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Painous C, Pascual-Diaz S, Muñoz-Moreno E, Sánchez V, Pariente JC, Prats-Galino A, Soto M, Fernández M, Pérez-Soriano A, Camara A, Muñoz E, Valldeoriola F, Caballol N, Pont-Sunyer C, Martin N, Basora M, Tio M, Rios J, Martí MJ, Bargalló N, Compta Y. Midbrain and pons MRI shape analysis and its clinical and CSF correlates in degenerative parkinsonisms: a pilot study. Eur Radiol 2023; 33:4540-4551. [PMID: 36773046 PMCID: PMC10290009 DOI: 10.1007/s00330-023-09435-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 10/19/2022] [Revised: 10/19/2022] [Accepted: 01/08/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVES To conduct brainstem MRI shape analysis across neurodegenerative parkinsonisms and control subjects (CS), along with its association with clinical and cerebrospinal fluid (CSF) correlates. METHODOLOGY We collected demographic and clinical variables, performed planimetric and shape MRI analyses, and determined CSF neurofilament-light chain (NfL) levels in 84 participants: 11 CS, 12 with Parkinson's disease (PD), 26 with multiple system atrophy (MSA), 21 with progressive supranuclear palsy (PSP), and 14 with corticobasal degeneration (CBD). RESULTS MSA featured the most extensive and significant brainstem shape narrowing (that is, atrophy), mostly in the pons. CBD presented local atrophy in several small areas in the pons and midbrain compared to PD and CS. PSP presented local atrophy in small areas in the posterior and upper midbrain as well as the rostral pons compared to MSA. Our findings of planimetric MRI measurements and CSF NfL levels replicated those from previous literature. Brainstem shape atrophy correlated with worse motor state in all parkinsonisms and with higher NfL levels in MSA, PSP, and PD. CONCLUSION Atypical parkinsonisms present different brainstem shape patterns which correlate with clinical severity and neuronal degeneration. In MSA, shape analysis could be further explored as a potential diagnostic biomarker. By contrast, shape analysis appears to have a rather limited discriminant value in PSP. KEY POINTS • Atypical parkinsonisms present different brainstem shape patterns. • Shape patterns correlate with clinical severity and neuronal degeneration. • In MSA, shape analysis could be further explored as a potential diagnostic biomarker.
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Affiliation(s)
- C Painous
- Parkinson's Disease & Movement Disorders Unit, Parkinson's Disease and Other Degenerative Movement Disorders Team, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, CIBERNED (CB06/05/0018-ISCIII), ERN-RND, Institut Clínic de Neurociències (UBNeuro), Department of Medicine, School of Medicine, Universitat de Barcelona, Catalonia, Barcelona, Spain
- Lab of Parkinson Disease and Other Neurodegenerative Movement Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Institut de Neurociències, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Universitat de Barcelona, Catalonia, Barcelona, Spain
| | - S Pascual-Diaz
- Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Laboratory of Surgical Neuroanatomy (LSNA), Universitat de Barcelona, Barcelona, Spain
| | - E Muñoz-Moreno
- Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - V Sánchez
- Centre de Diagnostic Per La Imatge (CDIC), Hospital Clinic, Barcelona, Spain
| | - J C Pariente
- Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - A Prats-Galino
- Centre de Diagnostic Per La Imatge (CDIC), Hospital Clinic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - M Soto
- Lab of Parkinson Disease and Other Neurodegenerative Movement Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Institut de Neurociències, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Universitat de Barcelona, Catalonia, Barcelona, Spain
| | - M Fernández
- Lab of Parkinson Disease and Other Neurodegenerative Movement Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Institut de Neurociències, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Universitat de Barcelona, Catalonia, Barcelona, Spain
| | - A Pérez-Soriano
- Parkinson's Disease & Movement Disorders Unit, Parkinson's Disease and Other Degenerative Movement Disorders Team, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, CIBERNED (CB06/05/0018-ISCIII), ERN-RND, Institut Clínic de Neurociències (UBNeuro), Department of Medicine, School of Medicine, Universitat de Barcelona, Catalonia, Barcelona, Spain
- Lab of Parkinson Disease and Other Neurodegenerative Movement Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Institut de Neurociències, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Universitat de Barcelona, Catalonia, Barcelona, Spain
| | - A Camara
- Parkinson's Disease & Movement Disorders Unit, Parkinson's Disease and Other Degenerative Movement Disorders Team, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, CIBERNED (CB06/05/0018-ISCIII), ERN-RND, Institut Clínic de Neurociències (UBNeuro), Department of Medicine, School of Medicine, Universitat de Barcelona, Catalonia, Barcelona, Spain
- Lab of Parkinson Disease and Other Neurodegenerative Movement Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Institut de Neurociències, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Universitat de Barcelona, Catalonia, Barcelona, Spain
| | - E Muñoz
- Parkinson's Disease & Movement Disorders Unit, Parkinson's Disease and Other Degenerative Movement Disorders Team, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, CIBERNED (CB06/05/0018-ISCIII), ERN-RND, Institut Clínic de Neurociències (UBNeuro), Department of Medicine, School of Medicine, Universitat de Barcelona, Catalonia, Barcelona, Spain
- Lab of Parkinson Disease and Other Neurodegenerative Movement Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Institut de Neurociències, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Universitat de Barcelona, Catalonia, Barcelona, Spain
| | - F Valldeoriola
- Parkinson's Disease & Movement Disorders Unit, Parkinson's Disease and Other Degenerative Movement Disorders Team, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, CIBERNED (CB06/05/0018-ISCIII), ERN-RND, Institut Clínic de Neurociències (UBNeuro), Department of Medicine, School of Medicine, Universitat de Barcelona, Catalonia, Barcelona, Spain
- Lab of Parkinson Disease and Other Neurodegenerative Movement Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Institut de Neurociències, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Universitat de Barcelona, Catalonia, Barcelona, Spain
| | - N Caballol
- UParkinson Centro Médico Teknon, Grupo Hospitalario Quirón Salud, Barcelona, Spain
- Department of Neurology, Hospital Sant Joan Despí Moisès Broggi and Hospital General de L'Hospitalet, Consorci Sanitari Integral, Barcelona, Spain
| | - C Pont-Sunyer
- Neurology Unit, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain
| | - N Martin
- Department of Anaesthesiology, Hospital Clinic, Barcelona, Spain
| | - M Basora
- Department of Anaesthesiology, Hospital Clinic, Barcelona, Spain
| | - M Tio
- Department of Anaesthesiology, Hospital Clinic, Barcelona, Spain
| | - J Rios
- Medical Statistics Core Facility, IDIBAPS & Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - M J Martí
- Parkinson's Disease & Movement Disorders Unit, Parkinson's Disease and Other Degenerative Movement Disorders Team, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, CIBERNED (CB06/05/0018-ISCIII), ERN-RND, Institut Clínic de Neurociències (UBNeuro), Department of Medicine, School of Medicine, Universitat de Barcelona, Catalonia, Barcelona, Spain
- Lab of Parkinson Disease and Other Neurodegenerative Movement Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Institut de Neurociències, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Universitat de Barcelona, Catalonia, Barcelona, Spain
| | - N Bargalló
- Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
- Laboratory of Surgical Neuroanatomy (LSNA), Universitat de Barcelona, Barcelona, Spain.
- Neuroradiology Service, Hospital Clínic de Barcelona, 170 Villarroel Street, 08036, Barcelona, Spain.
| | - Y Compta
- Parkinson's Disease & Movement Disorders Unit, Parkinson's Disease and Other Degenerative Movement Disorders Team, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, CIBERNED (CB06/05/0018-ISCIII), ERN-RND, Institut Clínic de Neurociències (UBNeuro), Department of Medicine, School of Medicine, Universitat de Barcelona, Catalonia, Barcelona, Spain.
- Lab of Parkinson Disease and Other Neurodegenerative Movement Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Institut de Neurociències, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Universitat de Barcelona, Catalonia, Barcelona, Spain.
- Neuroradiology Service, Hospital Clínic de Barcelona, 170 Villarroel Street, 08036, Barcelona, Spain.
