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Towns C, Richer M, Jasaityte S, Stafford EJ, Joubert J, Antar T, Martinez-Carrasco A, Makarious MB, Casey B, Vitale D, Levine K, Leonard H, Pantazis CB, Screven LA, Hernandez DG, Wegel CE, Solle J, Nalls MA, Blauwendraat C, Singleton AB, Tan MMX, Iwaki H, Morris HR. Defining the causes of sporadic Parkinson's disease in the global Parkinson's genetics program (GP2). NPJ Parkinsons Dis 2023; 9:131. [PMID: 37699923 PMCID: PMC10497609 DOI: 10.1038/s41531-023-00533-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/22/2023] [Indexed: 09/14/2023] Open
Abstract
The Global Parkinson's Genetics Program (GP2) will genotype over 150,000 participants from around the world, and integrate genetic and clinical data for use in large-scale analyses to dramatically expand our understanding of the genetic architecture of PD. This report details the workflow for cohort integration into the complex arm of GP2, and together with our outline of the monogenic hub in a companion paper, provides a generalizable blueprint for establishing large scale collaborative research consortia.
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Affiliation(s)
- Clodagh Towns
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
| | - Madeleine Richer
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
| | - Simona Jasaityte
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
| | - Eleanor J Stafford
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
- University College London, London, UK
| | - Julie Joubert
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
| | - Tarek Antar
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Alejandro Martinez-Carrasco
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
- University College London, London, UK
| | - Mary B Makarious
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- National Institutes of Health, Bethesda, MD, USA
| | - Bradford Casey
- Department of Clinical Research, Michael J. Fox Foundation for Parkinson's Research, New York City, NY, USA
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Dan Vitale
- National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International, Washington, DC, USA
| | - Kristin Levine
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International, Washington, DC, USA
| | - Hampton Leonard
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International, Washington, DC, USA
- National Institute on Aging/National Institutes of Health, Bethesda, MD, USA
| | - Caroline B Pantazis
- National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Laurel A Screven
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Dena G Hernandez
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Claire E Wegel
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Justin Solle
- Department of Clinical Research, Michael J. Fox Foundation for Parkinson's Research, New York City, NY, USA
| | - Mike A Nalls
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International, Washington, DC, USA
| | - Cornelis Blauwendraat
- National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Integrative Genomics Unit, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Andrew B Singleton
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- National Institute on Aging, Bethesda, MD, USA
| | - Manuela M X Tan
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Hirotaka Iwaki
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International, Washington, DC, USA
| | - Huw R Morris
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK.
- University College London, London, UK.
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Ghit A, Deeb HE. Cytokines, miRNAs, and Antioxidants as Combined Non-invasive Biomarkers for Parkinson's Disease. J Mol Neurosci 2022; 72:1133-1140. [PMID: 35199307 DOI: 10.1007/s12031-022-01984-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/04/2022] [Indexed: 01/11/2023]
Abstract
Parkinson's disease (PD) is one of the most common long-term degenerative disorders of the CNS that primarily affects the human locomotor system. Owing to the heterogeneity of PD etiology and the lack of appropriate diagnostic tests, blood-based biomarkers became the most promising method for diagnosing PD. Even though various biomarkers for PD have been found, their specificity and sensitivity are not optimum when used alone. Therefore, the aim of this study was directed to evaluate changes in a group of sensitive blood-based biomarkers in the same PD patients compared to healthy individuals. Serum samples were collected from 20 PD patients and 15 age-matched healthy controls. We analyzed serum levels of cytokines (IL10, IL12, and TNF-α), α-synuclein proteins, miRNAs (miR-214, miR-221, and miR-141), and antioxidants (UA, PON1, ARE). Our results showed an increase in sera levels of cytokines in PD patients as well as a positive correlation among them. Also, we found a significant increase in sera levels of α-synuclein protein associated with a decrease in miR-214 which regulates its gene expression. Lastly, we observed a decrease in sera levels of miR-221, miR-141, UA, PON1, and ARE, which have a prominent role against oxidative stress. Because of the many etiologies of PD, a single measure is unlikely to become a useful biomarker. Therefore, to correctly predict disease state and progression, a mix of noninvasive biomarkers is required. Although considerable work has to be done, this study sheds light on the role of certain biomarkers in the diagnosis of PD.
