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Johnston KE, Medved K, Raigal-Aran L, Crowley EK, Corkery S, Cahill A, Bambury RM, Noonan B, Gleeson JP. Patient and Public Involvement to Optimise a Patient Information Leaflet Format. Ir Med J 2024; 117:945. [PMID: 38682693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
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Collins LM, Roberts R, Cleary H, Diskin J, Kitt D, Van Bommel-Rutgers I, Smits-Engelsman BCM, Crowley EK, Sullivan AM. Intensive training programme improves handwriting in a community cohort of people with Parkinson's disease. Ir J Med Sci 2024; 193:389-395. [PMID: 37249793 PMCID: PMC10808167 DOI: 10.1007/s11845-023-03404-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/15/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND People with Parkinson's disease (PwP) often report problems with their handwriting before they receive a formal diagnosis. Many PwP suffer from deteriorating handwriting throughout their illness, which has detrimental effects on many aspects of their quality of life. AIMS To assess a 6-week online training programme aimed at improving handwriting of PwP. METHODS Handwriting samples from a community-based cohort of PwP (n = 48) were analysed using systematic detection of writing problems (SOS-PD) by two independent raters, before and after a 6-week remotely monitored physiotherapy-led training programme. Inter-rater variability on multiple measures of handwriting quality was analysed. The handwriting data was analysed using pre-/post-design in the same individuals. Multiple aspects of the handwriting samples were assessed, including writing fluency, transitions between letters, regularity in letter size, word spacing, and straightness of lines. RESULTS Analysis of inter-rater reliability showed high agreement for total handwriting scores and letter size, as well as speed and legibility scores, whereas there were mixed levels of inter-rater reliability for other handwriting measures. Overall handwriting quality (p = 0.001) and legibility (p = 0.009) significantly improved, while letter size (p = 0.012), fluency (p = 0.001), regularity of letter size (p = 0.009), and straightness of lines (p = 0.036) were also enhanced. CONCLUSIONS The results of this study show that this 6-week intensive remotely-monitored physiotherapy-led handwriting programme improved handwriting in PwP. This is the first study of its kind to use this tool remotely, and it demonstrated that the SOS-PD is reliable for measuring handwriting in PwP.
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Affiliation(s)
- Lucy M Collins
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Rachel Roberts
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Hannah Cleary
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - James Diskin
- Corrib Physiotherapy, Claregalway, Co, Galway, Ireland
| | - Donna Kitt
- Corrib Physiotherapy, Claregalway, Co, Galway, Ireland
| | | | - Bouwien C M Smits-Engelsman
- Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
- Physical Activity, Sport and Recreation, Faculty Health Sciences, North-West University, Potchefstroom, South Africa
| | - Erin K Crowley
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Aideen M Sullivan
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
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Fitzgerald I, Sahm LJ, Byrne A, O'Connell J, Ensor J, Dhubhlaing CN, O'Dwyer S, Crowley EK. Predicting antipsychotic-induced weight gain in first episode psychosis - a field-wide systematic review and meta-analysis of non-genetic prognostic factors. Eur Psychiatry 2023:1-39. [PMID: 37278237 DOI: 10.1192/j.eurpsy.2023.2417] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Affiliation(s)
- Ita Fitzgerald
- Pharmacy Department, St Patrick's Mental Health Services, Dublin, Ireland
- School of Pharmacy, University College Cork, Ireland
| | - Laura J Sahm
- School of Pharmacy, University College Cork, Ireland
- Pharmacy Department, Mercy University Hospital, Cork, Ireland
| | - Amy Byrne
- Pharmacy Department, Connolly Hospital, Blanchardstown, Dublin, Ireland
| | - Jean O'Connell
- Endocrinology Department, St Columcille's Hospital, Co. Dublin, Ireland
- St Vincent's University Hospital Group, Dublin, Ireland
| | - Joie Ensor
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Ciara Ní Dhubhlaing
- Pharmacy Department, St Patrick's Mental Health Services, Dublin, Ireland
- College of Mental Health Pharmacy, United Kingdom
| | - Sarah O'Dwyer
- Department of Medicine, St Patrick's Mental Health Services, Dublin, Ireland