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2
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Planellas L, Mayà G, Painous C, Santacruz P, Santamaria J, Martí MJ. Characterization of sleep in six patients with pantothenate kinase-associated neurodegeneration. Sleep Med 2021; 84:389-396. [PMID: 34252845 DOI: 10.1016/j.sleep.2021.06.019] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/08/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pantothenate kinase-associated neurodegeneration (PKAN) is a rare neurologic disorder included in the group of neurodegeneration with brain iron accumulation diseases (NBIA). Information regarding sleep in patients with PKAN is limited. OBJECTIVES To describe the clinical and polysomnographic characteristics of sleep in six patients with genetically confirmed PKAN. METHODS The evaluation included a clinical interview, sleep questionnaires -Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS)- and a video-polysomnography (VPSG). In addition to standard sleep measures we manually quantified sleep spindle density in stage N2 and rapid eye movements in REM sleep comparing the results with matched controls. Quantification of EMG activity in REM sleep was performed following standard criteria. RESULTS All the patients reported at least one sleep complaint, most commonly sleep fragmentation (4/6) and sleep onset insomnia (3/6). ESS and PSQI were abnormal in 3/6 and 4/6, respectively. VPSG showed in 4/6 decreased ocular movements during REM sleep, an increase in sleep spindles in 3/6 (all of them with deep brain pallidal stimulation), an absence of slow wave sleep in 2 and undifferentiated NREM sleep and delayed sleep phase in one. Three patients had an abnormal sleep apnea/hypopnea index, and 2 periodic limb movements of sleep. REM sleep muscular atonia was preserved in all. CONCLUSIONS Sleep disorders are common in patients with PKAN. Although our sample is small and heterogeneous, with different symptomatic treatments possibly influencing the results, it suggests that evaluation of sleep should be considered in their management.
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Affiliation(s)
- Lluís Planellas
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.
| | - Gerard Mayà
- Sleep Unit, Neurology Department, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.
| | - Cèlia Painous
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.
| | - Pilar Santacruz
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.
| | - Joan Santamaria
- Sleep Unit, Neurology Department, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain; Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Catalonia, Spain.
| | - M J Martí
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain; Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Catalonia, Spain; European Reference Network for Rare Neurological Diseases - Project ID No 739510, Spain.
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3
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Pérez-Soriano A, Arnal Segura M, Botta-Orfila T, Giraldo D, Fernández M, Compta Y, Fernández-Santiago R, Ezquerra M, Tartaglia GG, Martí MJ. Transcriptomic differences in MSA clinical variants. Sci Rep 2020; 10:10310. [PMID: 32587362 PMCID: PMC7316739 DOI: 10.1038/s41598-020-66221-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/15/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Multiple system atrophy (MSA) is a rare oligodendroglial synucleinopathy of unknown etiopathogenesis including two major clinical variants with predominant parkinsonism (MSA-P) or cerebellar dysfunction (MSA-C). Objective: To identify novel disease mechanisms we performed a blood transcriptomic study investigating differential gene expression changes and biological process alterations in MSA and its clinical subtypes. Methods: We compared the transcriptome from rigorously gender and age-balanced groups of 10 probable MSA-P, 10 probable MSA-C cases, 10 controls from the Catalan MSA Registry (CMSAR), and 10 Parkinson Disease (PD) patients. Results: Gene set enrichment analyses showed prominent positive enrichment in processes related to immunity and inflammation in all groups, and a negative enrichment in cell differentiation and development of the nervous system in both MSA-P and PD, in contrast to protein translation and processing in MSA-C. Gene set enrichment analysis using expression patterns in different brain regions as a reference also showed distinct results between the different synucleinopathies. Conclusions: In line with the two major phenotypes described in the clinic, our data suggest that gene expression and biological processes might be differentially affected in MSA-P and MSA-C. Future studies using larger sample sizes are warranted to confirm these results.
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Affiliation(s)
- Alexandra Pérez-Soriano
- Parkinson's Disease & Movement Disorders Unit, Hospital Clínic/IDIBAPS/CIBERNED/European Reference Network for Rare Neurological Diseases (ERN-RND)/Institut de Neurociències, University of Barcelona, Catalonia, Spain.,Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders, IDIBAPS, Barcelona, Catalonia, Spain.,Gene Function and Evolution Group, Centre for Genomic Regulation (CRG), Parc de Recerca Biomédica de Barcelona (PRBB), Barcelona, Catalonia, Spain
| | - Magdalena Arnal Segura
- Gene Function and Evolution Group, Centre for Genomic Regulation (CRG), Parc de Recerca Biomédica de Barcelona (PRBB), Barcelona, Catalonia, Spain.,Human Computational Biology Group, Hospital del Mar Medical Research Institute (IMIM), Parc de Recerca Biomédica de Barcelona (PRBB), Barcelona, Catalonia, Spain
| | - Teresa Botta-Orfila
- Gene Function and Evolution Group, Centre for Genomic Regulation (CRG), Parc de Recerca Biomédica de Barcelona (PRBB), Barcelona, Catalonia, Spain.,Biological Fluids Biobank; IDIBAPS-Hospital Clinic of Barcelona, Barcelona, Catalonia, Spain
| | - Darly Giraldo
- Parkinson's Disease & Movement Disorders Unit, Hospital Clínic/IDIBAPS/CIBERNED/European Reference Network for Rare Neurological Diseases (ERN-RND)/Institut de Neurociències, University of Barcelona, Catalonia, Spain
| | - Manel Fernández
- Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders, IDIBAPS, Barcelona, Catalonia, Spain.,María de Maeztu Unit of Excellence (Institute of Neurosciences, University of Barcelona), Ministry of Science, Innovation and Universities, Barcelona, Catalonia, Spain
| | - Yaroslau Compta
- Parkinson's Disease & Movement Disorders Unit, Hospital Clínic/IDIBAPS/CIBERNED/European Reference Network for Rare Neurological Diseases (ERN-RND)/Institut de Neurociències, University of Barcelona, Catalonia, Spain
| | - Rubén Fernández-Santiago
- Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders, IDIBAPS, Barcelona, Catalonia, Spain
| | - Mario Ezquerra
- Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders, IDIBAPS, Barcelona, Catalonia, Spain
| | - Gian G Tartaglia
- Gene Function and Evolution Group, Centre for Genomic Regulation (CRG), Parc de Recerca Biomédica de Barcelona (PRBB), Barcelona, Catalonia, Spain.,María de Maeztu Unit of Excellence (Institute of Neurosciences, University of Barcelona), Ministry of Science, Innovation and Universities, Barcelona, Catalonia, Spain.,Institució Catalana de Recerca I Estudis Avançats (ICREA), Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - M J Martí
- Parkinson's Disease & Movement Disorders Unit, Hospital Clínic/IDIBAPS/CIBERNED/European Reference Network for Rare Neurological Diseases (ERN-RND)/Institut de Neurociències, University of Barcelona, Catalonia, Spain.
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4
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Santos-García D, de Deus Fonticoba T, Suárez Castro E, Aneiros Díaz A, McAfee D, Catalán MJ, Alonso-Frech F, Villanueva C, Jesús S, Mir P, Aguilar M, Pastor P, García Caldentey J, Esltelrich Peyret E, Planellas LL, Martí MJ, Caballol N, Hernández Vara J, Martí Andrés G, Cabo I, Ávila Rivera MA, López Manzanares L, Redondo N, Martinez-Martin P, McAfee D. Non-motor symptom burden is strongly correlated to motor complications in patients with Parkinson's disease. Eur J Neurol 2020; 27:1210-1223. [PMID: 32181979 DOI: 10.1111/ene.14221] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 03/05/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE The objective of this study was to analyze the relationship between motor complications and non-motor symptom (NMS) burden in a population of patients with Parkinson's disease (PD) and also in a subgroup of patients with early PD. METHODS Patients with PD from the COPPADIS cohort were included in this cross-sectional study. NMS burden was defined according to the Non-Motor Symptoms Scale (NMSS) total score. Unified Parkinson's Disease Rating Scale (UPDRS) part IV was used to establish motor complication types and their severity. Patients with ≤5 years of symptoms from onset were included as patients with early PD. RESULTS Of 690 patients with PD (62.6 ± 8.9 years old, 60.1% males), 33.9% and 18.1% presented motor fluctuations and dyskinesia, respectively. The NMS total score was higher in patients with motor fluctuations (59.2 ± 43.1 vs. 38.3 ± 33.1; P < 0.0001) and dyskinesia (63.5 ± 40.7 vs. 41.4 ± 36.3; P < 0.0001). In a multiple linear regression model and after adjustment for age, sex, disease duration, Hoehn & Yahr stage, UPDRS-III score and levodopa equivalent daily dose, UPDRS-IV score was significantly related to a higher NMSS total score (β = 0.27; 95% confidence intervals, 2.81-5.61; P < 0.0001), as it was in a logistic regression model on dichotomous NMSS total score (≤40, mild or moderate vs. >40, severe or very severe) (odds ratio, 1.31; 95% confidence intervals, 1.17-1.47; P < 0.0001). In the subgroup of patients with early PD (n = 396; mean disease duration 2.7 ± 1.5 years), motor fluctuations were frequent (18.1%) and similar results were obtained. CONCLUSIONS Motor complications were frequent and were associated with a greater NMS burden in patients with PD even during the first 5 years of disease duration.