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Affiliation(s)
- Amr Ghit
- Department of Biotechnology, Institute of Graduate Studies and Research (IGSR), Alexandria University, Alexandria, Egypt.
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy.
| | - Hany El Deeb
- Department of Neuropsychiatry, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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3
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Malaty IA, Martinez-Martin P, Chaudhuri KR, Odin P, Skorvanek M, Jimenez-Shahed J, Soileau MJ, Lindvall S, Domingos J, Jones S, Alobaidi A, Jalundhwala YJ, Kandukuri PL, Onuk K, Bergmann L, Femia S, Lee MY, Wright J, Antonini A. Does the 5-2-1 criteria identify patients with advanced Parkinson's disease? Real-world screening accuracy and burden of 5-2-1-positive patients in 7 countries. BMC Neurol 2022; 22:35. [PMID: 35073872 PMCID: PMC8785442 DOI: 10.1186/s12883-022-02560-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/19/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The burden of Parkinson's disease (PD) worsens with disease progression. However, the lack of objective and uniform disease classification challenges our understanding of the incremental burden in patients with advanced Parkinson's disease (APD) and suboptimal medication control. The 5-2-1 criteria was proposed by clinical consensus to identify patients with advancing PD. Our objective was to evaluate the screening accuracy and incremental clinical burden, healthcare resource utilization (HCRU), and humanistic burden in PD patients meeting the 5-2-1 screening criteria. METHODS Data were drawn from the Adelphi Parkinson's Disease Specific Program (DSP™), a multi-country point-in-time survey (2017-2020). People with PD who were naive to device-aided therapy and on oral PD therapy were included. Patients meeting the 5-2-1 screening criteria had one or more of the three clinical indicators of APD: (i) ≥5 doses of oral levodopa/day, OR (ii) "off" symptoms for ≥2 h of waking day, OR (iii) ≥1 h of troublesome dyskinesia. Clinician assessment of PD stage was used as the reference in this study. Clinical screening accuracy of the 5-2-1 criteria was assessed using area under the curve and multivariable logistic regression models. Incremental clinical, HCRU, and humanistic burden were assessed by known-group comparisons between 5 and 2-1-positive and negative patients. RESULTS From the analytic sample (n = 4714), 33% of patients met the 5-2-1 screening criteria. Among physician-classified APD patients, 78.6% were 5-2-1 positive. Concordance between clinician judgment and 5-2-1 screening criteria was > 75%. 5-2-1-positive patients were nearly 7-times more likely to be classified as APD by physician judgment. Compared with the 5-2-1-negative group, 5-2-1-positive patients had significantly higher clinical, HCRU, and humanistic burden across all measures. In particular, 5-2-1-positive patients had 3.8-times more falls, 3.6-times higher annual hospitalization rate, and 3.4-times greater dissatisfaction with PD treatment. 5-2-1-positive patients also had significantly lower quality of life and worse caregiver burden. CONCLUSIONS 5-2-1 criteria demonstrated potential as a screening tool for identifying people with APD with considerable clinical, humanistic, and HCRU burden. The 5-2-1 screening criteria is an objective and reliable tool that may aid the timely identification and treatment optimization of patients inadequately controlled on oral PD medications.