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Burke A, O'Driscoll M, Crowley EK, Dhubhlaing CN. Implementation and evaluation of STOPP/START criteria to address polypharmacy in older adults in an inpatient psychiatric setting. Exploratory Research in Clinical and Social Pharmacy 2023; 9:100245. [PMID: 37065779 PMCID: PMC10091114 DOI: 10.1016/j.rcsop.2023.100245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/13/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023] Open
Abstract
Background There is a scarcity of research in applying the Screening Tool of Older Person's Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START) criteria to older adults admitted to a psychiatric hospital. Objectives The primary aim of this study was to determine the extent of polypharmacy in older adults admitted to a psychiatric hospital and to assess the number of STOPP/START triggers detected and recommended by pharmacists. Secondary objectives include evaluating if the STOPP/START criteria is a useful tool to improve prescribing in this setting by assessing the implementation rates of STOPP/START triggers. Methods This was a prospective, longitudinal study in a psychiatry inpatient setting. Data were collected over a 7-week period. Explicit informed consent was obtained from participants. Medication reconciliation was completed and participants' medications were reviewed using STOPP/START criteria. The number of STOPP/START triggers detected, recommended and implemented was recorded. Results Sixty-two patients were included in the study. Ninety-four percent were prescribed ≥5 medications and 55% were prescribed ≥10 medications on admission. The mean number of medications prescribed per patient increased from 10 on admission to 12 at follow-up. Of 174 Potential Inappropriate Medications (PIMs) detected, 41% were recommended for review and, of these only 31% were implemented. 27% of the 77 Potential Prescribing Omissions (PPOs) detected were recommended for review and only 23% of those were implemented. Conclusion STOPP/START did not reduce the prevalence of polypharmacy in this setting. The implementation rates observed in this study were much lower than those observed in non-psychiatric settings.
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Fitzgerald I, O'Connell J, Keating D, Hynes C, McWilliams S, Crowley EK. Metformin in the management of antipsychotic-induced weight gain in adults with psychosis: development of the first evidence-based guideline using GRADE methodology. Evid Based Ment Health 2022; 25:15-22. [PMID: 34588212 PMCID: PMC8788031 DOI: 10.1136/ebmental-2021-300291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/07/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Adjunctive metformin is the most well-studied intervention in the pharmacological management of antipsychotic-induced weight gain (AIWG). Although a relatively unaddressed area, among guidelines recommending consideration of metformin, prescribing information that would facilitate its applied use by clinicians, for example, provision of a dose titration schedule is absent. Moreover, recommendations differ regarding metformin's place in the hierarchy of management options. Both represent significant barriers to the applied, evidence-based use of metformin for this indication. OBJECTIVE To produce a guideline solely dedicated to the optimised use of metformin in AIWG management, using internationally endorsed guideline methodology. METHODS A list of guideline key health questions (KHQs) was produced. It was agreed that individual recommendations would be 'adopted or adapted' from current guidelines and/or developed de novo, in the case of unanswered questions. A systematic literature review (2008-2020) was undertaken to identify published guidelines and supporting (or more recent) research evidence. Quality appraisal was undertaken using the Appraisal of Guidelines Research and Evaluation II tool, A Measurement Tool to Assess Systematic Reviews (AMSTAR) assessment,and the Cochrane Risk of Bias 2 tool, where appropriate. Assessment of evidence certainty and recommendation development was undertaken using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. FINDINGS We confirmed that no published guideline-of appropriate quality, solely dedicated to the use of metformin to manage AIWG was available. Recommendations located within other guidelines inadequately addressed our KHQs. CONCLUSION All 11 recommendations and 7 supporting good practice developed here were formulated de novo. CLINICAL IMPLICATIONS These recommendations build on the number and quality of recommendations in this area, and facilitate the optimised use of metformin when managing AIWG.
