parkinson's Disease in South Korea, 2011-2020. J Mov Disord 2024; 17:270-281. [PMID: 38500248 PMCID: PMC11300399 DOI: 10.14802/jmd.23269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVE Physiotherapy (PT), which is an effective strategy for managing Parkinson's disease (PD), can influence health care utilization. We analyzed trends in health care utilization, PT interventions, and medical costs among patients with PD. METHODS Using data from the Korean National Health Insurance Service from 2011 to 2020, we analyzed the number of patients with PD and their health care utilization and assessed the odds ratio (OR) for receiving regular PTs. RESULTS Over 10 years, 169,613 patients with PD were included in the analysis. The number of patients with PD increased annually from 49,417 in 2011 to 91,841 in 2020. The number of patients with PD receiving PT increased from 4,847 (9.81%) in 2011 to 13,163 (14.33%) in 2020, and the number of PT prescriptions increased from 81,220 in 2011 to 377,651 in 2019. Medical costs per patient with PD increased from 1,686 United States dollars (USD) in 2011 to 3,202 USD in 2020. The medical expenses for each patient with PD receiving PT increased from 6,582 USD in 2011 to 13,475 USD in 2020. Moreover, regular PTs were administered to 31,782 patients (18.74%) and were administered only through hospitalization. Those patients in their 50s with disabilities demonstrated a high OR for regular PTs, whereas those aged 80 years or older and residing outside of Seoul had a low OR. CONCLUSION The PD burden increased in South Korea between 2011 and 2020, as did health care utilization and medical costs. A significant increase in medical expenses can be associated with increased PD incidence and PT interventions. Regular PT applications remain restricted and have barriers to access.
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Affiliation(s)
- Dong-Woo Ryu
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jinse Park
- Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, Korea
| | - Myung Jun Lee
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea
| | - Dallah Yoo
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sang-Myung Cheon
- Department of Neurology, School of Medicine, Dong-A University, Busan, Korea
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de la Rosa T, Berrocoso E, Scorza FA. Necropolitics of Death in Neurodegeneration. Cult Med Psychiatry 2024; 48:384-400. [PMID: 38652343 PMCID: PMC11217034 DOI: 10.1007/s11013-024-09855-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/25/2024]
Abstract
Neurodegenerative diseases (ND) pose significant challenges for biomedicine in the twenty-first century, particularly considering the global demographic ageing and the subsequent increase in their prevalence. Characterized as progressive, chronic and debilitating, they often result in higher mortality rates compared with the general population. Research agendas and biomedical technologies are shaped by power relations, ultimately affecting patient wellbeing and care. Drawing on the concepts of bio- and necropolitics, introduced by philosophers Foucault and Mbembe, respectively, this perspective examines the interplay between the territoriality and governmentality around demographic ageing, ND and death, focussing on knowledge production as a dispositif of power by highlighting the marginal role that the phenomenon of mortality plays in the ND research landscape. We propose a shift into acknowledging the coloniality of knowledge and embracing its situatedness to attain knowledge 'from death', understood as an epistemic position from which novel approaches and practices could emerge.
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Affiliation(s)
- T de la Rosa
- Neurology Department, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil.
- Neuroscience Department, Universidad de Cádiz, Plaza del Falla 9, Facultad de Medicina 3 Planta, 11003, Cádiz, Spain.
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain.
| | - E Berrocoso
- Neuroscience Department, Universidad de Cádiz, Plaza del Falla 9, Facultad de Medicina 3 Planta, 11003, Cádiz, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - F A Scorza
- Neurology Department, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
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Grotewold N, Albin RL. Update: Descriptive epidemiology of Parkinson disease. Parkinsonism Relat Disord 2024; 120:106000. [PMID: 38233324 PMCID: PMC10922566 DOI: 10.1016/j.parkreldis.2024.106000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/19/2024]
Abstract
We review the descriptive epidemiology of Parkinson disease (PD). PD is a prevalent neurologic disorder in high Socio-Demographic Index (SDI) nations with rising prevalence in low and middle SDI nations. PD became a prevalent disorder in high SDI nations during the 20th century. Population growth, population aging, and increased disease duration are major drivers of rising PD prevalence. Exposure to industrial toxicants may also be a contributor to rising PD prevalence. PD is an age-related disorder with incidence likely peaking in the 8th decade of life and prevalence in the 9th decade of life. PD is notable for significant sex difference in PD risk with greater risk in men. There may be ancestral differences in PD prevalence and risk. PD is associated with moderately increased mortality though this may be underestimated. Despite significant research, there is considerable uncertainty about basic features of PD epidemiology.
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Affiliation(s)
- Nikolas Grotewold
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Roger L Albin
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA; GRECC, VAAAHS, Ann Arbor, MI, 48105, USA; University of Michigan Morris K. Udall Center of Excellence for Parkinson's Disease Research, Ann Arbor, MI, 48109, USA; University of Michigan Parkinson's Foundation Research Center of Excellence, USA.