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Affiliation(s)
- D Santos-García
- Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain
| | - T de Deus Fonticoba
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - E Suárez Castro
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - A Aneiros Díaz
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - D McAfee
- University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | - S Jesús
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Universidad de Sevilla/CSIC, Sevilla, Spain
| | - P Mir
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Universidad de Sevilla/CSIC, Sevilla, Spain
| | - M Aguilar
- Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | - P Pastor
- Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | | | | | - L L Planellas
- Hospital Clínic de Barcelona, Fundació Clínic, IDIBAPS, CIBERNED, Barcelona, Spain
| | - M J Martí
- Hospital Clínic de Barcelona, Fundació Clínic, IDIBAPS, CIBERNED, Barcelona, Spain
| | - N Caballol
- Hospital de Sant Joan Despí Moisés Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
| | | | | | - I Cabo
- Hospital de Pontevedra, Pontevedra, Spain
| | - M A Ávila Rivera
- Hospital General de l'Hospitalet, Consorci Sanitari Integral, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - N Redondo
- Hospital Universitario de la Princesa, Madrid, Spain
| | - P Martinez-Martin
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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5
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Santos García D, Jesús S, Aguilar M, Planellas LL, García Caldentey J, Caballol N, Legarda I, Hernández Vara J, Cabo I, López Manzanares L, González Aramburu I, Ávila Rivera MA, Catalán MJ, López Díaz L, Puente V, García Moreno JM, Borrué C, Solano Vila B, Álvarez Sauco M, Vela L, Escalante S, Cubo E, Carrillo Padilla F, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Kulisevsky J, Menéndez González M, Seijo M, Rúiz Martínez J, Valero C, Kurtis M, Fábregues‐Boixar O, González Ardura J, Prieto Jurczynska C, Martinez‐Martin P, Mir P, Adarmes Astrid D, Almeria M, Alonso Cánovas A, Alonso Frech F, Aneiros Díaz A, Arnáiz S, Arribas S, Ascunce Vidondo A, Bernardo Lambrich N, Bejr‐Kasem H, Blázquez Estrada M, Botí M, Cabello González C, Cámara Lorenzo A, Carrillo F, Casas E, Clavero P, Cortina Fernández A, Cots Foraster A, Crespo Cuevas A, de Deus Fonticoba T, Díez‐Fairen M, Erro E, Estelrich Peyret E, Fernández Guillán N, Gámez P, Gallego M, García Campos C, Gómez Garre MP, González Aloy J, González García B, González Palmás MJ, González Toledo GR, Golpe Díaz A, Grau Solá M, Guardia G, Horta‐Barba A, Infante J, Labandeira C, Labrador MA, Lacruz F, Lage Castro M, López Seoane B, Macías Y, Mata M, Martí Andres G, Martí MJ, McAfee D, Meitín MT, Méndez del Barrio C, Miranda Santiago J, Morales Casado MI, Moreno Diéguez A, Nogueira V, Novo Amado A, Novo Ponte S, Ordás C, Pagonabarraga J, Pareés I, Pascual‐Sedano B, Pastor P, Pérez Fuertes A, Pérez Noguera R, Prats MA, Pueyo Morlans M, Redondo Rafales N, Rodríguez Méndez L, Rodríguez Pérez AB, Roldán F, Ruíz De Arcos M, Sánchez‐Carpintero M, Sánchez Díez G, Sánchez Rodríguez A, Santacruz P, Segundo Rodríguez JC, Serarols A, Sierra Peña M, Suárez Castro E, Tartari JP, Vargas L, Vázquez Gómez R, Villanueva C, Vives B, Villar MD. COPPADIS
‐2015 (
CO
hort of Patients with PArkinson's
DI
sease in Spain, 2015): an ongoing global Parkinson's disease project about disease progression with more than 1000 subjects included. Results from the baseline evaluation. Eur J Neurol 2019; 26:1399-1407. [DOI: 10.1111/ene.14008] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/23/2019] [Indexed: 01/03/2023]
Affiliation(s)
- D. Santos García
- CHUAC, Complejo Hospitalario Universitario de A Coruña A CoruñaSpain
| | - S. Jesús
- Hospital Universitario Virgen del Rocío SevillaSpain
| | - M. Aguilar
- Hospital Universitari Mutua de Terrassa Terrassa Barcelona Spain
| | | | | | - N. Caballol
- Consorci Sanitari Integral Hospital Moisés Broggi Sant Joan Despí Barcelona Spain
| | - I. Legarda
- Hospital Universitario Son Espases Palma de MallorcaSpain
| | | | - I. Cabo
- Complejo Hospitalario Universitario de Pontevedra (CHOP) PontevedraSpain
| | | | | | - M. A. Ávila Rivera
- Consorci Sanitari Integral Hospital General de L'Hospitalet, L'Hospitalet de Llobregat Barcelona Spain
| | - M. J. Catalán
- Hospital Universitario Clínico San Carlos Madrid Spain
| | - L. López Díaz
- Complejo Hospitalario Universitario de Orense (CHUO) Orense Spain
| | | | | | | | - B. Solano Vila
- Institut d'Assistència Sanitària (IAS) – Institut Català de la Salut Girona Spain
| | | | - L. Vela
- Fundación Hospital de Alcorcón MadridSpain
| | - S. Escalante
- Hospital de Tortosa Verge de la Cinta (HTVC) Tortosa Tarragona Spain
| | - E. Cubo
- Complejo Asistencial Universitario de Burgos Burgos Spain
| | - F. Carrillo Padilla
- Hospital Universitario de Canarias San Cristóbal de la LagunaSanta Cruz de Tenerife Spain
| | | | | | - M. G. Alonso Losada
- Hospital Álvaro Cunqueiro Complejo Hospitalario Universitario de Vigo (CHUVI) Vigo Spain
| | | | - I. Gastón
- Complejo Hospitalario de Navarra Pamplona Spain
| | | | | | - M. Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP) PontevedraSpain
| | | | - C. Valero
- Hospital Arnau de Vilanova Valencia Spain
| | - M. Kurtis
- Hospital Ruber Internacional Madrid Spain
| | | | | | | | - P. Martinez‐Martin
- Centro Nacional de Epidemiología y CIBERNED Instituto de Salud Carlos III Madrid Spain
| | - P. Mir
- Hospital Universitario Virgen del Rocío SevillaSpain
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Compta Y, Ramos-Campoy O, Grau-Rivera O, Colom-Cadena M, Clarimón J, Martí MJ, Gelpi E. Conjoint FTLD-FUS of the neuronal intermediate filament inclusion disease type, progressive supranuclear palsy and Alzheimer's pathology presenting as parkinsonism with early falls and late hallucinations, psychosis and dementia. Neuropathol Appl Neurobiol 2017; 43:352-357. [DOI: 10.1111/nan.12340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 08/01/2016] [Accepted: 08/04/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Y. Compta
- Parkinson's Disease & Movement Disorders Unit; Neurology Service; ICN; Hospital Clínic; University of Barcelona; IDIBAPS; Barcelona Catalonia Spain
| | - O. Ramos-Campoy
- Parkinson's Disease & Movement Disorders Unit; Neurology Service; ICN; Hospital Clínic; University of Barcelona; IDIBAPS; Barcelona Catalonia Spain
- Neurological Tissue Bank; Biobanc Hospital Clínic-IDIBAPS; Barcelona Catalonia Spain
| | - O. Grau-Rivera
- Neurological Tissue Bank; Biobanc Hospital Clínic-IDIBAPS; Barcelona Catalonia Spain
| | - M. Colom-Cadena
- Neurology Department; Institut d'Investigacions Biomèdiques Sant Pau; Hospital de Sant Pau; Universitat Autònoma de Barcelona; Barcelona Catalonia Spain
| | - J. Clarimón
- Neurology Department; Institut d'Investigacions Biomèdiques Sant Pau; Hospital de Sant Pau; Universitat Autònoma de Barcelona; Barcelona Catalonia Spain
| | - M. J. Martí
- Parkinson's Disease & Movement Disorders Unit; Neurology Service; ICN; Hospital Clínic; University of Barcelona; IDIBAPS; Barcelona Catalonia Spain
| | - E. Gelpi
- Neurological Tissue Bank; Biobanc Hospital Clínic-IDIBAPS; Barcelona Catalonia Spain