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Affiliation(s)
- Ita Fitzgerald
- Pharmacy Department, Saint John of God Hospitaller Services, Dublin, Ireland
- School of Pharmacy, University College Cork, Cork, Ireland
| | - Jean O'Connell
- Endocrinology, St Columcille's Hospital, Loughlinstown, Ireland
- Endocrinology, St Vincent's University Hospital, Dublin, Ireland
| | - Dolores Keating
- Pharmacy Department, Saint John of God Hospital, Dublin, Ireland
| | - Caroline Hynes
- Pharmacy, Saint John of God Hospitaller Services, Dublin, Ireland
| | - Stephen McWilliams
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
- Medical, Saint John of God Hospitaller Services, Dublin, Ireland
| | - Erin K Crowley
- Pharmaceutical Care Research Group, University College Cork, Cork, Ireland
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Crowley EK, Grabrucker S, Long-Smith CM, Stack A, O'Gorman DM, Nolan YM. A Reduction in Behavioral Pattern Separation Is Attenuated by Dietary Supplementation with a Magnesium-Rich Marine Mineral Blend in Middle-Aged Rats. J Med Food 2021; 25:924-929. [PMID: 34185600 DOI: 10.1089/jmf.2020.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Middle age is increasingly accepted as a key period during which individuals are susceptible to the effect of environmental and lifestyle factors. Emerging research indicates that dietary factors play a crucial role in brain health and cognitive function, and studies in both animals and humans have demonstrated that dietary interventions can mitigate cognitive impairment. Specifically, magnesium has been shown to enhance learning and memory, and magnesium deficiency is associated with impaired hippocampal-dependent memory formation in animal studies. The aim of this study was to examine if supplementation with a magnesium-rich marine mineral blend (MMB) could alter middle-age-related cognitive impairment. Young and middle-aged rats were given access to a control diet or an experimental diet formulated with an MMB for 4 weeks before undergoing a series of behavioral assessments. Supplementation of MMB to middle-aged rats rescued a deficit in cognitive impairment, specifically a pattern separation paradigm that is sensitive to alterations in a type of brain plasticity called neurogenesis. It had no effect on general activity in the open field or performance on other hippocampal-associated tasks. Changes in cognitive function occur as a predictable consequence of aging. Research into whether modification of dietary factors, such as this MMB, may play a role in the prevention of age-related cognitive impairment warrants further investigation.
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Affiliation(s)
- Erin K Crowley
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Stefanie Grabrucker
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | | | - Alice Stack
- Marigot Ltd., Strand Farm, Currabinny, Carrigaline, Co. Cork, Ireland
| | - Denise M O'Gorman
- Marigot Ltd., Strand Farm, Currabinny, Carrigaline, Co. Cork, Ireland
| | - Yvonne M Nolan
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.,APC Microbiome Ireland, University College Cork, Cork, Ireland
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Gleeson LL, Tobin L, O'Brien GL, Crowley EK, Delaney A, O'Mahony D, Byrne S. Safety culture in a major accredited Irish university teaching hospital: a mixed methods study using the safety attitudes questionnaire. Ir J Med Sci 2020; 189:1171-1178. [PMID: 32274618 DOI: 10.1007/s11845-020-02228-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 04/02/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The measurement of safety culture, the way in which members of an organisation think about and prioritise safety, in a hospital can provide valuable insight and inform quality improvement strategies. AIMS The aim of this study is to describe the safety culture of a university teaching hospital in the Republic of Ireland. METHODS This is a mixed methods survey study using the Safety Attitudes Questionnaire (SAQ). The SAQ was distributed to all staff in the study hospital. Staff attitudes towards six domains of patient safety culture were assessed over 32 Likert-scaled items. Thematic analysis was performed on qualitative data. RESULTS A total of 768 staff members completed and returned a copy of the SAQ. The hospital scored above the international benchmark in five out of six domains, indicating a positive safety culture, but scored below the international benchmark in the domain 'Working Conditions'. This positive safety culture was not mirrored in the qualitative data, from which five themes emerged; three major-Staffing Issues, Patient-Focused Care and Hospital Environment-and two minor-Safe Reporting Culture and Training and Education. CONCLUSIONS In this study, a mixed methods approach was successfully used to investigate the safety culture in a large Irish hospital. Although the SAQ results indicated a positive safety culture, the qualitative data revealed a number of issues that the hospital staff felt impacted negatively on patient safety. The results of this study will inform future work on the design of an intervention to improve patient safety in the hospital.