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Affiliation(s)
- Irene A. Malaty
- University of Florida, Fixel Institute for Neurological Diseases, Gainesville, FL USA
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - K. Ray Chaudhuri
- Parkinson Foundation Centre of Excellence, King’s College Hospital and King’s College, London, UK
| | - Per Odin
- University of Lund, Lund, Sweden
| | - Matej Skorvanek
- Department of Neurology, P. J. Šafárik University, Košice, Slovakia
- Department of Neurology, University Hospital of L. Pasteur, Košice, Slovakia
| | - Joohi Jimenez-Shahed
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | | | - Josefa Domingos
- European Parkinson’s Disease Association (EPDA), Sevenoaks, UK
- Grupo de patologia médica, nutrição e exercício clínico (PaMNEC) do CiiEM, Almada, Portugal
| | - Sarah Jones
- Parkinson & Movement Disorder Alliance, Tucson, USA
| | - Ali Alobaidi
- AbbVie Inc., North Chicago, IL USA
- University of Illinois at Chicago, Chicago, IL USA
| | | | | | | | | | | | | | | | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Department of Neuroscience, University of Padua, Padova, Italy
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Liepelt-Scarfone I, Gräber S, Kalbe E, Riedel O, Ringendahl H, Schmidt N, Witt K, Roeske S. [Guidelines for the Neuropsychological Assessment of Patients with Parkinson's Disease]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 89:363-373. [PMID: 33561875 DOI: 10.1055/a-1099-9332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Presence of mild cognitive impairment is currently the best predictor for the development of Parkinson's disease dementia. Diagnostic criteria for both Parkinson's with mild cognitive impairment and Parkinson's disease dementia have been suggested by the Movement Disorder Society. However, not all cognitive tests recommended are available in the German language with proper standard values. OBJECTIVES To define evidence-based guidelines for neuropsychological assessment of patients with Parkinson's disease in German. METHODS Two systematic literature searches were conducted. First, articles that presented international guidelines (consensus papers or reviews) for the application of standardized neuropsychological assessments for the diagnosis of cognitive impairment in Parkinson's disease were selected. Of those, only neuropsychological assessments in German language with normative values referring either to a German, Austrian, or Swiss population were considered. Second, articles comparing test performances of healthy controls vs. Parkinson's disease and/or different cognitive Parkinson's disease subtypes (e.g. no cognitive impairment, Parkinson's with mild cognitive impairment, Parkinson's disease dementia) were selected. Effect sizes for group differentiation were calculated. RESULTS Out of 127 full-text articles reviewed, 48 tests were identified during the first literature search. In the second search, 1716 articles were reviewed and 23 papers selected. The strongest effect sizes for group discrimination were revealed for tests assessing executive function, attention, and visuo-cognitive abilities. Based on the results of the two literature searches, consensus guidelines were defined by the authors, allowing for Level-II diagnosis for Parkinson's with mild cognitive impairment and Parkinson's disease dementia. CONCLUSIONS The presented guidelines may have the potential to standardize and improve the neuropsychological assessment of Parkinson's disease patients in German speaking countries.
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Affiliation(s)
- Inga Liepelt-Scarfone
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Tübingen, Deutschland.,Abteilung Neurodegeneration, Hertie Institut für Klinische Forschung, Tübingen, Deutschland
| | - Susanne Gräber
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Tübingen, Deutschland.,Zentrum für ambulante Rehabilitation am Universitätsklinikum Tübingen, Deutschland
| | - Elke Kalbe
- Medizinische Psychologie: Neuropsychologie und Genderforschung & Center für Neuropsychologische Diagnostik und Intervention, Universitätsklinikum Köln, Köln, Deutschland
| | - Oliver Riedel
- Abteilung Klinische Epidemiologie, Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS GmbH, Bremen, Deutschland
| | - Hubert Ringendahl
- Klinik für Neurologie und klinische Neurophysiologie, Helios Universitätsklinikum Wuppertal, Universitäts Witten/Herdecke, Wuppertal, Deutschland
| | - Nele Schmidt
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Deutschland
| | - Karsten Witt
- Forschungszentrum Neurosensorik, Carl von Ossietzy Universität Oldenburg, Universitätsklinik für Neurologie, Oldenburg, Deutschland
| | - Sandra Roeske
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Bonn, Deutschland
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5
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Kuhlenbäumer G, Berg D. Parkinson disease genetics: too early to predict progression? Nat Rev Neurol 2020; 15:625-626. [PMID: 31534210 DOI: 10.1038/s41582-019-0264-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Daniela Berg
- Department of Neurology, Christian-Albrechts University, Kiel, Germany. .,Department of Neurodegeneration, Hertie-Institute of Clinical Brain Research, Tübingen, Germany.