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Wang J, Zhao J, Zhao K, Wu S, Chen X, Hu W. The Role of Calcium and Iron Homeostasis in Parkinson's Disease. Brain Sci 2024; 14:88. [PMID: 38248303 PMCID: PMC10813814 DOI: 10.3390/brainsci14010088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Calcium and iron are essential elements that regulate many important processes of eukaryotic cells. Failure to maintain homeostasis of calcium and iron causes cell dysfunction or even death. PD (Parkinson's disease) is the second most common neurological disorder in humans, for which there are currently no viable treatment options or effective strategies to cure and delay progression. Pathological hallmarks of PD, such as dopaminergic neuronal death and intracellular α-synuclein deposition, are closely involved in perturbations of iron and calcium homeostasis and accumulation. Here, we summarize the mechanisms by which Ca2+ signaling influences or promotes PD progression and the main mechanisms involved in ferroptosis in Parkinson's disease. Understanding the mechanisms by which calcium and iron imbalances contribute to the progression of this disease is critical to developing effective treatments to combat this devastating neurological disorder.
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Affiliation(s)
- Ji Wang
- School of Chinese Materia Medica & Yunnan Key Laboratory of Southern Medicine Utilization, Yunnan University of Chinese Medicine, Kunming 650500, China;
- School of Pharmaceutical Science & Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming 650500, China; (J.Z.); (K.Z.); (S.W.)
| | - Jindong Zhao
- School of Pharmaceutical Science & Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming 650500, China; (J.Z.); (K.Z.); (S.W.)
| | - Kunying Zhao
- School of Pharmaceutical Science & Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming 650500, China; (J.Z.); (K.Z.); (S.W.)
| | - Shangpeng Wu
- School of Pharmaceutical Science & Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming 650500, China; (J.Z.); (K.Z.); (S.W.)
| | - Xinglong Chen
- School of Chinese Materia Medica & Yunnan Key Laboratory of Southern Medicine Utilization, Yunnan University of Chinese Medicine, Kunming 650500, China;
| | - Weiyan Hu
- School of Pharmaceutical Science & Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming 650500, China; (J.Z.); (K.Z.); (S.W.)
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Steendam-Oldekamp E, van Laar T. The Effectiveness of Inpatient Rehabilitation in Parkinson's Disease: A Systematic Review of Recent Studies. JOURNAL OF PARKINSON'S DISEASE 2024; 14:S93-S112. [PMID: 38788087 DOI: 10.3233/jpd-230271] [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: 05/26/2024]
Abstract
Background Parkinson's disease (PD) is a progressive disease, which is associated with the loss of activities of daily living independency. Several rehabilitation options have been studied during the last years, to improve mobility and independency. Objective This systematic review will focus on inpatient multidisciplinary rehabilitation (MR) in people with Parkinson's disease (PwPD), based on recent studies from 2020 onwards. Methods Search strategy in three databases included: multidisciplinary rehabilitation, Parkinson's Disease, inpatient rehabilitation, motor-, functional- and cognitive performance, cost-effectiveness, Quality of Life, and medication changes/Levodopa equivalent daily doses. Results Twenty-two studies were included, consisting of 13 studies dealing with inpatient MR and 9 studies on inpatient non-MR interventions. Inpatient PD multidisciplinary rehabilitation proved to be effective, as well as non-MR rehabilitation. Conclusions This review confirms the efficacy of inpatient MR and non-MR in PD, but is skeptical about the past and current study designs. New study designs, including new physical training methods, more attention to medication and costs, new biomarkers, artificial intelligence, and the use of wearables, will hopefully change rehabilitation trials in PwPD in the future.