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Iranzo A, Stefani A, Serradell M, Martí MJ, Lomeña F, Mahlknecht P, Stockner H, Gaig C, Fernández-Arcos A, Poewe W, Tolosa E, Högl B, Santamaria J. 0728 CHARACTERIZATION OF PATIENTS WITH LONG-TERM IDIOPATHIC REM SLEEP BEHAVIOR DISORDER. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sierra M, Gelpi E, Martí MJ, Compta Y. Lewy- and Alzheimer-type pathologies in midbrain and cerebellum across the Lewy body disorders spectrum. Neuropathol Appl Neurobiol 2016; 42:451-62. [DOI: 10.1111/nan.12308] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/08/2016] [Accepted: 01/26/2016] [Indexed: 11/29/2022]
Affiliation(s)
- M. Sierra
- Parkinson's disease and Movement Disorders Unit; Neurology Service; IDIBAPS; CIBERNED; Hospital Clínic; University of Barcelona; Barcelona, Catalonia Spain
- Service of Neurology; Hospital Universitario Marqués de Valdecilla (IFIMAV); University of Cantabria (UC); Santander, Cantabria Spain
| | - E. Gelpi
- Neurological Tissue Bank of the Biobanc-Hospital Clinic-IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer); Barcelona, Catalonia Spain
| | - M. J. Martí
- Parkinson's disease and Movement Disorders Unit; Neurology Service; IDIBAPS; CIBERNED; Hospital Clínic; University of Barcelona; Barcelona, Catalonia Spain
| | - Y. Compta
- Parkinson's disease and Movement Disorders Unit; Neurology Service; IDIBAPS; CIBERNED; Hospital Clínic; University of Barcelona; Barcelona, Catalonia Spain
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9
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Arbizu J, Luquin MR, Abella J, de la Fuente-Fernández R, Fernandez-Torrón R, García-Solís D, Garrastachu P, Jiménez-Hoyuela JM, Llaneza M, Lomeña F, Lorenzo-Bosquet C, Martí MJ, Martinez-Castrillo JC, Mir P, Mitjavila M, Ruiz-Martínez J, Vela L. [Functional neuroimaging in the diagnosis of patients with Parkinsonism: Update and recommendations for clinical use]. Rev Esp Med Nucl Imagen Mol 2014; 33:215-26. [PMID: 24731551 DOI: 10.1016/j.remn.2014.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 02/04/2014] [Accepted: 02/04/2014] [Indexed: 11/19/2022]
Abstract
Functional Neuroimaging has been traditionally used in research for patients with different Parkinsonian syndromes. However, the emergence of commercial radiotracers together with the availability of single photon emission computed tomography (SPECT) and, more recently, positron emission tomography (PET) have made them available for clinical practice. Particularly, the development of clinical evidence achieved by functional neuroimaging techniques over the past two decades have motivated a progressive inclusion of several biomarkers in the clinical diagnostic criteria for neurodegenerative diseases that occur with Parkinsonism. However, the wide range of radiotracers designed to assess the involvement of different pathways in the neurodegenerative process underlying Parkinsonian syndromes (dopaminergic nigrostriatal pathway integrity, basal ganglia and cortical neuronal activity, myocardial sympathetic innervation), and the different neuroimaging techniques currently available (scintigraphy, SPECT and PET), have generated some controversy concerning the best neuroimaging test that should be indicated for the differential diagnosis of Parkinsonism. In this article, a panel of nuclear medicine and neurology experts has evaluated the functional neuroimaging techniques emphazising practical considerations related to the diagnosis of patients with uncertain origin parkinsonism and the assessment Parkinson's disease progression.
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Affiliation(s)
- J Arbizu
- Grupo de Trabajo de Neuroimagen de la SEMNIM, Servicio de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, España.
| | - M R Luquin
- Grupo de Trastornos del Movimiento de la SEN, Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, España
| | - J Abella
- Servicio de Neurología, Hospital A, Marcide, Ferrol, España
| | | | - R Fernandez-Torrón
- Servicio de Neurología, Hospital Universitario Donostia, Área de Neurociencias, Instituto de Investigación Biodonostia, CIBERNED, San Sebastián, España
| | - D García-Solís
- Servicio de Medicina Nuclear, UDIM, Hospital Universitario Virgen del Rocío, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Sevilla, España
| | - P Garrastachu
- Servicio de Medicina Nuclear, Hospital San Pedro, CIBIR, Logroño, España
| | - J M Jiménez-Hoyuela
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M Llaneza
- Servicio de Neurología, Hospital A, Marcide, Ferrol, España
| | - F Lomeña
- Servicio de Medicina Nuclear, Hospital Clinic, Barcelona, España
| | - C Lorenzo-Bosquet
- Servicio de Medicina Nuclear, Hospital Vall d́Hebron, CETIR-ERESA, Unitat Teknon, Barcelona, España
| | - M J Martí
- Unidad de Parkinson y Trastornos del Movimiento, Servicio de Neurología, ICN, CIBERNET, Hospital Clinic, Barcelona, España
| | | | - P Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Sevilla, España
| | - M Mitjavila
- Servicio de Medicina Nuclear, Hospital Universitario Puerta de Hierro, Madrid, España
| | - J Ruiz-Martínez
- Unidad de Parkinson y otros Trastornos del Movimiento, Servicio de Neurología, Hospital Universitario Donostia, CIBERNED, Instituto de Salud Carlos III, San Sebastián (Guipúzcoa), España
| | - L Vela
- Servicio de Neurología, Hospital Universitario Fundación Alcorcón, Alcorcón, España
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Navarro-Otano J, Gaig C, Muxi A, Lomeña F, Compta Y, Buongiorno MT, Martí MJ, Tolosa E, Valldeoriola F. 123I-MIBG cardiac uptake, smell identification and 123I-FP-CIT SPECT in the differential diagnosis between vascular parkinsonism and Parkinson's disease. Parkinsonism Relat Disord 2013; 20:192-7. [PMID: 24252299 DOI: 10.1016/j.parkreldis.2013.10.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [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: 06/21/2013] [Revised: 10/10/2013] [Accepted: 10/25/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED Vascular parkinsonism (VP) may occur as a distinct clinicopathological entity but the comorbid presence of vascular damage in Parkinson's disease (PD) is very frequent too. This differential diagnosis has therapeutic and prognostic implications but remains challenging as the usefulness of a number of supporting tools is still controversial. OBJECTIVE To ascertain the clinical value of cardiac (123)I-meta-iodobenzylguanidine ((123)I-MIBG) SPECT, olfactory function and (123)I-FP-CIT SPECT as supporting tools in the differential diagnosis between VP and PD. METHODS Cross-sectional study of 15 consecutive patients with suspected VP, 15 PD patients and 9 healthy subjects. Cardiac (123)I-MIBG SPECT (heart-to-mediastinum ratio) and olfactory testing (University of Pennsylvania Smell Identification Test-UPSIT) were performed in all of them. (123)I-FP-CIT SPECT was performed in VP-suspected patients. RESULTS Heart-to-mediatinum ratio was significant lower in suspected VP (mean 1.45) and PD (mean 1.16) compared to control group (mean 1.69) (p = 0.017 and p < 0.0001). VP patients presented a higher ratio than PD patients (p = 0.001). Control group presented a significant higher UPSIT score (mean 30.71) when compared to both VP (mean 18.33) and PD (mean 15.29) (p = 0.001 for both groups). Those VP with a cardiac (123)I-MIBG non suggestive of PD were more likely to have a higher UPSIT score (p = 0.006). (123)I-FP-CIT SPECT imaging was heterogeneous (7/15 VP normal, 3/15 abnormal suggestive of PD and 5/15 abnormal but atypical for PD). CONCLUSIONS The use of cardiac (123)I-MIBG SPECT and to a lesser extent UPSIT could assist the differential diagnosis between VP and PD in subjects in which the diagnosis remains uncertain despite (123)I-FP-CIT SPECT imaging.