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6
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Bloem BR, Marks WJ, Silva de Lima AL, Kuijf ML, van Laar T, Jacobs BPF, Verbeek MM, Helmich RC, van de Warrenburg BP, Evers LJW, intHout J, van de Zande T, Snyder TM, Kapur R, Meinders MJ. The Personalized Parkinson Project: examining disease progression through broad biomarkers in early Parkinson's disease. BMC Neurol 2019; 19:160. [PMID: 31315608 PMCID: PMC6636112 DOI: 10.1186/s12883-019-1394-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Our understanding of the etiology, pathophysiology, phenotypic diversity, and progression of Parkinson's disease has stagnated. Consequently, patients do not receive the best care, leading to unnecessary disability, and to mounting costs for society. The Personalized Parkinson Project (PPP) proposes an unbiased approach to biomarker development with multiple biomarkers measured longitudinally. Our main aims are: (a) to perform a set of hypothesis-driven analyses on the comprehensive dataset, correlating established and novel biomarkers to the rate of disease progression and to treatment response; and (b) to create a widely accessible dataset for discovery of novel biomarkers and new targets for therapeutic interventions in Parkinson's disease. METHODS/DESIGN This is a prospective, longitudinal, single-center cohort study. The cohort will comprise 650 persons with Parkinson's disease. The inclusion criteria are purposely broad: age ≥ 18 years; and disease duration ≤5 years. Participants are followed for 2 years, with three annual assessments at the study center. Outcomes include a clinical assessment (including motor and neuro-psychological tests), collection of biospecimens (stool, whole blood, and cerebrospinal fluid), magnetic resonance imaging (both structural and functional), and ECG recordings (both 12-lead and Holter). Additionally, collection of physiological and environmental data in daily life over 2 years will be enabled through the Verily Study Watch. All data are stored with polymorphic encryptions and pseudonyms, to guarantee the participants' privacy on the one hand, and to enable data sharing on the other. The data and biospecimens will become available for scientists to address Parkinson's disease-related research questions. DISCUSSION The PPP has several distinguishing elements: all assessments are done in a single center; inclusion of "real life" subjects; deep and repeated multi-dimensional phenotyping; and continuous monitoring with a wearable device for 2 years. Also, the PPP is powered by privacy and security by design, allowing for data sharing with scientists worldwide respecting participants' privacy. The data are expected to open the way for important new insights, including identification of biomarkers to predict differences in prognosis and treatment response between patients. Our long-term aim is to improve existing treatments, develop new therapeutic approaches, and offer Parkinson's disease patients a more personalized disease management approach. TRIAL REGISTRATION Clinical Trials NCT03364894 . Registered December 6, 2017 (retrospectively registered).
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Affiliation(s)
- B. R. Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - W. J. Marks
- Verily Life Sciences, South San Francisco, CA USA
| | - A. L. Silva de Lima
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- CAPES Foundation, Ministry of Education of Brazil, Brasília/DF, Brazil
| | - M. L. Kuijf
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - T. van Laar
- Department of Neurology, Universtity Medical Center Groningen, Groningen, The Netherlands
| | - B. P. F. Jacobs
- Faculty of Science, University of Nijmegen, Nijmegen, The Netherlands
| | - M. M. Verbeek
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R. C. Helmich
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B. P. van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - L. J. W. Evers
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Institute for Computing and Information Sciences, Radboud University, Nijmegen, The Netherlands
| | - J. intHout
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - T. van de Zande
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - T. M. Snyder
- Verily Life Sciences, South San Francisco, CA USA
| | - R. Kapur
- Neurology Platform, Verily Life Sciences, South San Francisco, CA USA
| | - M. J. Meinders
- Scientific Center for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
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7
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Novel Immunotherapeutic Approaches to Target Alpha-Synuclein and Related Neuroinflammation in Parkinson's Disease. Cells 2019; 8:cells8020105. [PMID: 30708997 PMCID: PMC6406239 DOI: 10.3390/cells8020105] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/23/2019] [Accepted: 01/29/2019] [Indexed: 12/12/2022] Open
Abstract
The etiology of Parkinson’s disease (PD) is significantly influenced by disease-causing changes in the protein alpha-Synuclein (aSyn). It can trigger and promote intracellular stress and thereby impair the function of dopaminergic neurons. However, these damage mechanisms do not only extend to neuronal cells, but also affect most glial cell populations, such as astroglia and microglia, but also T lymphocytes, which can no longer maintain the homeostatic CNS milieu because they produce neuroinflammatory responses to aSyn pathology. Through precise neuropathological examination, molecular characterization of biomaterials, and the use of PET technology, it has been clearly demonstrated that neuroinflammation is involved in human PD. In this review, we provide an in-depth overview of the pathomechanisms that aSyn elicits in models of disease and focus on the affected glial cell and lymphocyte populations and their interaction with pathogenic aSyn species. The interplay between aSyn and glial cells is analyzed both in the basic research setting and in the context of human neuropathology. Ultimately, a strong rationale builds up to therapeutically reduce the burden of pathological aSyn in the CNS. The current antibody-based approaches to lower the amount of aSyn and thereby alleviate neuroinflammatory responses is finally discussed as novel therapeutic strategies for PD.