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Affiliation(s)
- Elien Steendam-Oldekamp
- Department of Neurology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Teus van Laar
- Department of Neurology, University Medical Center Groningen, University of Groningen, The Netherlands
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Albin RL, Grotewold N. What is the Parkinson Pandemic? Mov Disord 2023; 38:2141-2144. [PMID: 37859586 PMCID: PMC10843050 DOI: 10.1002/mds.29637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Affiliation(s)
- Roger L. Albin
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, USA
- Neurology Service & GRECC, VAAAHS, Ann Arbor, MI, USA
- University of Michigan Morris K. Udall Center of Excellence for Parkinson;s Disease Reseach
- Parkinson’s Foundation Research Center of Excellence
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Soilemezi D, Palmar‐Santos A, Navarta‐Sánchez MV, Roberts HC, Pedraz‐Marcos A, Haahr A, Sørensen D, Bragstad LK, Hjelle EG, Haavaag SB, Portillo MC. Understanding support systems for Parkinson's disease management in community settings: A cross-national qualitative study. Health Expect 2023; 26:670-682. [PMID: 36573594 PMCID: PMC10010098 DOI: 10.1111/hex.13691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/27/2022] [Accepted: 12/09/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Health and social care systems face difficulties in managing multimorbidity, disease burden and complex needs in long-term conditions such as Parkinson's disease. OBJECTIVE This study aimed to develop a European understanding of how health and social care professionals can collaborate with stakeholders from different organizations and sectors to enhance the management of Parkinson's disease in a community setting by identifying the existing gaps in this process and how people with Parkinson's disease and their family carers could benefit from these partnerships. METHODS A mixed-methods sequential study was conducted in Denmark, Norway, Spain and the United Kingdom. The findings from the qualitative phase are presented. Individual semistructured interviews were analysed using Braun's and Clarke's thematic analysis. A meta-ethnography approach was used to analyse and synthesize cross-national findings. RESULTS A total of 41 healthcare professionals and 39 stakeholders from different disciplines and sectors were interviewed in the four countries. The participants acknowledged a lack of awareness of available resources and poor communication between the different support systems in the management of Parkinson's disease. To promote multiagency collaborations, the participants highlighted the need to organize services along the Parkinson's disease journey, patient involvement and strategic involvement of carers in organizing resources and Parkinson's disease care pathways. According to the participants, the benefits from multiagency partnerships could lead to an enhanced continuity of care and specialized knowledge, mobilization of resources in the community, personalized support and improved access to services. CONCLUSIONS Policymakers are called upon to create formal structures that facilitate multisectoral collaborations to promote an integrated system of care for the management of Parkinson's disease in the community. To address this challenge, we propose five strategies showing how organizations can work together to optimize the use of resources and enhance the management of Parkinson's disease throughout the illness trajectory. PATIENT OR PUBLIC CONTRIBUTION Patient and Public Involvement groups made up of stakeholders, healthcare professionals, patients with Parkinson's disease and family carers participated in the design of the study, the development of the interview guides and the validation of the findings.
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Affiliation(s)
- Dia Soilemezi
- Department of Psychology, Faculty of Science and HealthUniversity of PortsmouthPortsmouthUK
| | - Ana Palmar‐Santos
- Nursing Department, Faculty of MedicineUniversidad Autónoma de MadridMadridSpain
| | | | - Helen C. Roberts
- National Institute for Health Research Applied Research Collaboration Wessex, Long Term Conditions, SouthamptonUK
- Academic Geriatric Medicine, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Azucena Pedraz‐Marcos
- Unidad de Investigación en Cuidados y Sistemas de SaludThe Carlos III Health Institute (ISCIII)MadridSpain
- Grupo de investigación ISCiiiResearch Network on Chronicity, Primary Care, and Health Promotion (RICAPPS)TenerifeSpain
| | - Anita Haahr
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University CollegeAarhusDenmark
- Nursing and Healthcare, Department of Public HealthAarhus UniversityAarhusDenmark
| | - Dorthe Sørensen
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University CollegeAarhusDenmark
| | - Line K. Bragstad
- Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM)University of OsloOsloNorway
- Department of Occupational Therapy, Prosthetics and OrthoticsOslo Metropolitan UniversityOsloNorway
| | - Ellen G. Hjelle
- Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM)University of OsloOsloNorway
- Department of Occupational Therapy, Prosthetics and OrthoticsOslo Metropolitan UniversityOsloNorway
| | | | - Mari Carmen Portillo
- National Institute for Health Research Applied Research Collaboration Wessex, Long Term Conditions, SouthamptonUK
- Faculty of Environmental and Life Sciences, School of Health SciencesUniversity of SouthamptonSouthamptonUK
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Castillo-Rangel C, Marin G, Hernández-Contreras KA, Vichi-Ramírez MM, Zarate-Calderon C, Torres-Pineda O, Diaz-Chiguer DL, De la Mora González D, Gómez Apo E, Teco-Cortes JA, Santos-Paez FDM, Coello-Torres MDLÁ, Baldoncini M, Reyes Soto G, Aranda-Abreu GE, García LI. Neuroinflammation in Parkinson’s Disease: From Gene to Clinic: A Systematic Review. Int J Mol Sci 2023; 24:ijms24065792. [PMID: 36982866 PMCID: PMC10051221 DOI: 10.3390/ijms24065792] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/22/2023] Open
Abstract
Parkinson’s disease is a neurodegenerative disease whose progression and clinical characteristics have a close bidirectional and multilevel relationship with the process of neuroinflammation. In this context, it is necessary to understand the mechanisms involved in this neuroinflammation–PD link. This systematic search was, hereby, conducted with a focus on the four levels where alterations associated with neuroinflammation in PD have been described (genetic, cellular, histopathological and clinical-behavioral) by consulting the PubMed, Google Scholar, Scielo and Redalyc search engines, including clinical studies, review articles, book chapters and case studies. Initially, 585,772 articles were included, and, after applying the inclusion and exclusion criteria, 84 articles were obtained that contained information about the multilevel association of neuroinflammation with alterations in gene, molecular, cellular, tissue and neuroanatomical expression as well as clinical-behavioral manifestations in PD.