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Affiliation(s)
- J Navarro-Otano
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer-IDIBAPS, Barcelona, Spain
| | - C Gaig
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer-IDIBAPS, Barcelona, Spain
| | - A Muxi
- Nuclear Medicine Service Centre de Diagnòstic per la Imatge Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
| | - F Lomeña
- Nuclear Medicine Service Centre de Diagnòstic per la Imatge Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
| | - Y Compta
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer-IDIBAPS, Barcelona, Spain
| | - M T Buongiorno
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer-IDIBAPS, Barcelona, Spain
| | - M J Martí
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer-IDIBAPS, Barcelona, Spain
| | - E Tolosa
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer-IDIBAPS, Barcelona, Spain
| | - F Valldeoriola
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer-IDIBAPS, Barcelona, Spain.
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Grau-Rivera O, Gelpi E, Rey MJ, Valldeoriola F, Tolosa E, Compta Y, Martí MJ. Prominent psychiatric symptoms in patients with Parkinson's disease and concomitant argyrophilic grain disease. J Neurol 2013; 260:3002-9. [PMID: 24046066 DOI: 10.1007/s00415-013-7101-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 09/05/2013] [Accepted: 09/06/2013] [Indexed: 10/26/2022]
Abstract
In Parkinson's disease (PD), cognitive decline and psychiatric symptoms may occur and very often co-exist, eventually leading to PD-dementia. We report three patients with PD who presented striking psychiatric manifestations along with mild cognitive decline not progressing to dementia across the course of disease and in which postmortem neuropathological study revealed, besides alpha-synuclein inmunoreactive Lewy-body pathology, concomitant four-repeat tau positive argyrophilic grain pathology. We consider that argyrophilic grains might have modulated the clinical presentation of PD in these patients, being the main substrate of their prominent psychiatric symptoms in the absence of definite dementia.
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Affiliation(s)
- O Grau-Rivera
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic/IDIBAPS (Institut d'Investigacions Biomèdiques August Pi I Sunyer), Hospital Clinic de Barcelona, c/Villarroel 170, 08036, Barcelona, Catalonia, Spain,
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12
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Ortega-Cubero S, Lorenzo-Betancor O, Lorenzo E, Alonso E, Coria F, Pastor MA, Fernández-Santiago R, Martí MJ, Ezquerra M, Valldeoriola F, Compta Y, Tolosa E, Agundez JA, Jiménez-Jiménez FJ, Gironell A, Clarimon J, de Castro P, García-Martín E, Alonso-Navarro H, Pastor P. Fused in Sarcoma (FUS) gene mutations are not a frequent cause of essential tremor in Europeans. Neurobiol Aging 2013; 34:2441.e9-2441.e11. [PMID: 23731953 DOI: 10.1016/j.neurobiolaging.2013.04.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [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: 04/23/2013] [Accepted: 04/27/2013] [Indexed: 12/22/2022]
Abstract
FUS/TLS (denoting fused in sarcoma/translocated in liposarcoma [MIM 137070]) codifies an RNA binding protein. Mutations in this gene cause amyotrophic lateral sclerosis (ALS; MIM 608030). Essential tremor (ET [MIM 190300]) is the most frequent movement disorder. Despite its strong familiar aggregation, recently a whole exome sequencing study has identified FUS mutations as a cause of familial ET. To determine whether mutations in FUS are also common in other populations, we sequenced FUS gene in 178 unrelated Spanish subjects with ET. We detected only an intronic single-pair nucleotide deletion (c.1293-37delC), which was predicted to affect mRNA splicing. However, leukocyte mRNA analysis showed no changes in FUS expression. In conclusion, coding or splicing FUS mutations are not a frequent cause of ET in the Spanish population.
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Affiliation(s)
- S Ortega-Cubero
- Neurogenetics Laboratory, Division of Neurosciences, Center for Applied Medical Research, University of Navarra, Pamplona, Spain
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Garrabou G, Inoriza JM, Morén C, Oliu G, Miró Ò, Martí MJ, Cardellach F. Hyperbaric oxygen therapy for carbon monoxide poisoning. Intensive Care Med 2011; 37:1711-2. [DOI: 10.1007/s00134-011-2262-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2011] [Indexed: 11/24/2022]
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Garrabou G, Inoriza JM, Morén C, Oliu G, Miró Ò, Martí MJ, Cardellach F. Mitochondrial injury in human acute carbon monoxide poisoning: the effect of oxygen treatment. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev 2011; 29:32-51. [PMID: 21424975 DOI: 10.1080/10590501.2011.551316] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The best oxygen therapy for acute carbon monoxide poisoning (ACOP) remains unestablished. Reported mitochondrial complex IV (mtCIV) inhibition, together with carboxyhaemoglobin (COHb)-induced hypoxia, may influence acute clinical symptoms and outcome. To "mitochondrially" evaluate treatment efficacy, we correlated intoxication severity and symptoms with mitochondrial function (mtCIV activity) and oxidative stress (lipid peroxidation) in 60 poisoned patients and determined ACOP recovery depending on either normobaric or hyperbaric oxygen therapy along a 3-month follow-up. In the present article we positively evaluate mtCIV as a good marker of ACOP recovery, treatment effectiveness, and late neurological syndrome development, which advocates for hyperbaric oxygen therapy as the treatment of choice. However, we discourage its usefulness as a severity marker because of its excessive sensitivity. We additionally evaluate oxidative stress role and prognostic factors for neurological sequelae development.
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Affiliation(s)
- G Garrabou
- Mitochondrial Research Laboratory, Muscle Research Unit, IDIBAPS-University of Barcelona, Internal Medicine Department-Hospital Clinic of Barcelona, Barcelona, Spain.
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Botta-Orfila T, Ezquerra M, Ríos J, Fernández-Santiago R, Cervantes S, Samaranch L, Pastor P, Martí MJ, Muñoz E, Valldeoriola F, Aguilar M, Calopa M, Hernández-Vara J, Tolosa E. Lack of interaction of SNCA and MAPT genotypes in Parkinson's disease. Eur J Neurol 2010; 18:e32. [PMID: 21054681 DOI: 10.1111/j.1468-1331.2010.03245.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Limb dystonia (LD) refers to dystonia affecting one arm or leg. Depending on the site of onset, age at onset, and the etiology, progression and prognosis will be different. Usually young-onset primary dystonia affects the lower limbs and tends to generalize, while in adult-onset, it appears in the arm and remains focal. Lower limb dystonia in adults is rare as a primary cause, and parkinsonism or other neurological diseases must always be ruled out. In the text that follows, we review the main clinical features of the primary and secondary limb dystonias considering the age at onset and etiology.
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Affiliation(s)
- C Pont-Sunyer
- Parkinson disease and Movement Disorders Unit, Neurology Service, Faculty of Medicine, Institut Clínic de Neurociències, Centro de Investigación en Red de Enfermedades Neurodegenerativas, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
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Valldeoriola F, Regidor I, Mínguez-Castellanos A, Lezcano E, García-Ruiz P, Rojo A, Salvador A, Castro A, Grandas F, Kulisevsky J, Martí MJ, Martínez-Martín P, Relova L, Rumià J, Cámara A, Burguera JA, Linazasoro G, de Val JL, Obeso J, Rodríguez-Oroz MC, Tolosa E. Efficacy and safety of pallidal stimulation in primary dystonia: results of the Spanish multicentric study. J Neurol Neurosurg Psychiatry 2010; 81:65-9. [PMID: 19744963 DOI: 10.1136/jnnp.2009.174342] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Dystonia is a complex clinical syndrome originated by a wide range of aetiologies. The diagnosis of dystonia is made after the evaluation of aetiological, phenomenological and genetic factors. Medications, except in patients with dopa-responsive dystonia, are of limited efficacy. Botulinum toxin injections are not applicable to patients with generalised dystonia, since many muscular groups contribute to disability. Clinical studies in children and adults with primary generalised dystonia (PGD) have reported beneficial effects of bilateral GPi deep brain stimulation (DBS) in both motor symptoms and disability produced by dystonia as well as a favourable impact of DBS in the health-related quality of life (HRQoL). Some clinical aspects of GPi stimulation in primary dystonia still remain controversial such as the influence of disease duration or age at onset in determining the postoperative clinical outcome. RESULTS The authors report the results of a multicentric study designed to assess the tolerability and clinical effects of bilateral pallidal DBS on motor impairment, functional disability, quality of life, pain and mood in patients with medically refractory primary generalised or segmental dystonia.
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Affiliation(s)
- F Valldeoriola
- Hospital Clínic, University of Barcelona, Barcelona, Spain.
