A study on risk factors for Parkinson׳s disease in Indian population

A comprehensive examination of the evidence for whole of diet patterns in Parkinson's disease: a scoping review

Both motor and non-motor symptoms of Parkinson's disease (PD), a progressive neurological condition, have broad-ranging impacts on nutritional intake and dietary behaviour. Historically studies focused on individual dietary components, but evidence demonstrating ameliorative outcomes with whole-of-diet patterns such as Mediterranean and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) is emerging. These diets provide plenty of antioxidant rich fruits, vegetables, nuts, wholegrains and healthy fats. Paradoxically, the ketogenic diet, high fat and very low carbohydrate, is also proving to be beneficial. Within the PD community, it is well advertised that nutritional intake is associated with disease progression and symptom severity but understandably, the messaging is inconsistent. With projected prevalence estimated to rise to 1.6 million by 2037, more data regarding the impact of whole-of-diet patterns is needed to develop diet-behaviour change programmes and provide clear advice for PD management. Objectives and Methods: Objectives of this scoping review of both peer-reviewed academic and grey literatures are to determine the current evidence-based consensus for best dietary practice in PD and to ascertain whether the grey literature aligns. Results and Discussion: The consensus from the academic literature was that a MeDi/MIND whole of diet pattern (fresh fruit, vegetables, wholegrains, omega-3 fish and olive oil) is the best practice for improving PD outcomes. Support for the KD is emerging, but further research is needed to determine long-term effects. Encouragingly, the grey literature mostly aligned but nutrition advice was rarely forefront. The importance of nutrition needs greater emphasis in the grey literature, with positive messaging on dietary approaches for management of day-to-day symptoms.

Alcohol and Parkinson's Disease: A Systematic Review and Meta-Analysis

BACKGROUND

A substantial body of research has examined the relationship between alcohol consumption and risk of Parkinson's disease (PD).

OBJECTIVE

To provide an updated systematic review and meta-analysis of observational studies examining the relationship between alcohol consumption and risk of PD.

METHODS

Eligible studies comparing PD risk in ever vs. never alcohol drinkers were sourced from six databases. Outcomes were pooled using standard meta-analysis techniques. Separate female and male estimates were generated from studies reporting sex-specific data. Additionally, cohort studies stratifying participants by quantity of alcohol intake were integrated in a dose-response analysis.

RESULTS

52 studies were included, totaling 63,707 PD patients and 9,817,924 controls. Our meta-analysis supported a statistically significant overrepresentation of never drinkers among PD subjects; odds ratio (OR) for ever drinking alcohol 0.84 (95% confidence interval (CI) 0.76 - 0.92). A subgroup analysis revealed similar effect estimates in females and males. A further synthesis of seven cohort studies suggested a negative, dose-dependent association between alcohol and risk of PD.

CONCLUSION

In the absence of a known neuroprotective pathway, there may be reason to doubt a true biological effect. The role of survivor bias, selection and recall bias, misclassification, and residual confounding requires consideration. Alternatively, observations might be attributable to reverse causation if those predestined for PD alter their alcohol habits during the preclinical phase. Major limitations of our study include high between-study heterogeneity (I2 = 93.2%) and lack of adjustment for key confounders, namely smoking status.

Protective Activity of Aspirin Eugenol Ester on Paraquat-Induced Cell Damage in SH-SY5Y Cells

Aspirin eugenol ester (AEE) is a new pharmaceutical compound esterified by aspirin and eugenol, which has anti-inflammatory, antioxidant, and other pharmacological activities. The aim of this study was to investigate the protective effect of AEE on paraquat- (PQ-) induced cell damage of SH-SY5Y human neuroblastoma cells and its potential molecular mechanism. There was no significant change in cell viability when AEE was used alone. PQ treatment reduced cell viability in a concentration-dependent manner. However, AEE reduced the PQ-induced loss of cell viability. Flow cytometry, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), and 4′6-diamidino-2-phenylindole (DAPI) staining were used to evaluate cell apoptosis. Compared with the PQ group, AEE pretreatment could significantly inhibit PQ-induced cell damage. AEE pretreatment could reduce the cell damage of SH-SY5Y cells induced by PQ via reducing superoxide anion, intracellular reactive oxygen species (ROS), and mitochondrial ROS (mtROS) and increasing the levels of mitochondrial membrane potential (ΔΨm). At the same time, AEE could increase the activity of glutathione peroxidase (GSH-Px), catalase (CAT), and superoxide dismutase (SOD) and decrease the activity of malondialdehyde (MDA). The results showed that compared with the control group, the expression of p-PI3K, p-Akt, and Bcl-2 was significantly decreased, while the expression of caspase-3 and Bax was significantly increased in the PQ group. In the AEE group, AEE pretreatment could upregulate the expression of p-PI3K, p-Akt, and Bcl-2 and downregulate the expression of caspase-3 and Bax in SH-SY5Y cells. PI3K inhibitor LY294002 and the silencing of PI3K by shRNA could weaken the protective effect of AEE on PQ-induced SH-SY5Y cells. Therefore, AEE has a protective effect on PQ-induced SH-SY5Y cells by regulating the PI3K/Akt signal pathway to inhibit oxidative stress.