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Affiliation(s)
- Carlos Castillo-Rangel
- Neurosurgery Department, “Hospital Regional 1° de Octubre”, Institute of Social Security and Services for State Workers (ISSSTE), México City 07300, Mexico
| | - Gerardo Marin
- Neural Dynamics and Modulation Lab, Cleveland Clinic, Cleveland, OH 44195, USA
- Correspondence: ; Tel.: +52-296-102-5707
| | | | | | | | | | - Dylan L. Diaz-Chiguer
- Neurosurgery Department, “Hospital Regional 1° de Octubre”, Institute of Social Security and Services for State Workers (ISSSTE), México City 07300, Mexico
| | | | - Erick Gómez Apo
- Pathology Department, “Hospital General de México”, Dr. Eduardo Liceaga, México City 06720, Mexico
| | | | | | | | - Matías Baldoncini
- Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, University of Buenos Aires, Buenos Aires C1052AAA, Argentina
| | | | | | - Luis I. García
- Brain Research Institute, Universidad Veracruzana, Xalapa 91192, Mexico
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Use of invertebrates to model chemically induced parkinsonism-symptoms. Biochem Soc Trans 2023; 51:435-445. [PMID: 36645005 PMCID: PMC9987996 DOI: 10.1042/bst20221172] [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: 11/16/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/17/2023]
Abstract
The prevalence of neurological diseases is currently growing due to the combination of several factor, including poor lifestyle and environmental imbalance which enhance the contribution of genetic factors. Parkinson's disease (PD), a chronic and progressive neurological condition, is one of the most prevalent neurodegenerative human diseases. Development of models may help to understand its pathophysiology. This review focuses on studies using invertebrate models to investigate certain chemicals that generate parkinsonian-like symptoms models. Additionally, we report some preliminary results of our own research on a crustacean (the crab Ucides cordatus) and a solitary ascidian (Styela plicata), used after induction of parkinsonism with 6-hydroxydopamine and the pesticide rotenone, respectively. We also discuss the advantages, limits, and drawbacks of using invertebrate models to study PD. We suggest prospects and directions for future investigations of PD, based on invertebrate models.
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Hu D, Cui Y, Zhang J. Influence of Nervonic Acid on Parkinson’s Disease Model Cells through Ras/MEK/ERK Axis. INT J PHARMACOL 2022. [DOI: 10.3923/ijp.2022.1309.1321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Chen H, Wang K, Scheperjans F, Killinger B. Environmental triggers of Parkinson's disease - Implications of the Braak and dual-hit hypotheses. Neurobiol Dis 2022; 163:105601. [PMID: 34954321 PMCID: PMC9525101 DOI: 10.1016/j.nbd.2021.105601] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/05/2021] [Accepted: 12/22/2021] [Indexed: 11/22/2022] Open
Abstract
Idiopathic Parkinson's disease (PD) may take decades to develop, during which many risk or protective factors may come into play to initiate the pathogenesis or modify its progression to clinical PD. The lack of understanding of this prodromal phase of PD and the factors involved has been a major hurdle in the study of PD etiology and preventive strategies. Although still controversial, the Braak and dual-hit hypotheses that PD may start peripherally in the olfactory structures and/or the gut provides a theoretical platform to identify the triggers and modifiers of PD prodromal development and progression. This is particularly true for the search of environmental causes of PD as the olfactory structures and gut are the major human mucosal interfaces with the environment. In this review, we lay out our personal views about how the Braak and dual-hit hypotheses may help us search for the environmental triggers and modifiers for PD, summarize available experimental and epidemiological evidence, and discuss research gaps and strategies.
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Affiliation(s)
- Honglei Chen
- Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA.
| | - Keran Wang
- Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Filip Scheperjans
- Department of Neurology, Helsinki University Hospital, and Clinicum, University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Bryan Killinger
- Graduate College, Rush University Medical Center, Chicago, IL 60612, USA
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Abstract
Advanced Parkinson's disease (PD) often brings a set of motor and non-motor features that are particularly challenging to manage. Medication options can be limited by side-effects and quality of life can be severely affected by an accumulating burden of nonmotor symptoms. Here, we reviewed the literature and our clinical experience with the aim of providing a practical approach to the management of advanced PD. We provide guidelines for treatment of physical and neurobehavioral concerns, that occur in advanced PD.