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8
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Hipp G, Vaillant M, Diederich NJ, Roomp K, Satagopam VP, Banda P, Sandt E, Mommaerts K, Schmitz SK, Longhino L, Schweicher A, Hanff AM, Nicolai B, Kolber P, Reiter D, Pavelka L, Binck S, Pauly C, Geffers L, Betsou F, Gantenbein M, Klucken J, Gasser T, Hu MT, Balling R, Krüger R. The Luxembourg Parkinson's Study: A Comprehensive Approach for Stratification and Early Diagnosis. Front Aging Neurosci 2018; 10:326. [PMID: 30420802 PMCID: PMC6216083 DOI: 10.3389/fnagi.2018.00326] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 09/26/2018] [Indexed: 11/13/2022] Open
Abstract
While genetic advances have successfully defined part of the complexity in Parkinson's disease (PD), the clinical characterization of phenotypes remains challenging. Therapeutic trials and cohort studies typically include patients with earlier disease stages and exclude comorbidities, thus ignoring a substantial part of the real-world PD population. To account for these limitations, we implemented the Luxembourg PD study as a comprehensive clinical, molecular and device-based approach including patients with typical PD and atypical parkinsonism, irrespective of their disease stage, age, comorbidities, or linguistic background. To provide a large, longitudinally followed, and deeply phenotyped set of patients and controls for clinical and fundamental research on PD, we implemented an open-source digital platform that can be harmonized with international PD cohort studies. Our interests also reflect Luxembourg-specific areas of PD research, including vision, gait, and cognition. This effort is flanked by comprehensive biosampling efforts assuring high quality and sustained availability of body liquids and tissue biopsies. We provide evidence for the feasibility of such a cohort program with deep phenotyping and high quality biosampling on parkinsonism in an environment with structural specificities and alert the international research community to our willingness to collaborate with other centers. The combination of advanced clinical phenotyping approaches including device-based assessment will create a comprehensive assessment of the disease and its variants, its interaction with comorbidities and its progression. We envision the Luxembourg Parkinson's study as an important research platform for defining early diagnosis and progression markers that translate into stratified treatment approaches.
