Depression is Associated with Impulse-compulsive Behaviors in Parkinson's disease

BACKGROUND

Depression and impulse control disorders (ICDs) are both common in Parkinson's disease (PD) patients and their coexistence is frequent. Our aim was to determine the relationship between depression and impulsive-compulsive behaviors (ICBs) in a large cohort of PD patients.

METHODS

PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017 were included in the study. The QUIP-RS (Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale) was used for screening ICDs (cutoff points: gambling ≥6, buying ≥8, sex≥8, eating≥7) and compulsive behaviors (CBs) (cutoff points: hobbyism-punding ≥7). Mood was assessed with the BDI-II (Beck Depression Inventory - II) and major, minor, and subthreshold depression were defined.

RESULTS

Depression was more frequent in PD patients with ICBs than in those without: 66.3% (69/104) vs 47.5% (242/509); p<0.0001. Major depression was more frequent in this group as well: 22.1% [23/104] vs 14.5% [74/509]; p=0.041. Considering types of ICBs individually, depression was more frequent in patients with pathological gambling (88.9% [8/9] vs 50.2% [303/603]; p=0.021), compulsive eating behavior (65.9% [27/41] vs 49.7% [284/572]; p=0.032), and hobbyism-punding (69% [29/42] vs 49.4% [282/571]; p=0.010) than in those without, respectively. The presence of ICBs was also associated with depression (OR=1.831; 95%CI 1.048-3.201; p=0.034) after adjusting for age, sex, civil status, disease duration, equivalent daily levodopa dose, antidepressant treatment, Hoehn&Yahr stage, non-motor symptoms burden, autonomy for activities of daily living, and global perception of QoL.

LIMITATIONS

Cross-sectional design.

CONCLUSIONS

Depression is associated with ICBs in PD. Specifically, with pathological gambling, compulsive eating behavior, and hobbyism-punding.

High ultrasensitive serum C-reactive protein may be related to freezing of gait in Parkinson's disease patients

C-reactive protein (CRP) is a biomarker of systemic inflammation that has been linked to accelerated decline in walking speed in older adults. The aim of the present study was to compare the CRP levels of PD patients with vs patients without freezing of gait (FOG). Patients and controls participating in the COPPADIS-2015 study that performed blood extraction for determining molecular serum biomarkers were included. Patients with FOG were identified as those with a score of 1 or greater on item-3 of the Freezing of Gait Questionnaire (FOG-Q). Immunoassay was used for determining ultrasensitive CRP (US-CRP) level (mg/dL). In the PD group (n = 225; 61.8 ± 9.5 years old, 61.8% males), 32% of the patients presented FOG but none in the control group (n = 65; 60.3 ± 6.1 years old, 56.9% males) (p < 0.0001). Differences in US-CRP level were significant in patients with FOG vs patients without FOG and vs controls (0.31 ± 0.52 vs 0.16 ± 0.21 vs 0.21 ± 0.22; p = 0.04). Significant differences were also observed between patients with vs without FOG (p = 0.001) but not between patients and controls (p = 0.163). US-CRP level was related to FOG (OR = 4.369; 95% CI 1.105-17.275; p = 0.036) along with H&Y (OR = 2.974; 95% CI 1.113-7.943; p = 0.030) and non-motor symptoms burden (NMSS total score; OR = 1.017; 95% CI 1.005-1.029; p = 0.006) after adjusting for age, gender, disease duration, equivalent daily levodopa dose, number of non-antiparkinsonian drugs per day, motor fluctuations, cognition, motor phenotype, and chronic use of anti-inflammatory drugs. The present study suggests that serum US-CRP level is related to FOG in PD patients. Inflammation could be linked to FOG development.

Non-motor symptoms burden, mood, and gait problems are the most significant factors contributing to a poor quality of life in non-demented Parkinson's disease patients: Results from the COPPADIS Study Cohort

OBJECTIVE

To identify factors related to a poor health-related and global quality of life (QoL) in a cohort of non-demented Parkinson's disease (PD) patients and compare to a control group.