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Rong S, Xu G, Liu B, Sun Y, Snetselaar LG, Wallace RB, Li B, Liao J, Bao W. Trends in Mortality From Parkinson Disease in the United States, 1999-2019. Neurology 2021; 97:e1986-e1993. [PMID: 34706971 DOI: 10.1212/wnl.0000000000012826] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/25/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The mortality from Parkinson disease (PD) and its long-term trends in the United States in recent decades remains unknown. This study aimed to describe the trends in PD mortality in the United States from 1999 to 2019. METHODS We used data from the National Vital Statistics System, a nationwide, population-based death registry, to determine national trends in PD mortality, overall and by age, sex, race/ethnicity, urban-rural classification, and geographic location. Analyses focused on the data from 479,059 deaths due to PD from 1999 to 2019. Joinpoint regression was performed to examine temporal trends in age-adjusted death rates. RESULTS The age-adjusted mortality from PD increased from 5.4 (95% confidence interval [CI] 5.3-5.5) per 100,000 population in 1999 to 8.8 (95% CI, 8.7-8.9) per 100,000 population in 2019, with an average annual percent change of 2.4% (95% CI, 1.8%-3.0%). From 1999 to 2019, PD mortality increased significantly across all age groups, both sexes, various racial/ethnic groups, and different urban-rural classifications. The US states and District of Columbia with reported death rates all experienced an increase in PD mortality. Significant differences by sex and race/ethnicity were noted. Age-adjusted PD mortality rates were twice as high in men as in women and were greater in White individuals than those from other racial/ethnic groups. DISCUSSION From 1999 to 2019, the mortality from PD in the United States has increased significantly. The increase was regardless of age, sex, race/ethnicity, urban-rural classification, and geographic location. A comprehensive evaluation of long-term trends in PD mortality is important for health care priority setting.
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Affiliation(s)
- Shuang Rong
- From the Department of Nutrition and Food Hygiene (S.R., B.L., J.L.), School of Public Health, Medical College, Wuhan University of Science and Technology, China; and Department of Epidemiology (S.R., G.X., B.L., Y.S., L.G.S., R.B.W., W.B.), College of Public Health, University of Iowa, Iowa City
| | - Guifeng Xu
- From the Department of Nutrition and Food Hygiene (S.R., B.L., J.L.), School of Public Health, Medical College, Wuhan University of Science and Technology, China; and Department of Epidemiology (S.R., G.X., B.L., Y.S., L.G.S., R.B.W., W.B.), College of Public Health, University of Iowa, Iowa City
| | - Buyun Liu
- From the Department of Nutrition and Food Hygiene (S.R., B.L., J.L.), School of Public Health, Medical College, Wuhan University of Science and Technology, China; and Department of Epidemiology (S.R., G.X., B.L., Y.S., L.G.S., R.B.W., W.B.), College of Public Health, University of Iowa, Iowa City
| | - Yangbo Sun
- From the Department of Nutrition and Food Hygiene (S.R., B.L., J.L.), School of Public Health, Medical College, Wuhan University of Science and Technology, China; and Department of Epidemiology (S.R., G.X., B.L., Y.S., L.G.S., R.B.W., W.B.), College of Public Health, University of Iowa, Iowa City
| | - Linda G Snetselaar
- From the Department of Nutrition and Food Hygiene (S.R., B.L., J.L.), School of Public Health, Medical College, Wuhan University of Science and Technology, China; and Department of Epidemiology (S.R., G.X., B.L., Y.S., L.G.S., R.B.W., W.B.), College of Public Health, University of Iowa, Iowa City
| | - Robert B Wallace
- From the Department of Nutrition and Food Hygiene (S.R., B.L., J.L.), School of Public Health, Medical College, Wuhan University of Science and Technology, China; and Department of Epidemiology (S.R., G.X., B.L., Y.S., L.G.S., R.B.W., W.B.), College of Public Health, University of Iowa, Iowa City
| | - Benchao Li
- From the Department of Nutrition and Food Hygiene (S.R., B.L., J.L.), School of Public Health, Medical College, Wuhan University of Science and Technology, China; and Department of Epidemiology (S.R., G.X., B.L., Y.S., L.G.S., R.B.W., W.B.), College of Public Health, University of Iowa, Iowa City
| | - Jingling Liao
- From the Department of Nutrition and Food Hygiene (S.R., B.L., J.L.), School of Public Health, Medical College, Wuhan University of Science and Technology, China; and Department of Epidemiology (S.R., G.X., B.L., Y.S., L.G.S., R.B.W., W.B.), College of Public Health, University of Iowa, Iowa City
| | - Wei Bao
- From the Department of Nutrition and Food Hygiene (S.R., B.L., J.L.), School of Public Health, Medical College, Wuhan University of Science and Technology, China; and Department of Epidemiology (S.R., G.X., B.L., Y.S., L.G.S., R.B.W., W.B.), College of Public Health, University of Iowa, Iowa City.
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15
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Wang J, Cao H. Zebrafish and Medaka: Important Animal Models for Human Neurodegenerative Diseases. Int J Mol Sci 2021; 22:10766. [PMID: 34639106 PMCID: PMC8509648 DOI: 10.3390/ijms221910766] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 02/06/2023] Open
Abstract
Animal models of human neurodegenerative disease have been investigated for several decades. In recent years, zebrafish (Danio rerio) and medaka (Oryzias latipes) have become popular in pathogenic and therapeutic studies about human neurodegenerative diseases due to their small size, the optical clarity of embryos, their fast development, and their suitability to large-scale therapeutic screening. Following the emergence of a new generation of molecular biological technologies such as reverse and forward genetics, morpholino, transgenesis, and gene knockout, many human neurodegenerative disease models, such as Parkinson's, Huntington's, and Alzheimer's, were constructed in zebrafish and medaka. These studies proved that zebrafish and medaka genes are functionally conserved in relation to their human homologues, so they exhibit similar neurodegenerative phenotypes to human beings. Therefore, fish are a suitable model for the investigation of pathologic mechanisms of neurodegenerative diseases and for the large-scale screening of drugs for potential therapy. In this review, we summarize the studies in modelling human neurodegenerative diseases in zebrafish and medaka in recent years.