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Compta Y, Martí MJ, Rey MJ, Ezquerra M. Parkinsonism, dysautonomia, REM behaviour disorder and visual hallucinations mimicking synucleinopathy in a patient with progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 2009; 80:578-9. [PMID: 19372296 DOI: 10.1136/jnnp.2007.142810] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bartrés-Faz D, Martí MJ, Junqué C, Solé-Padullés C, Ezquerra M, Bralten LBC, Gaig C, Campdelacreu J, Mercader JM, Tolosa E. Increased cerebral activity in Parkinson?s disease patients carrying the DRD2 TaqIA A1 allele during a demanding motor task: a compensatory mechanism? Genes Brain Behav 2007; 6:588-92. [PMID: 17147698 DOI: 10.1111/j.1601-183x.2006.00290.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Previous studies suggest that neuroimaging techniques are useful for detecting the effects of functional genetic polymorphisms on brain function in healthy subjects or in patients presenting with psychiatric or neurodegenerative conditions. Former evidence showed that individuals carrying risk alleles displayed broader patterns of brain activity during behavioural and cognitive tasks, despite being clinically comparable to non-carriers. This suggests the presence of compensatory brain mechanisms. In the present study, we investigated this effect in Parkinson's disease (PD) patients carrying the DRD2 TaqIA A1 allelic variant. This variant may confer an increased risk of developing the disease and/or influence the clinical presentation. During a complex sequential motor task, we evidenced by functional magnetic resonance imaging that A1 allele carriers activated a larger network of bilateral cerebral areas than non-carriers, including cerebellar and premotor regions. Both groups had similar clinical and demographic measures. In addition, their motor performance during the functional magnetic resonance experiment was comparable. Therefore, our conclusions, pending replication in a larger sample, seem to reflect the recruitment of compensatory cerebral resources during motor processing in PD patients carrying the A1 allele.
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Affiliation(s)
- D Bartrés-Faz
- Department de Psiquiatria i Psicobiologia Clinica, Facultat de Medicina, Universitat de Barcelona, and Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
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Iranzo A, Santamaría J, Rye DB, Valldeoriola F, Martí MJ, Muñoz E, Vilaseca I, Tolosa E. Characteristics of idiopathic REM sleep behavior disorder and that associated with MSA and PD. Neurology 2006; 65:247-52. [PMID: 16043794 DOI: 10.1212/01.wnl.0000168864.97813.e0] [Citation(s) in RCA: 263] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare the clinical and video-polysomnographic (VPSG) characteristics of idiopathic REM sleep behavior disorder (RBD) vs the RBD seen in multiple system atrophy (MSA) and Parkinson disease (PD). METHODS Clinical features and VPSG measures were evaluated in 110 consecutive nondemented subjects (26 MSA, 45 PD, and 39 idiopathic RBD) free of psychoactive medications referred for suspected RBD to our sleep unit over a 5-year period, with extended follow-up (mean 26.9 +/- 21.3 months). RESULTS Across the three groups studied, logistic regression analysis demonstrated that there were no differences in the quality of RBD symptoms (e.g., nature of unpleasant dream recall or behaviors witnessed by bed partners), most PSG variables, abnormal behaviors captured by VPSG, and clinical response to clonazepam. When compared to subjects with PD, however, patients with MSA had a significantly shorter duration of disease, a higher REM sleep without atonia percentage, a greater periodic leg movement index, and less total sleep time. Subjects with idiopathic RBD, as compared to those with either MSA or PD, were more often male, had greater self-reported clinical RBD severity, and were more often aware of their abnormal sleep behaviors. CONCLUSIONS REM sleep behavior disorder (RBD)-related symptoms and neurophysiologic features are qualitatively similar in RBD subjects with the idiopathic form, multiple system atrophy (MSA), and Parkinson disease (PD). Polysomnographic abnormalities associated with RBD in the setting of MSA are greater than in PD, suggesting a more severe dysfunction in the structures that modulate REM sleep.
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Affiliation(s)
- A Iranzo
- Neurology Service, ospital Clínic and Institut d'Investigació Biomèdiques August Pi i Sunyer, Barcelona, Spain.
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Gaig C, Martí MJ, Tolosa E, Gómez-Choco MJ, Amaro S. Parkinsonism–hyperpyrexia syndrome not related to antiparkinsonian treatment withdrawal during the 2003 summer heat wave. J Neurol 2005; 252:1116-9. [PMID: 15778809 DOI: 10.1007/s00415-005-0798-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2004] [Revised: 12/13/2004] [Accepted: 01/03/2005] [Indexed: 11/26/2022]
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Mascia MM, Valls-Solé J, Martí MJ, Salazar G. Sensorimotor integration in patients with parkinsonian type multisystem atrophy. J Neurol 2005; 252:473-81. [PMID: 15726255 DOI: 10.1007/s00415-005-0678-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2004] [Revised: 09/08/2004] [Accepted: 10/05/2004] [Indexed: 10/25/2022]
Abstract
Sensorimotor integration is an essential feature of the central nervous system that contributes to the accurate performance of motor tasks. Some patients with multiple system atrophy with parkinsonian features (MSAp) exhibit clinical signs compatible with an abnormal central nervous system excitability to somatosensory inputs, such as action myoclonus or enhanced cutaneo-muscular reflexes. To investigate further the site where such dysfunction in sensorimotor integration takes place, we examined the inhibitory effects of a cutaneous afferent volley at two different levels of the motor system in 10 MSAp patients and in 10 age-matched healthy volunteers. Electrical digital nerve stimuli were given as the conditioning stimulus for the motor evoked potentials (MEP) elicited by transcranial magnetic stimulation in hand muscles, and for the blink reflex responses obtained in the orbicularis oculi muscles by supraorbital nerve stimulation. Intervals for the conditioning were 20 to 50 ms for the MEP and 90 to 110 ms for the blink reflex. The MEP was significantly inhibited in test trials in healthy volunteers, reaching a mean of 32% of the baseline values at the ISI of 35 ms. Significant inhibition occurred also in the blink reflex, in which the R2 response was a mean of 12% of baseline values at the ISI of 100 ms. The inhibitory effects were abnormally reduced in 8 patients on the MEP, and in 7 patients on the blink reflex. There were significant group differences between patients and control subjects in the size of the conditioned MEP and blink reflex. These results suggest that sensorimotor integration is abnormal in patients with MSAp in at least two central nervous system sites: the sensorimotor cortex, and the brainstem reticular formation.
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Affiliation(s)
- M M Mascia
- Unitat d'EMG. Servei de Neurologia, Hospital Clínic, Villarroel,170, Barcelona 08036, Spain.
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Iranzo A, Santamaria J, Tolosa E, Vilaseca I, Valldeoriola F, Martí MJ, Muñoz E. Long-term effect of CPAP in the treatment of nocturnal stridor in multiple system atrophy. Neurology 2004; 63:930-2. [PMID: 15365155 DOI: 10.1212/01.wnl.0000137043.76383.a4] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The authors found that continuous positive airway pressure (CPAP) eliminated video-polysomnographic documented stridor in 13 multiple system atrophy (MSA) subjects with vocal cord abnormalities. Long-term follow-up showed high CPAP tolerance, no recurrence of stridor, no major side effects, subjective improvement in sleep quality, and that median survival time was similar to a group of 26 MSA patients without stridor. This study shows that in MSA, CPAP is an effective noninvasive long-term therapy for nocturnal stridor.
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Affiliation(s)
- A Iranzo
- Neurology Service, Hospital Clínic and Instisut d'Investigació Biomèdiques August Pi i Sunyer, Barcelona, Spain.
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Muñoz E, Tolosa E, Pastor P, Martí MJ, Valldeoriola F, Campdelacreu J, Oliva R. Relative high frequency of the c.255delA parkin gene mutation in Spanish patients with autosomal recessive parkinsonism. J Neurol Neurosurg Psychiatry 2002; 73:582-4. [PMID: 12397156 PMCID: PMC1738117 DOI: 10.1136/jnnp.73.5.582] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Autosomal recessive juvenile parkinsonism is a neurodegenerative disorder associated with mutations in the parkin gene. OBJECTIVES To search for the presence of parkin gene mutations in Spanish patients with Parkinson's disease (PD) and characterise the phenotype associated with these mutations. METHODS Thirty seven PD patients with either early onset or autosomal recessive pattern of inheritance were selected for genetic study. RESULTS Mutations were identified in seven index patients (19%). Homozygous mutations were detected in six patients and a heterozygous mutation in one. The age at onset was lower in patients with mutations than in patients without mutations. Dystonia at onset was present in two patients with parkin gene mutations. The disease began in two patients with postural tremor in the upper limbs mimicking essential tremor. Four patients exhibited a long term response to dopamine agonists. The c.255delA mutation was identified in four unrelated families. This is a frameshift mutation leading to protein truncation. CONCLUSIONS Parkin gene mutations are present in Spanish patients with early onset and/or an autosomal recessive parkinsonism. The c.255delA is the most frequent mutation found, suggesting a relative high prevalence in the Spanish population.