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Affiliation(s)
- Laura L Gleeson
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
| | - Leanne Tobin
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Gary L O'Brien
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Erin K Crowley
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Aoife Delaney
- Medication Safety, Cork University Hospital, Wilton, Cork, Ireland
| | - Denis O'Mahony
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland.,Department of Medicine, School of Medicine, University College Cork, Cork, Ireland
| | - Stephen Byrne
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
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Crowley EK, Sallevelt BTGM, Huibers CJA, Murphy KD, Spruit M, Shen Z, Boland B, Spinewine A, Dalleur O, Moutzouri E, Löwe A, Feller M, Schwab N, Adam L, Wilting I, Knol W, Rodondi N, Byrne S, O’Mahony D. Intervention protocol: OPtimising thERapy to prevent avoidable hospital Admission in the Multi-morbid elderly (OPERAM): a structured medication review with support of a computerised decision support system. BMC Health Serv Res 2020; 20:220. [PMID: 32183810 PMCID: PMC7076919 DOI: 10.1186/s12913-020-5056-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 02/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several approaches to medication optimisation by identifying drug-related problems in older people have been described. Although some interventions have shown reductions in drug-related problems (DRPs), evidence supporting the effectiveness of medication reviews on clinical and economic outcomes is lacking. Application of the STOPP/START (version 2) explicit screening tool for inappropriate prescribing has decreased inappropriate prescribing and significantly reduced adverse drug reactions (ADRs) and associated healthcare costs in older patients with multi-morbidity and polypharmacy. Therefore, application of STOPP/START criteria during a medication review is likely to be beneficial. Incorporation of explicit screening tools into clinical decision support systems (CDSS) has gained traction as a means to improve both quality and efficiency in the rather time-consuming medication review process. Although CDSS can generate more potential inappropriate medication recommendations, some of these have been shown to be less clinically relevant, resulting in alert fatigue. Moreover, explicit tools such as STOPP/START do not cover all relevant DRPs on an individual patient level. The OPERAM study aims to assess the impact of a structured drug review on the quality of pharmacotherapy in older people with multi-morbidity and polypharmacy. The aim of this paper is to describe the structured, multi-component intervention of the OPERAM trial and compare it with the approach in the comparator arm. METHOD This paper describes a multi-component intervention, integrating interventions that have demonstrated effectiveness in defining DRPs. The intervention involves a structured history-taking of medication (SHiM), a medication review according to the systemic tool to reduce inappropriate prescribing (STRIP) method, assisted by a clinical decision support system (STRIP Assistant, STRIPA) with integrated STOPP/START criteria (version 2), followed by shared decision-making with both patient and attending physician. The developed method integrates patient input, patient data, involvement from other healthcare professionals and CDSS-assistance into one structured intervention. DISCUSSION The clinical and economical effectiveness of this experimental intervention will be evaluated in a cohort of hospitalised, older patients with multi-morbidity and polypharmacy in the multicentre, randomized controlled OPERAM trial (OPtimising thERapy to prevent Avoidable hospital admissions in the Multi-morbid elderly), which will be completed in the last quarter of 2019. TRIAL REGISTRATION Universal Trial Number: U1111-1181-9400 Clinicaltrials.gov: NCT02986425, Registered 08 December 2016. FOPH (Swiss national portal): SNCTP000002183. Netherlands Trial Register: NTR6012 (07-10-2016).