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Affiliation(s)
- Jing Wang
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Donghu South Road 7#, Wuhan 430072, China;
- College of Advanced Agriculture Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hong Cao
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Donghu South Road 7#, Wuhan 430072, China;
- College of Advanced Agriculture Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
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16
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Nicholas R, Nicholas E, Hannides M, Gautam V, Friede T, Koffman J. Influence of individual, illness and environmental factors on place of death among people with neurodegenerative diseases: a retrospective, observational, comparative cohort study. BMJ Support Palliat Care 2021:bmjspcare-2021-003105. [PMID: 34489324 DOI: 10.1136/bmjspcare-2021-003105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/11/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND In long-term neurological conditions, location of death is poorly understood but is seen as a marker of quality of dying. OBJECTIVE To examine individual, illness and environmental factors on place of death among people with multiple sclerosis (MS) and Parkinson's disease (PD) in isolation or in combination and compare them with people without either condition. METHODS Retrospective, observational, comparative cohort study of 582 people with MS, 579 people with PD and 95 controls from UK Multiple Sclerosis and Parkinson's Disease Tissue Bank. A subset of people with MS and PD were selected for analysis of individual clinical encounters 2 years before death and further subset of all groups for analysis of impact of advance care planning (ACP) and recognition of dying. RESULTS People with MS died more often (50.8%) in hospital than those with PD (35.3%). Examining individual clinical encounters over 2 years (4931 encounters) identified increased contact with services 12 months before death (F(1, 58)=69.71, p<0.0001) but was not associated with non-hospital deaths (F(1, 58)=1.001, p=0.321). The presence of ACPs and recognition of dying were high among people with MS and PD and both associated with a non-hospital death. ACPs were more likely to prevent hospital deaths when initiated by general practitioners (GPs) compared with other professional groups (χ2=68.77, p=0.0007). CONCLUSIONS For people with MS and PD, ACPs contribute to reducing dying in hospital. ACPs appear to be most effective when facilitated by GPs underlining the importance of primary care involvement in delivering holistic care at the end of life.
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Affiliation(s)
- Richard Nicholas
- UK Multiple Sclerosis Tissue Bank, Imperial College London, London, UK
| | - Emma Nicholas
- UK Multiple Sclerosis Tissue Bank, Imperial College London, London, UK
| | - Mike Hannides
- UK Multiple Sclerosis Tissue Bank, Imperial College London, London, UK
| | - Vishal Gautam
- UK Multiple Sclerosis Tissue Bank, Imperial College London, London, UK
| | - Tim Friede
- Department of Medical Statistics, University Medical Center, University of Göttingen, Göttingen, Germany
| | - Jonathan Koffman
- Department of Palliative Care, Policy and Rehabiltation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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17
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Mustapha M, Taib CNM. MPTP-induced mouse model of Parkinson's disease: A promising direction of therapeutic strategies. Bosn J Basic Med Sci 2021; 21:422-433. [PMID: 33357211 PMCID: PMC8292858 DOI: 10.17305/bjbms.2020.5181] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/10/2020] [Indexed: 12/23/2022] Open
Abstract
Among the popular animal models of Parkinson's disease (PD) commonly used in research are those that employ neurotoxins, especially 1-methyl- 4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP). This neurotoxin exerts it neurotoxicity by causing a barrage of insults, such as oxidative stress, mitochondrial apoptosis, inflammation, excitotoxicity, and formation of inclusion bodies acting singly and in concert, ultimately leading to dopaminergic neuronal damage in the substantia nigra pars compacta and striatum. The selective neurotoxicity induced by MPTP in the nigrostriatal dopaminergic neurons of the mouse brain has led to new perspectives on PD. For decades, the MPTP-induced mouse model of PD has been the gold standard in PD research even though it does not fully recapitulate PD symptomatology, but it does have the advantages of simplicity, practicability, affordability, and fewer ethical considerations and greater clinical correlation than those of other toxin models of PD. The model has rejuvenated PD research and opened new frontiers in the quest for more novel therapeutic and adjuvant agents for PD. Hence, this review summarizes the role of MPTP in producing Parkinson-like symptoms in mice and the experimental role of the MPTP-induced mouse model. We discussed recent developments of more promising PD therapeutics to enrich our existing knowledge about this neurotoxin using this model.