Well-Water Consumption and Risk of Parkinson's Disease: A Meta-Analysis of 15 Observational Studies

INTRODUCTION

The relationship between the risk of Parkinson disease and well-water consumption has been extensively studied, but the results have been contradictory. Therefore, we conducted a meta-analysis of observational studies to systematically assess the relationship between well-water consumption and Parkinson disease risk.

METHODS

We followed the PRISMA checklist in completing the meta-analysis. We searched two electronic databases (PubMed, EBSCO, EMBASE and Cochrane) from establishment to October, 2021, to identify relevant studies linking well-water drinking to Parkinson risk. We used a random-effects model to calculate the overall odds ratio (OR) with 95% confidence interval (CI). To reduce intragroup heterogeneity, we conducted subgroup analyses according to the research design and geographic area.

RESULTS

After careful review, a total of 15 case-control-designed studies included data suitable for our meta-analysis. The total number of cases and total controls that contribute to the combined OR were 2182 and 2456. The combined OR for ever well-water drinkers versus non-drinkers was 1.16 (95% CI: 0.97-1.39, I² = 44.52%). In subgroup analysis by geographic area, a significant association was observed in studies conducted in Asia (OR 1.29, 95% CI: 1.05-1.58, I² = 0.0%, p for heterogeneity = 0.460) but not in studies conducted in America (OR 0.97, 95% CI: 0.76-1.24, I² = 41.2%, p for heterogeneity = 0.164). In subgroup analysis by study design, a borderline significant association emerged in hospital-based case-control studies (OR 1.31, 95% CI: 1.04-1.65, I² = 40.9%, p for heterogeneity = 0.118) but not in population-based case-control studies (OR 0.96, 95% CI: 0.73-1.26, I² = 41.1%, p for heterogeneity = 0.165).

DISCUSSION

Our results indicate that there is no significant correlation between well-water consumption and PD risk.

Parkinson's Disease in the Middle East, North Africa, and South Asia: Consensus from the International Parkinson and Movement Disorder Society Task Force for the Middle East

BACKGROUND

Understanding the regional needs and available healthcare resources to treat Parkinson's disease (PD) is essential to plan appropriate future priorities. The International Parkinson and Movement Disorder Society (MDS) Task Force for the Middle East was established to raise awareness and promote education across the region on PD and other movement disorders. Broadly, the task force encompasses the countries of the Middle East but has included North Africa and South Asia as well (MENASA).

OBJECTIVE

To create a list of needs and priorities in the advancement of PD in MENASA countries based on consensuses generated by the MDS task force for the Middle East.

METHODS

A Strengths Weaknesses-Opportunities-Threats (SWOT) analysis was conducted by the task force members to generate consensus about PD care this region.

RESULTS

Eight overarching principles emerged for the consensus statement on current needs: more movement disorders specialists, multidisciplinary care, accurate epidemiologic data, educational programs, availability of drugs, and availability of more advanced therapy, enhanced health care resources and infrastructure, and greater levels of awareness within the general population and among health care professionals.

CONCLUSION

This pilot study sheds light on unmet needs for providing care to people with PD in the MENASA region. These data offer directions on priorities to increase awareness of PD, to develop better infrastructure for research and management of PD, to foster healthcare policy discussions for PD and to provide educational opportunities within these countries.

Clinical Response of Levodopa Carbidopa Combination in Patients with Idiopathic Parkinsonism

INTRODUCTION

Parkinson's disease is the most common form of a group of progressive neurodegenerative disorders. The use of levodopa as dopamine - replacement therapy is highly effective in ameliorating the symptoms of the disease and remains the standard drug with which other therapies are compared.

AIM

To study the change in Unified Parkinson's Disease Rating scale (UPDRS) scores in patients receiving levodopa and carbidopa treatment (levodopa- carbidopa combination).

MATERIALS AND METHODS

Study was conducted in Department of Neurology, Government Medical College, Trivandrum, India on 75 patients. All patients diagnosed with Idiopathic Parkinson's disease (PD) satisfying inclusion criteria were enrolled into the study. Informed written consent was taken from all patients. Baseline UPDRS scores were recorded followed by reassessment at the end of six month. Data was analysed using paired t-test with help of SPSS-16 statistical software.

RESULTS

Baseline UPDRS was collected and after 6 months of treatment, it was reassessed. Baseline total score was 49.8; the follow-up score was 39.5. A decrease in score was seen in various components of UPDRS.

CONCLUSION

Upon statistical analysis this difference was found to be significant, which implies that, there is improvement in patient's condition. Improvement was noted in Mentation, behaviour, mood, activities of daily living and motor functions. Hence there is positive treatment response for levodopa carbidopa therapy in patients with idiopathic PD.