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Affiliation(s)
- Erin K. Crowley
- Pharmaceutical Care Research Group. School of Pharmacy, Cavanagh Pharmacy Building, University College Cork, Cork, Ireland
| | - Bastiaan T. G. M. Sallevelt
- Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Corlina J. A. Huibers
- Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kevin D. Murphy
- Pharmaceutical Care Research Group. School of Pharmacy, Cavanagh Pharmacy Building, University College Cork, Cork, Ireland
| | - Marco Spruit
- Department of Information and Computing Sciences, Utrecht University, Princetonplein 5, 3584CC Utrecht, The Netherlands
| | - Zhengru Shen
- Department of Information and Computing Sciences, Utrecht University, Princetonplein 5, 3584CC Utrecht, The Netherlands
| | - Benoît Boland
- Department of Geriatric Medicine, Cliniques universitaires Saint-Luc, Université catholique de Louvain UCLouvain, Brussels, Belgium
- Institute of Health and Society, Université catholique de Louvain UCLouvain, Brussels, Belgium
| | - Anne Spinewine
- Clinical Pharmacy Research Group, Louvain Drug Research Institute, Université catholique de Louvain UCLouvain, Brussels, Belgium
- Pharmacy Department, CHU Dinant-Godinne UCL Namur, Université catholique de Louvain UCLouvain, Yvoir, Belgium
| | - Olivia Dalleur
- Clinical Pharmacy Research Group, Louvain Drug Research Institute, Université catholique de Louvain UCLouvain, Brussels, Belgium
- Pharmacy Department, Cliniques universitaires Saint-Luc, Université catholique de Louvain UCLouvain, Brussels, Belgium
| | - Elisavet Moutzouri
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Axel Löwe
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Martin Feller
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Nathalie Schwab
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Luise Adam
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ingeborg Wilting
- Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Wilma Knol
- Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Nicolas Rodondi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Stephen Byrne
- Pharmaceutical Care Research Group. School of Pharmacy, Cavanagh Pharmacy Building, University College Cork, Cork, Ireland
| | - Denis O’Mahony
- Department of Medicine, University College Cork, Cork, Ireland
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
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O'Donovan SM, Crowley EK, Brown JRM, O'Sullivan O, O'Leary OF, Timmons S, Nolan YM, Clarke DJ, Hyland NP, Joyce SA, Sullivan AM, O'Neill C. Nigral overexpression of α-synuclein in a rat Parkinson's disease model indicates alterations in the enteric nervous system and the gut microbiome. Neurogastroenterol Motil 2020; 32:e13726. [PMID: 31576631 DOI: 10.1111/nmo.13726] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND A hallmark feature of Parkinson's disease (PD) is the build-up of α-synuclein protein aggregates throughout the brain; however α-synuclein is also expressed in enteric neurons. Gastrointestinal (GI) symptoms and pathology are frequently reported in PD, including constipation, increased intestinal permeability, glial pathology, and alterations to gut microbiota composition. α-synuclein can propagate through neuronal systems but the site of origin of α-synuclein pathology, whether it be the gut or the brain, is still unknown. Physical exercise is associated with alleviating symptoms of PD and with altering the composition of the gut microbiota. METHODS This study investigated the effects of bilateral nigral injection of adeno-associated virus (AAV)-α-synuclein on enteric neurons, glia and neurochemistry, the gut microbiome, and bile acid metabolism in rats, some of whom were exposed to voluntary exercise. KEY RESULTS Nigral overexpression of α-synuclein resulted in significant neuronal loss in the ileal submucosal plexus with no change in enteric glia. In contrast, the myenteric plexus showed a significant increase in glial expression, while neuronal numbers were maintained. Concomitant alterations were observed in the gut microbiome and related bile acid metabolism. Voluntary running protected against neuronal loss, increased enteric glial expression, and modified gut microbiome composition in the brain-injected AAV-α-synuclein PD model. CONCLUSIONS AND INFERENCES These results show that developing nigral α-synuclein pathology in this PD model exerts significant alterations on the enteric nervous system (ENS) and gut microbiome that are receptive to modification by exercise. This highlights brain to gut communication as an important mechanism in PD pathology.