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Affiliation(s)
- Musa Mustapha
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor (Darul Ehsan), Malaysia
- Department of Human Anatomy, Faculty of Basic Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Che Norma Mat Taib
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor (Darul Ehsan), Malaysia
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18
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Ypinga JHL, Van Halteren AD, Henderson EJ, Bloem BR, Smink AJ, Tenison E, Munneke M, Ben-Shlomo Y, Darweesh SKL. Rationale and design to evaluate the PRIME Parkinson care model: a prospective observational evaluation of proactive, integrated and patient-centred Parkinson care in The Netherlands (PRIME-NL). BMC Neurol 2021; 21:286. [PMID: 34294077 PMCID: PMC8298196 DOI: 10.1186/s12883-021-02308-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 07/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Culminating evidence shows that current care does not optimally meet the needs of persons with parkinsonism, their carers and healthcare professionals. Recently, a new model of care was developed to address the limitations of usual care: Proactive and Integrated Management and Empowerment in Parkinson's Disease (PRIME Parkinson). From 2021 onwards, PRIME Parkinson care will replace usual care in a well-defined region in The Netherlands. The utility of PRIME Parkinson care will be evaluated on a single primary endpoint (parkinsonism-related complications), which reflects the health of people with parkinsonism. Furthermore, several secondary endpoints will be measured for four dimensions: health, patient and carer experience, healthcare professional experience, and cost of healthcare. The reference will be usual care, which will be continued in other regions in The Netherlands. METHODS This is a prospective observational study which will run from January 1, 2020 until December 31, 2023. Before the new model of care will replace the usual care in the PRIME Parkinson care region all baseline assessments will take place. Outcomes will be informed by two data sources. We will use healthcare claims-based data to evaluate the primary endpoint, and costs of healthcare, in all persons with parkinsonism receiving PRIME Parkinson care (estimated number: 2,000) and all persons with parkinsonism receiving usual care in the other parts of The Netherlands (estimated number: 48,000). We will also evaluate secondary endpoints by performing annual questionnaire-based assessments. These assessments will be administered to a subsample across both regions (estimated numbers: 1,200 persons with parkinsonism, 600 carers and 250 healthcare professionals). DISCUSSION This prospective cohort study will evaluate the utility of a novel integrated model of care for persons with parkinsonism in The Netherlands. We anticipate that the results of this study will also provide insight for the delivery of care to persons with parkinsonism in other regions and may inform the design of a similar model for other chronic health conditions.
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Affiliation(s)
- Jan H L Ypinga
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Angelika D Van Halteren
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Emily J Henderson
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
- Older People's Unit, Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, UK
| | - Bastiaan R Bloem
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Agnes J Smink
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Emma Tenison
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
| | - Marten Munneke
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Yoav Ben-Shlomo
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
| | - Sirwan K L Darweesh
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
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Najib NH, Nies YH, Abd Halim SA, Yahaya MF, Das S, Lim WL, Teoh SL. Modeling Parkinson’s Disease in Zebrafish. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2020; 19:386-399. [DOI: 10.2174/1871527319666200708124117] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/10/2020] [Accepted: 06/17/2020] [Indexed: 01/04/2023]
Abstract
Parkinson’s Disease (PD) is one of the most common neurodegenerative disorders that affects
the motor system, and includes cardinal motor symptoms such as resting tremor, cogwheel rigidity,
bradykinesia and postural instability. Its prevalence is increasing worldwide due to the increase in
life span. Although, two centuries since the first description of the disease, no proper cure with regard
to treatment strategies and control of symptoms could be reached. One of the major challenges faced
by the researchers is to have a suitable research model. Rodents are the most common PD models
used, but no single model can replicate the true nature of PD. In this review, we aim to discuss another
animal model, the zebrafish (Danio rerio), which is gaining popularity. Zebrafish brain has all the major
structures found in the mammalian brain, with neurotransmitter systems, and it also possesses a
functional blood-brain barrier similar to humans. From the perspective of PD research, the zebrafish
possesses the ventral diencephalon, which is thought to be homologous to the mammalian substantia
nigra. We summarize the various zebrafish models available to study PD, namely chemical-induced
and genetic models. The zebrafish can complement the use of other animal models for the mechanistic
study of PD and help in the screening of new potential therapeutic compounds.