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Affiliation(s)
- Geraldine Hipp
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg
- Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Michel Vaillant
- Competence Centre in Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - Kirsten Roomp
- Bioinformatics Core, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur Alzette, Luxembourg
| | - Venkata P. Satagopam
- Bioinformatics Core, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur Alzette, Luxembourg
| | - Peter Banda
- Bioinformatics Core, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur Alzette, Luxembourg
| | - Estelle Sandt
- Integrated BioBank of Luxembourg, Dudelange, Luxembourg
| | - Kathleen Mommaerts
- Integrated BioBank of Luxembourg, Dudelange, Luxembourg
- Developmental and Cellular Biology, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur Alzette, Luxembourg
| | - Sabine K. Schmitz
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg
| | - Laura Longhino
- Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | | | - Anne-Marie Hanff
- Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Béatrice Nicolai
- Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Pierre Kolber
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg
- Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Dorothea Reiter
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg
- Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Lukas Pavelka
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg
- Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Sylvia Binck
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg
- Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Claire Pauly
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg
- Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Lars Geffers
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg
| | - Fay Betsou
- Integrated BioBank of Luxembourg, Dudelange, Luxembourg
| | - Manon Gantenbein
- Clinical and Epidemiological Investigation Center, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Jochen Klucken
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas Gasser
- Department of Neurodegeneration, Hertie-Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Michele T. Hu
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Rudi Balling
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg
| | - Rejko Krüger
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg
- Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
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Heinzel S, Lerche S, Maetzler W, Berg D. Global, Yet Incomplete Overview of Cohort Studies in Parkinson's disease. JOURNAL OF PARKINSONS DISEASE 2018; 7:423-432. [PMID: 28582871 DOI: 10.3233/jpd-171100] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is characterized by heterogeneity and multifactorial longitudinal changes. To identify PD subtypes and factors influencing the disease course, multiple cohort studies have been designed globally. Knowledge about existing cohorts is pivotal to foster collaboration, which may help to advance the understanding of PD. OBJECTIVE To raise the awareness about PD cohorts and potential global collaboration opportunities. METHODS Observational cohort studies in clinical PD were identified by a European working group (JPND BioLoC-PD) and through literature search. Using a structured survey investigators of 44 cohorts provided basic information on cohorts and assessments performed. RESULTS For the 44 cohorts (32% on early/de-novo PD), 14.666 participants (cohorts' median: 138; range: 23-3.090), a median 1.5-year follow-up interval (0.5-4 years) and a median (planned) observational period of 5 years (1-20 years) were indicated. All studies have assessed motor functions often using rating scales (UPDRS-III; 93% of studies) and less frequently quantitative gait/balance (25%) or fine motor assessments (27%). Cognitive (100%), neuropsychiatric (91%), daily living (78%), sleep (70%), sensory (63%), and gastrointestinal/autonomic (55%) assessments were common and often comparable. Neuroimaging data (82%) and biomaterial (69%) have been collected in many studies. Surprisingly, possible disease modifiers, such as sport/physical activity (11%), have rarely been assessed. CONCLUSIONS Existing data of PD cohorts provide vast collaboration opportunities. We propose to establish a comprehensive, up-to-date, open-access internet platform with easy-to-use search tools of PD cohort descriptions and potentially available data. Bringing researchers together to enable collaborative joint, meta- and replication analyses is timely and necessary to advance PD research ultimately required for an understanding of PD that can be translated into more effective therapies.
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Affiliation(s)
- Sebastian Heinzel
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Stefanie Lerche
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany.,Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Daniela Berg
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany.,Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
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10
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Titova N, Martinez-Martin P, Katunina E, Chaudhuri KR. Advanced Parkinson's or "complex phase" Parkinson's disease? Re-evaluation is needed. J Neural Transm (Vienna) 2017; 124:1529-1537. [PMID: 29116411 PMCID: PMC5686262 DOI: 10.1007/s00702-017-1799-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 10/13/2017] [Indexed: 01/01/2023]
Abstract
Holistic management of Parkinson's disease, now recognised as a combined motor and nonmotor disorder, remains a key unmet need. Such management needs relatively accurate definition of the various stages of Parkinson's from early untreated to late palliative as each stage calls for personalised therapies. Management also needs to have a robust knowledge of the progression pattern and clinical heterogeneity of the presentation of Parkinson's which may manifest in a motor dominant or nonmotor dominant manner. The "advanced" stages of Parkinson's disease qualify for advanced treatments such as with continuous infusion or stereotactic surgery yet the concept of "advanced Parkinson's disease" (APD) remains controversial in spite of growing knowledge of the natural history of the motor syndrome of PD. Advanced PD is currently largely defined on the basis of consensus opinion and thus with several caveats. Nonmotor aspects of PD may also reflect advancing course of the disorder, so far not reflected in usual scale based assessments which are largely focussed on motor symptoms. In this paper, we discuss the problems with current definitions of "advanced" PD and also propose the term "complex phase" Parkinson's disease as an alternative which takes into account a multimodal symptoms and biomarker based approach in addition to patient preference.