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Affiliation(s)
- E Muñoz
- Movemente Disorder Unit, Neurology Service, Institut Clinic de Malalties del Sistema Nervios, Villarroel 170, 08036 Barcelona, Spain.
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Abstract
Spasmodic Dysphonia (SD) is a dystonia involving laryngeal musculature thus causing a characteristic voice disorder. Two main types of SD have been described. The adductor type is the commonest and it is characterized by a strain-strangle, choked voice. The abductor type can be distinguished from the previous one by episodes of a blown and whispering voice, interrupting speech. Botulism toxin (BTX) has demonstrated to be the most effective treatment for this condition. Thirty patients diagnosed of SD (twenty-nine adductor type/one abductor type) were included. Their degree of dysphonia was evaluated using both functional and visual-analogue scales. They were treated with BTX vocal cord injections using a percutaneous technique under EMG guidance. Improvements up to a 100% of the normal vocal function were obtained, with an average of 82% in the adductor type. The adverse effects were mild and transient. Hypophonia affected 61.3% of patients lasting an average of 11.3 days. Dysphagia was reported in 44.1% of cases lasting an average of 5.8 days.
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Affiliation(s)
- F Larrosa
- Servicio de Otorrinolaringología, Hospital Clínic i Provincial de Barcelona
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Pastor P, Muñoz E, Ezquerra M, Obach V, Martí MJ, Valldeoriola F, Tolosa E, Oliva R. Analysis of the coding and the 5' flanking regions of the alpha-synuclein gene in patients with Parkinson's disease. Mov Disord 2001; 16:1115-9. [PMID: 11748744 DOI: 10.1002/mds.1198] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Missense mutations of the alpha-synuclein gene have been reported to explain a few kindreds with autosomal dominant Parkinson's disease (PD). In order to identify mutations in our PD patients, we have screened the coding region and 5'flanking region of the gene. DNA samples from 50 patients with familial PD were screened via single-strand conformation polymorphism (SSCP) for mutations in the alpha-synuclein gene. The 5' flanking region was examined in 117 additional PD patients (27 patients with unclear family history for PD, and 90 patients without family history) and in 169 control subjects. We found one change (G199A) in exon 4 in one family with a pattern of autosomal dominant PD. However, this mutation did not result in an amino acid substitution (valine) and did not segregate completely with PD. The analysis of the 5' flanking region also showed a new polymorphism, a nucleotide insertion (- 164insA) linked to a nucleotide substitution (C-116G), in patients and in controls. The -164insA/C-116G allele was present in 52.3% of the patients and in 47.6% of the controls. We did not find significant differences regarding the allelic and genotype frequencies between PD and control groups. These results suggest that mutations in the alpha-synuclein gene are a very rare cause of familial PD and that the novel -164insA/C-116G polymorphism in the 5' flanking region does not confer susceptibility to develop PD.
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Affiliation(s)
- P Pastor
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut Clínic de Malalties del Sistema Nerviós, Hospital Clínic, IDIBAPS, Barcelona, Spain.
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Abstract
To systematically investigate obsessive-compulsive traits in Parkinson's disease, patients were administered the Maudsley obsessional-compulsive inventory (MOCI) and a modification of the Leyton obsessional inventory (LOI) to a sample of non-demented and non-depressed patients with Parkinson's disease. Patients with severe Parkinson's disease showed more obsessive traits than normal controls in MOCI and LOI total scores, and in the "checking", "doubting", and "cleaning" subscales of the MOCI. By contrast, patients with mild disease did not differ from controls. A significant correlation was found between severity and duration of illness and MOCI total score. These results support the involvement of basal ganglia in obsessive-compulsive symptomatology. As patients with mild Parkinson's disease did not differ from controls, obsessive-compulsive disorder does not seem to be directly related to the initial nigrostriatal dopaminergic deficiency which causes clinical Parkinson's disease symptomatology. The appearance of obsessive symptoms could be related to the subset of neurochemical changes taking place at the level of the basal ganglia circuitry as disease progresses.
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Affiliation(s)
- M Alegret
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Pg Vall d'Hebron 171, 08035 Barcelona, Spain
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Abstract
We have investigated the presence of mutations in the parkin gene in patients with early-onset parkinsonism. Direct sequencing of the polymerase chain reaction (PCR) products showed a homozygous G deletion in the exon 7 (c.871delG) in one patient. This was a 38-year-old Moroccan woman with a history of parkinsonism of 18 years of duration. The disease appeared as an apparently sporadic case and was characterized by dystonia of the legs at onset and a rapid progression to severe generalized parkinsonism but with an excellent maintained response to dopamine agonists treatment. The deletion was a frameshift mutation resulting in a stop codon at position 297 which causes truncation of the parkin protein. Mutations in the parkin gene can be encountered in patients with an apparently sporadic early-onset parkinsonism, rapidly progressive course and marked and maintained response to dopamine agonists.
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Affiliation(s)
- E Muñoz
- Parkinson's disease and Movement Disorders Unit, Neurology Service, institut Clínic Malalties Sistema Nerviós, Hospital Clínic i Universitari, University of Barcelona, Spain
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Pastor P, Ezquerra M, Muñoz E, Martí MJ, Blesa R, Tolosa E, Oliva R. Significant association between the tau gene A0/A0 genotype and Parkinson's disease. Ann Neurol 2000; 47:242-5. [PMID: 10665497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
A significant association between the tau gene A0/A0 genotype and progressive supranuclear palsy has been reported recently. To determine if the presence of a tau polymorphism could constitute a risk factor for the development of sporadic and familial Parkinson's disease, a dinucleotide repeat marker at intron 11 was genotyped in 152 patients with PD, 52 patients with Alzheimer's disease, and 150 healthy controls. We detected a significant difference in A0 allelic frequency in the Parkinson's disease group (79.27%) compared with the control group (71%) and the Alzheimer's disease group (73.07%). Individuals homozygous for the A0 allele were also detected significantly more frequently in the Parkinson's disease group (63.8%) compared with the control group (52.66%) and the Alzheimer's disease group (48.07%). These results suggest a possible involvement of the tau gene in the pathogenesis of some cases of Parkinson's disease.
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Affiliation(s)
- P Pastor
- Neurology Service, Hospital Clínic Universitari, Institut d'Investigacions Biomèdique August Pi i Sunyer, Barcelona, Spain
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Abstract
Patients with a parkinsonian syndrome and features of multisystem atrophy (pMSA) may exhibit abnormal movements of the hands and fingers, which are reported in the literature either as "jerky" tremor or myoclonus. We studied clinically and electrophysiologically these movements in 11 consecutive patients with pMSA. No abnormal movements were observed when the patients were at complete rest, except for a characteristic parkinsonian "pill-rolling" tremor in one patient. Abnormal small-amplitude, nonrhythmic movements involving just one or a few fingers, or more rarely the whole hand, were observed in nine patients when holding a posture or at the beginning of an action. Accelerometric recordings showed small-amplitude irregular oscillations which, contrary to those of patients with tremor, had no predominant peak in the Fast Fourier frequency spectrum analysis. Electromyographic recordings in the forearm and hand muscles showed brief jerks of less than 100 ms duration which were synchronous in antagonist muscles of the forearm and alternated with brief periods of silence. Electrical stimulation of the digital nerves evoked consistent reflex responses in the wrist flexor and extensor muscles at a latency of 55.3+/-4.1 ms (range, 50-63 ms). Routine electroencephalographic (EEG) and somatosensory evoked potentials to median nerve stimulation were normal. Back-averaging of the EEG activity time-locked to the jerks was performed in two patients with no evidence of abnormal cortical activity. Two patients had episodes of transient respiratory failure related to pneumonia. This caused a long-lasting enhancement of the abnormal hand and finger movements, which became larger and more widespread, with features of posthypoxic myoclonus. We conclude that the abnormal hand and finger movements of patients with pMSA are a form of postural and action myoclonus, and can be described as mini-polymyoclonus.