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Affiliation(s)
- Nor H.M. Najib
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Yong H. Nies
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Syarifah A.S. Abd Halim
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Mohamad F. Yahaya
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Srijit Das
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Wei L. Lim
- Department of Biological Sciences, School of Science and Technology, Sunway University, Selangor, Malaysia
| | - Seong L. Teoh
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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20
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RADPAC-PD: A tool to support healthcare professionals in timely identifying palliative care needs of people with Parkinson's disease. PLoS One 2020; 15:e0230611. [PMID: 32315302 PMCID: PMC7173770 DOI: 10.1371/journal.pone.0230611] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/03/2020] [Indexed: 01/21/2023] Open
Abstract
Background Parkinson’s disease (PD) is a progressive degenerative disease without curative treatment perspectives. Even when palliative care for people with PD seems to be beneficial, the need for palliative care is often not timely recognized. Aim Our aim was to develop a tool that can help healthcare professionals in timely identifying palliative care needs in people with PD. Design We used a mixed-methods design, including individual and focus group interviews and a three-round modified Delphi study with healthcare professionals from a multidisciplinary field. Results Data from the interviews suggested two distinct moments in the progressive PD trajectory: 1) an ultimate moment to initiate Advance Care Planning (ACP); and 2) the actual start of the palliative phase. During the Delphi process, six indicators for ACP were identified, such as presence of frequent falls and first unplanned hospital admission. The start of the palliative phase involved four indicators: 1) personal goals have started to focus on maximization of comfort; 2) care needs have changed; 3) PD drug treatment has become less effective or an increasingly complex regime of drug treatments is needed; and 4) specific PD-symptoms or complications have appeared, such as significant weight loss, recurrent infections, or progressive dysphagia. Indicators for both moments are included in the RADboud indicators for PAlliative Care Needs in Parkinson’s Disease (RADPAC-PD) tool. Conclusion The RADPAC-PD may support healthcare professionals in timely initiating palliative care for persons with PD. Identification of one or more indicators can mark the need for ACP or the palliative phase. We expect that applying the RADPAC-PD, for example on an annual basis throughout the PD trajectory, can facilitate identification of the palliative phase in PD patients in daily practice. However, further prospective research is needed on the implementation of the RADPAC-PD.
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21
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The global burden of neurological disorders: translating evidence into policy. Lancet Neurol 2020; 19:255-265. [PMID: 31813850 PMCID: PMC9945815 DOI: 10.1016/s1474-4422(19)30411-9] [Citation(s) in RCA: 379] [Impact Index Per Article: 94.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/09/2019] [Accepted: 10/16/2019] [Indexed: 01/13/2023]
Abstract
Neurological disorders are the leading cause of disability and the second leading cause of death worldwide. In the past 30 years, the absolute numbers of deaths and people with disabilities owing to neurological diseases have risen substantially, particularly in low-income and middle-income countries, and further increases are expected globally as a result of population growth and ageing. This rise in absolute numbers of people affected suggests that advances in prevention and management of major neurological disorders are not sufficiently effective to counter global demographic changes. Urgent measures to reduce this burden are therefore needed. Because resources for health care and research are already overstretched, priorities need to be set to guide policy makers, governments, and funding organisations to develop and implement action plans for prevention, health care, and research to tackle the growing challenge of neurological disorders.
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22
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Dorsey ER, Sherer T, Okun MS, Bloem BR. The Emerging Evidence of the Parkinson Pandemic. JOURNAL OF PARKINSONS DISEASE 2019; 8:S3-S8. [PMID: 30584159 PMCID: PMC6311367 DOI: 10.3233/jpd-181474] [Citation(s) in RCA: 699] [Impact Index Per Article: 139.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Neurological disorders are now the leading source of disability globally, and the fastest growing neurological disorder in the world is Parkinson disease. From 1990 to 2015, the number of people with Parkinson disease doubled to over 6 million. Driven principally by aging, this number is projected to double again to over 12 million by 2040. Additional factors, including increasing longevity, declining smoking rates, and increasing industrialization, could raise the burden to over 17 million. For most of human history, Parkinson has been a rare disorder. However, demography and the by-products of industrialization have now created a Parkinson pandemic that will require heightened activism, focused planning, and novel approaches.
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Affiliation(s)
- E Ray Dorsey
- Department of Neurology and Center for Health+Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Todd Sherer
- Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Michael S Okun
- Fixel Center for Neurological Diseases, Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Bastiaan R Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Nijmegen, The Netherlands
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23
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Chen H, Ritz B. The Search for Environmental Causes of Parkinson's Disease: Moving Forward. JOURNAL OF PARKINSON'S DISEASE 2018; 8:S9-S17. [PMID: 30584168 PMCID: PMC6311360 DOI: 10.3233/jpd-181493] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/15/2018] [Indexed: 12/12/2022]
Abstract
It is widely believed that environmental exposures contribute to the vast majority of late-onset sporadic Parkinson's disease (PD), alone or via interactions with genetic factors. The search for environmental causes of PD has however been hampered by lack of understanding the prodromal phase of PD development and the difficulties in exposure assessment during this prolonged period. On the other hand, the existence of this prodromal period, along with an increasingly better understanding of PD prodromal symptoms, provides an exciting opportunity to identify environmental factors that initiate PD pathogenesis and/or modify its progression. For prevention efforts, this prodromal stage is of a major interest. Targeting factors that enter the body via the nose or gut has become even more important since the discovery of α-synuclein aggregates in the enteric and olfactory nervous systems. In this paper, we speculate about novel research hypotheses and approaches that may help us better define the role of environment in PD etiology, especially during its extended and complex prodromal phase.
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Affiliation(s)
- Honglei Chen
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Beate Ritz
- Department of Epidemiology and Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
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