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Affiliation(s)
- Nataliya Titova
- Department of Neurology, Neurosurgery and Medical Genetics, Federal State Budgetary Educational Institution of Higher Education « N.I. Pirogov Russian National Research Medical University » of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
| | - Elena Katunina
- Department of Neurology, Neurosurgery and Medical Genetics, Federal State Budgetary Educational Institution of Higher Education « N.I. Pirogov Russian National Research Medical University » of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - K Ray Chaudhuri
- National Parkinson Foundation International Centre of Excellence, Kings College Hospital and The Maurice Wohl Clinical Neuroscience Institute, Kings College, 5 Cutcombe Road, London, SE59RT, UK.
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11
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Pilotto A, Heinzel S, Suenkel U, Lerche S, Brockmann K, Roeben B, Schaeffer E, Wurster I, Yilmaz R, Liepelt-Scarfone I, von Thaler AK, Metzger FG, Eschweiler GW, Postuma RB, Maetzler W, Berg D. Application of the movement disorder society prodromal Parkinson's disease research criteria in 2 independent prospective cohorts. Mov Disord 2017; 32:1025-1034. [DOI: 10.1002/mds.27035] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/27/2017] [Accepted: 03/30/2017] [Indexed: 12/15/2022] Open
Affiliation(s)
- Andrea Pilotto
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
- Neurology Unit, Department of Clinical and Experimental Sciences; University of Brescia, Brescia, Italy and Parkinson's Disease Rehabilitation Centre, FERB ONLUS S.Isidoro Hospital, Trescore Balneario (BG); Italy
| | - Sebastian Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
- Department of Neurology; Christian-Albrechts-University; Kiel Germany
| | - Ulrike Suenkel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Stefanie Lerche
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Kathrin Brockmann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Eva Schaeffer
- Department of Neurology; Christian-Albrechts-University; Kiel Germany
| | - Isabel Wurster
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Rezzak Yilmaz
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
- German Center for Neurodegenerative Diseases; Tuebingen Germany
| | - Anna-Katharina von Thaler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Florian G. Metzger
- Department of Psychiatry and Psychotherapy, Geriatric Center; Tuebingen University Hospital; Tuebingen Germany
| | - Gerhard W. Eschweiler
- Department of Psychiatry and Psychotherapy, Geriatric Center; Tuebingen University Hospital; Tuebingen Germany
| | - Ron B. Postuma
- Department of Neurology; Montreal General Hospital; Montreal Quebec Canada
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
- Department of Neurology; Christian-Albrechts-University; Kiel Germany
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
- Department of Neurology; Christian-Albrechts-University; Kiel Germany
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12
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[Diagnostics of clinical and prodromal idiopathic Parkinson's disease : New criteria]. DER NERVENARZT 2017; 88:356-364. [PMID: 28213756 DOI: 10.1007/s00115-017-0290-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Recently, the Movement Disorder Society (MDS) published an adaptation of the previous United Kingdom Brain Bank Society (UKBBS) criteria for the diagnosis of idiopathic Parkinson's disease (iPD). OBJECTIVES This article presents the changes in the current clinical diagnostic criteria for IPD. Furthermore, the new MDS criteria for prodromal iPD are discussed. RESULTS The recently introduced MDS criteria for the clinical diagnosis of iPD include useful novel features (e.g. postural instability is no longer listed as a cardinal symptom, familiar history of iPD and intake of neuroleptics at the first visit no longer lead to exclusion of the diagnosis) and red flags do not lead to exclusion of the diagnosis; however, they must be counterbalanced by the presence of supportive criteria for iPD. The criteria for identification of persons in the prodromal stage are currently established only for scientific investigations. CONCLUSION The new MDS criteria for the diagnostics of iPD should help to improve the sensitivity and specificity.
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Alamri Y, MacAskill M, Anderson T. Commentary: Aiming for Study Comparability in Parkinson's Disease: Proposal for a Modular Set of Biomarker Assessments to be Used in Longitudinal Studies. Front Aging Neurosci 2017; 8:331. [PMID: 28119600 PMCID: PMC5220072 DOI: 10.3389/fnagi.2016.00331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 12/19/2016] [Indexed: 11/25/2022] Open
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