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Affiliation(s)
- Sarah M O'Donovan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,School of Biochemistry and Cell Biology, University College Cork, Cork, Ireland.,Cork Neuroscience Centre, University College Cork, Cork, Ireland
| | - Erin K Crowley
- Cork Neuroscience Centre, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | | | - Orla O'Sullivan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre Moorepark, Cork, Ireland
| | - Olivia F O'Leary
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Cork Neuroscience Centre, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Suzanne Timmons
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Cork Neuroscience Centre, University College Cork, Cork, Ireland.,Centre of Gerontology and Rehabilitation, University College Cork, Cork, Ireland
| | - Yvonne M Nolan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Cork Neuroscience Centre, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - David J Clarke
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,School of Microbiology, University College Cork, Cork, Ireland
| | - Niall P Hyland
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Physiology, University College Cork, Cork, Ireland
| | - Susan A Joyce
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,School of Biochemistry and Cell Biology, University College Cork, Cork, Ireland
| | - Aideen M Sullivan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Cork Neuroscience Centre, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Cora O'Neill
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,School of Biochemistry and Cell Biology, University College Cork, Cork, Ireland.,Cork Neuroscience Centre, University College Cork, Cork, Ireland
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10
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Crowley EK, Nolan YM, Sullivan AM. Exercise as a therapeutic intervention for motor and non-motor symptoms in Parkinson's disease: Evidence from rodent models. Prog Neurobiol 2018; 172:2-22. [PMID: 30481560 DOI: 10.1016/j.pneurobio.2018.11.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 10/25/2018] [Accepted: 11/23/2018] [Indexed: 12/11/2022]
Abstract
Parkinson's disease (PD) is characterised by degeneration of dopaminergic neurons of the nigrostriatal pathway, which leads to the cardinal motor symptoms of the disease - tremor, rigidity and postural instability. A number of non-motor symptoms are also associated with PD, including cognitive impairment, mood disturbances and dysfunction of gastrointestinal and autonomic systems. Current therapies provide symptomatic relief but do not halt the disease process, so there is an urgent need for preventative strategies. Lifestyle interventions such as aerobic exercise have shown potential to lower the risk of developing PD and to alleviate both motor and non-motor symptoms. However, there is a lack of large-scale randomised clinical trials that have employed exercise in PD patients. This review will focus on the evidence from studies on rodent models of PD, for employing exercise as an intervention for both motor and non-motor symptoms.
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Affiliation(s)
- E K Crowley
- Department of Anatomy and Neuroscience, University College Cork, Ireland
| | - Y M Nolan
- Department of Anatomy and Neuroscience, University College Cork, Ireland; APC Microbiome Institute, University College Cork, Ireland
| | - A M Sullivan
- Department of Anatomy and Neuroscience, University College Cork, Ireland; APC Microbiome Institute, University College Cork, Ireland.