METHODS

The data correspond to the baseline evaluation of the COPPADIS-2015 Study, an observational, 5-year follow-up, multicenter, evaluation study. Three instruments were used to assess QoL: (1) the 39-item Parkinson's disease Questionnaire (PDQ-39), (2) a subjective rating of global QoL (PQ-10), and (3) the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Multiple linear regression methods were used to evaluate the direct impact of different variables on these QoL measures.

RESULTS

QoL was worse in PD patients (n = 692; 62.6 ± 8.9 years old, 60.3% males) than controls (n = 206; 61 ± 8.3 years old, 49.5% males): PDQ-39, 17.1 ± 13.5 vs 4.4 ± 6.3 (p < 0.0001); PQ-10, 7.3 ± 1.6 vs 8.1 ± 1.2 (p < 0.0001); EUROHIS-QOL8, 3.8 ± 0.6 vs 4.2 ± 0.5 (p < 0.0001). A high correlation was observed between PDQ-39 and Non-Motor Symptoms Scale (NMSS) (r = 0.72; p < 0.0001), and PDQ-39 and Beck Depression Inventory-II (BDI-II) (r = 0.65; p < 0.0001). For health-related QoL (PDQ-39), non-motor symptoms burden (NMSS), mood (BDI-II), and gait problems (Freezing Of Gait Questionnaire [FOGQ]) provided the highest contribution to the model (β = 0.32, 0.28, and 0.27, respectively; p < 0.0001); whereas mood and gait problems contributed the most to global QoL (PQ-10, β = -0.46 and -0.21, respectively; EUROHIS-QOL8, β = -0.44 and -0.23, respectively).

CONCLUSIONS

QoL is worse in PD patients than in controls. Mood, non-motor symptoms burden, and gait problems seem to be the most relevant factors affecting health-related and global perceived QoL in non-demented PD patients.

Evaluation of 'nuez de barinas' (caryodendron orinocense) oil for possible use in cosmetic

Caryodendron orinocense, Karst., is a tree that grows along the eastern base of the Andes mountains in Venezuela, Ecuador, and Colombia. It is known in Venezuela as 'Nuez de Barinas, nuez or nogal de Barquisimeto' and in other countries as 'inchi', 'taque', 'abay' or 'palo de nuez'. The oil extracted from the 'nuts' (seeds) is edible. The objective of this study was to assess the potential use of the oil extracted from the seeds in cosmetics. The organoleptic characteristics, some physical (viscosity, specific density, extensibility, UV absorbance), and chemical (fatty acid profile, titratable acidity, saponification index, unsaponifiable matter and peroxide value) characteristics, were determined by official methods. The results show a high polyunsaturated fatty acid content (75.13%) and good physical, chemical and toxicological characteristics appropriate for use in cosmetics. It was concluded that the Caryodendron oil should be useful in cosmetic formulations.

'Guapo' (Myrosma cannifolia) starch: a natural product with potential use in cosmetic formulations

The objective of the present work was to evaluate the possible use of Myrosma cannifolia starch L.F. Maranthaceae ('Guapo'), as a raw material in heterogeneous systems or powdered cosmetic and pharmaceutical products formulation. The starch chemical and physical characteristics, physico-chemical properties, and rheological behaviour, previously studied, were considered. Flowing characteristics, particle size distribution, water absorption capacity at 25 degrees C (ambient temperature), and toxicity were assessed. Results showed that Myrosma starch complies with the USP and British pharmacopoeia, and presented a normal particle distribution. More than 25% of the granules had a diameter >23.81 mum and the average size of particles was >16.92 mum. When compared with talc, 'guapo' starch presented higher values for water absorption capacity and flowing characteristics. Starch showed negative local toxicity, and low acute toxicity in vitro on two human dermis cell types. The amylographic study and the difractograms suggest the possible use of this starch in heterogeneous systems. A facial transparent powder was formulated and some of its properties were determined by sensorial analysis. It was concluded that the M. cannifolia starch presents certain characteristics useful in the formulation of new powdered products.

[Polyphenol content and antioxidant activity of several seeds and nuts]

Foods from plant origin not only provide human diet with certain antioxidant vitamins (C, E and beta-carotene), but also a complex mixture of polyphenols, with antioxidant activity. Numerous studies have been focused on the protective and preventing effect of this antioxidant activity on certain degenerative illnesses such as cardiovascular, cancer, and neurological diseases, cataracts and oxidative stress dysfunctions. The objective of this work was to evaluate total polyphenol content and antioxidant activity of several seeds, nuts, or grains such as Theobroma cacao, Canpsiandra comosa Benth (chiga), Sorghum bicolor, L. Moench, Melicoccus bijugatus (genip). Total polyphenol content was assessed by the Folin-Ciocalteau method and the antioxidant activity by the beta carotene/linoleate, reducing power, and the anti-radical activity methods. Results showed genip pericarp with the lowest polyphenol content (1.40 gGAE/100 g), and cacao beans with the highest (6.66 gGAE/100 g). Reducing power of cacao beans was also the highest and similar to the reducing power of 5.80 g ascorbic acid/100 g, followed by Campsiandra comosa. Moreover, Campsiandra comosa and cacao seeds presented an antioxidant activity comparable to that of the butylhydroxianisol, a synthetic antioxidant. The highest anti-radical activity was shown by Campsiandra comosa with an EC50 of 2.67 g/gDPPH. Total polyphenol content shows a good correlation with the antioxidant activity. Moreover, these seeds might have the same health beneficial effects attributed to other fruits and vegetables.

Caryodendron orinocense ('nuez de Barinas') oil: tocopherol content and use in cosmetics

Preliminary studies showed the possibility of using the oil extracted from the 'nuez de Barinas' (Caryodendron orinocense Karst.) (also known as 'taque nut'), in cosmetic formulation, due to its UV absorbance spectrum as well as other physical, chemical and toxicological characteristics. Some Amerindians have used this oil as unction. The tree, also called in Venezuela 'nueza' or 'nogal de Barquisimeto', and in other countries 'Inchi' or 'taque', belongs to the Euphorbiaceae, and grows wild along the base of the Andes mountains in Venezuela, Ecuador, Peru and Colombia. The oil presented a high polyunsaturated fatty acid content, especially linoleic acid (75.13%), which makes it susceptible to oxidation. alpha, beta, gamma and delta-tocopherols are chemical compounds that have antioxidant and vitamin E activity. Tocopherols are used in cosmetics owing to these two characteristics. These properties vary depending on the isomer, the alpha-tocopherol having higher vitamin activity, while the delta-tocopherol has the highest antioxidant power, acting as free radical scavenger. The objective of this study was to assess the presence of tocopherols in the oil, as well as the emollient efficiency and activity of the oil after incorporation as a base in formulation of cosmetic products. Results showed good emollient efficiency and activity, and the presence of alpha, beta, gamma and delta-tocopherols, which means that the oil will be stable in cosmetic formulations.

Characterization of cocoa butter extracted from hybrid cultivars of Theobroma cacao L

Cocoa butter is the most important fat used in the confectionery and chocolate industries. The main objective of the present study was to determine the physical and chemical characteristics of cocoa butter extracted from hybrid cultivars belonging to the germplasm bank of the Fondo Nacional de Investigaciones Agropecuarias (National Foundation for Agricultural Research). AOAC methods were used for the assessment of the proximal composition of the beans, physical and chemical characteristics as well as for the fatty acid profile of the fat. It was found that there were statistical differences in the proximate composition of the cocoa beans among the cultivars studied as well as the iodine and saponification indices of the butter. Saturated fatty acids were present in higher proportions than unsaturated fatty acids, with palmitic and stearic acid as the main fractions. Oleic acid content was higher than linoleic acid. The fatty acid profile found is the main factor that influences the hard texture of the cocoa butter from Venezuelan cocoa hybrids cultivars.

[Paroxysmal dystonia as the first manifestation of multiple sclerosis]

We discuss the case of a patient with episodes of left unilateral paroxysmal dystonia as first manifestation of multiple sclerosis, secondary to a demyelinization lesion in posterior arm of right internal capsule, detected by nuclear magnetic resonance (NMR). These episodes diminished with carbamazepine at low doses.