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11
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Affiliation(s)
- Erin K. Crowley
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Yvonne M. Nolan
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Aideen M. Sullivan
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
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12
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Crowley EK, Long-Smith CM, Murphy A, Patterson E, Murphy K, O'Gorman DM, Stanton C, Nolan YM. Dietary Supplementation with a Magnesium-Rich Marine Mineral Blend Enhances the Diversity of Gastrointestinal Microbiota. Mar Drugs 2018; 16:E216. [PMID: 29925774 PMCID: PMC6024889 DOI: 10.3390/md16060216] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 04/25/2018] [Accepted: 06/09/2018] [Indexed: 02/06/2023] Open
Abstract
Accumulating evidence demonstrates that dietary supplementation with functional food ingredients play a role in systemic and brain health as well as in healthy ageing. Conversely, deficiencies in calcium and magnesium as a result of the increasing prevalence of a high fat/high sugar "Western diet" have been associated with health problems such as obesity, inflammatory bowel diseases, and cardiovascular diseases, as well as metabolic, immune, and psychiatric disorders. It is now recognized that modulating the diversity of gut microbiota, the population of intestinal bacteria, through dietary intervention can significantly impact upon gut health as well as systemic and brain health. In the current study, we show that supplementation with a seaweed and seawater-derived functional food ingredient rich in bioactive calcium and magnesium (0.1% supplementation) as well as 70 other trace elements, significantly enhanced the gut microbial diversity in adult male rats. Given the significant impact of gut microbiota on health, these results position this marine multi-mineral blend (MMB) as a promising digestive-health promoting functional food ingredient.
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Affiliation(s)
- Erin K Crowley
- Department of Anatomy and Neuroscience, University College Cork, T12XF62 Cork, Ireland.
| | | | - Amy Murphy
- APC Microbiome Ireland, Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland.
- School of Microbiology, University College Cork, T12YT20 Cork, Ireland.
| | - Elaine Patterson
- APC Microbiome Ireland, Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland.
| | - Kiera Murphy
- APC Microbiome Ireland, Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland.
| | - Denise M O'Gorman
- Marigot Ltd., Strand Farm, Currabinny, Carrigaline, P43NN62 Cork, Ireland.
| | - Catherine Stanton
- APC Microbiome Ireland, Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland.
- APC Microbiome Ireland, University College Cork, T12YT20 Cork, Ireland.
| | - Yvonne M Nolan
- Department of Anatomy and Neuroscience, University College Cork, T12XF62 Cork, Ireland.
- APC Microbiome Ireland, University College Cork, T12YT20 Cork, Ireland.
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Crowley EK, Nolan YM, Sullivan AM. Neuroprotective effects of voluntary running on cognitive dysfunction in an α-synuclein rat model of Parkinson's disease. Neurobiol Aging 2018; 65:60-68. [PMID: 29407467 DOI: 10.1016/j.neurobiolaging.2018.01.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 12/21/2017] [Accepted: 01/17/2018] [Indexed: 02/04/2023]
Abstract
Parkinson's disease (PD) is no longer primarily classified as a motor disorder due to increasing recognition of the impact on patients of several nonmotor PD symptoms, including cognitive dysfunction. These nonmotor symptoms are highly prevalent and greatly affect the quality of life of patients with PD, and so, therapeutic interventions to alleviate these symptoms are urgently needed. The aim of this study was to investigate the potential neuroprotective effects of voluntary running on cognitive dysfunction in an adeno-associated virus-α-synuclein rat model of PD. Bilateral intranigral administration of adeno-associated virus-α-synuclein was found to induce motor dysfunction and a significant loss of nigral dopaminergic neurons, neither of which were rescued by voluntary running. Overexpression of α-synuclein also resulted in significant impairment on hippocampal neurogenesis-dependent pattern separation, a cognitive task; this was rescued by voluntary running. This was substantiated by an effect of running on neurogenesis levels in the dorsal dentate gyrus, suggesting that the functional effects of running on pattern separation were mediated via increased neurogenesis.
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Affiliation(s)
- Erin K Crowley
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Yvonne M Nolan
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland; APC Microbiome Institute, University College Cork, Cork, Ireland
| | - Aideen M Sullivan
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland; APC Microbiome Institute, University College Cork, Cork, Ireland.
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