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Affiliation(s)
- G Salazar
- Departament de Medicina, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Facultat de Medicina, Universitat de Barcelona, Spain
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Abstract
An association between the intronic allele 3 of the dopamine receptor D2 (DRD2) gene and European Parkinson's disease (PD) cases has been reported recently. We initiated the present work in order to determine whether this association between the DRD2 locus and PD is also present in our population from Spain. The DRD2 gene polymorphism has been genotyped in 154 patients and in 125 controls. The allele 3 is present in 60.3% of the patients and in 55.2% of the controls. The genotype 3/3 is present in 36.3% of the patients and in 34.4% of the controls. No statistical differences in the genotype and allelic frequencies between the two groups have been found. No differences were also found when the patients were classified according to different criteria such as onset, family history, gender or clinical presentation. Thus our results do not support a role for the DRD2 locus to develop PD.
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Affiliation(s)
- P Pastor
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic Universitari, Institut dInvestigacions Biomèdiques Agustí Pi i Sunyer, Barcelona, Spain
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Muñoz E, Obach V, Oliva R, Martí MJ, Ezquerra M, Pastor P, Ballesta F, Tolosa E. Alpha1-antichymotrypsin gene polymorphism and susceptibility to Parkinson's disease. Neurology 1999; 52:297-301. [PMID: 9932947 DOI: 10.1212/wnl.52.2.297] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether the alpha1-antichymotrypsin AA genotype (ACT-AA) confers susceptibility for developing Parkinson's disease (PD) in the Spanish population. BACKGROUND A correlation between the ACT-AA genotype and the risk of developing PD has been recently reported in the Japanese population. METHODS The ACT genotypes of 71 patients diagnosed with clinically definite PD were compared with those of 109 age-matched healthy control subjects. RESULTS The authors found that the ACT-AA polymorphism frequency was not increased significantly in the PD group (31%) compared with the control group (28.4%). The ACT allelic distribution was also similar for familial and sporadic PD, for female and male patients, and for the different clinical subtypes of PD. The age at onset of PD was significantly lower in the ACT-AA patients compared with non-ACT-AA patients. When the actual age was considered, the ACT-AA frequency was higher in PD patients < or =50 years old (50%) compared with that present in patients >50 years old (26.8%), but the same effect was found in control subjects. CONCLUSIONS The ACT-AA polymorphism is not related to an increased risk of developing PD in the Spanish population. The ACT-AA overrepresentation in PD and control subjects < or =50 years old suggests that this polymorphism could be associated with life-threatening conditions other than PD.
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Affiliation(s)
- E Muñoz
- Neurology Service, Institut d'Investigaciones Biomèdiques August Pi i Sunyer, Hospital Clínic i Universitari, University of Barcelona, Spain
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Valldeoriola F, Valls-Solé J, Tolosa E, Ventura PJ, Nobbe FA, Martí MJ. Effects of a startling acoustic stimulus on reaction time in different parkinsonian syndromes. Neurology 1998; 51:1315-20. [PMID: 9818852 DOI: 10.1212/wnl.51.5.1315] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The functional assessment of the startle circuit is usually done by analyzing the acoustic startle response (ASR). However, a startling acoustic stimulus (SAS) also induces changes in the excitability of neural structures that can be demonstrated by studying the SAS-induced change in the behavior of certain neurophysiologic responses. OBJECTIVE To examine the effects induced by an SAS on voluntary reaction time in patients with parkinsonian syndromes (StartReact effect) and to compare the results with those obtained in a group of age-matched healthy volunteers. METHODS Twelve patients with idiopathic PD (IPD), seven patients with progressive supranuclear palsy (PSP), seven patients with multisystem atrophy (MSA), and seven healthy age-matched control volunteers performed a simple visual reaction time task and received SAS together with the "go" signal in random trials. RESULTS Baseline reaction time was significantly slower in PSP patients than in control subjects and MSA patients. The SAS induced a significant shortening of the reaction time in control subjects and in patients with IPD and MSA, but not in patients with PSP. The percentage of reaction time shortening with regard to the baseline values also differed significantly between PSP patients and the other groups of subjects. The StartReact effect was consistent throughout the experiment and showed reduced habituation with repeated testing. CONCLUSIONS The results are consistent with an abnormal function of the startle circuit in patients with PSP and agree with previous studies using the ASR. The reduced habituation of the StartReact effect favors its clinical applicability in the assessment of differences between patients with parkinsonian syndromes.
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Affiliation(s)
- F Valldeoriola
- Neurology Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Spain
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Abstract
OBJECTIVE To measure the effects of a prepulse stimulus on the blink reflex responses elicited by an electrical stimulation of the supraorbital nerve in patients with blepharospasm with and without an effective sensory trick. DESIGN Blink reflexes to supraorbital nerve stimulation were preceded in test trials by a prepulse electrical stimulus to the third finger at various leading intervals. SETTING Ambulatory patients were treated regularly with botulinum toxin in the Neurology Department of the Hospital Clinic in Barcelona, Spain. SUBJECTS Seventeen patients with dystonic blepharospasm and 11 age-matched control subjects. Eight of the patients with dystonic blepharospasm used a sensory trick to alleviate spasms and 9 did not. MAIN OUTCOME MEASURES We measured amplitude of R1 and area of R2 responses elicited by the supraorbital electrical stimulus and determined the percentage of facilitation or inhibition induced by the prepulse. RESULTS Prepulse facilitation occurred in the R1 response at intervals of 60 to 100 milliseconds and was normal in all patients. Prepulse inhibition occurred in the R2 response at intervals between 50 and 200 milliseconds and was abnormally reduced in 11 patients (64.7%), including all 9 patients who did not use a sensory trick and 2 of the 8 patients who did use a sensory trick. There was a positive correlation between absence of sensory trick and abnormality of the prepulse effects (chi(2)= 23.8; P < .001). CONCLUSIONS Prepulse inhibition of the trigeminofacial reflex is abnormal in a percentage of patients with blepharospasm, and this abnormality occurs more frequently in patients who do not use a sensory trick. This sensory derangement may contribute to the maintenance of the dystonic spasms by reducing the amount of physiological gating from peripheral nerve inputs on trigeminofacial reflexes.
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Affiliation(s)
- E Gómez-Wong
- Department of Medicine, IDIBAPS, Barcelona, Spain
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Gómez-Wong E, Martí MJ, Cossu G, Fabregat N, Tolosa ES, Valls-Solé J. The 'geste antagonistique' induces transient modulation of the blink reflex in human patients with blepharospasm. Neurosci Lett 1998; 251:125-8. [PMID: 9718990 DOI: 10.1016/s0304-3940(98)00519-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The mechanism of action of the 'geste antagonistique', or sensory trick, used by patients with dystonic blepharospasm (BSP) to transiently diminish their symptoms is presently unknown. In this paper we examined the effects induced by a sensory trick consisting of finger contact with the face on the electrically induced blink reflex and the blink reflex excitability recovery curve to paired stimuli. The results were compared with those obtained in a group of six healthy volunteers who mimicked the manoeuvre used by the patients as a sensory trick. In all subjects, the area of R2 was significantly reduced, and the amplitude of R1 was significantly enhanced, during a mean of 10 min after the onset of finger-face contact in comparison to rest. However, there were no changes in the blink reflex excitability recovery curve. The contact-induced effect on the magnitude of the R2 component of the blink reflex is probably caused by sensory gating on trigeminal afferents. Such a reduction in the gain of trigemino-facial reflexes may partly underly the transient benefit experienced by patients with BSP with the use of sensory tricks.
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Affiliation(s)
- E Gómez-Wong
- Unitat d'EMG, Department de Medicina, IDIBAPS, Hospital Clínic, Universitat de Barcelona, Spain
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Abstract
Striatal dopamine deficiency in Parkinson's disease (PD), first described in 1960, was a key event that led to the era of levodopa therapy. In 1961, levodopa was first tried in PD patients, but throughout most of the 1960s the results were inconsistent. In 1967, questions about the effectiveness of levodopa in PD were finally set aside when Cotzias and colleagues reported dramatic improvement in PD patients with oral administration of levodopa in increasing amounts over long periods. The major side effects of levodopa administration, i.e., dyskinesias and motor fluctuations, also became apparent at this time. In the early 1970s, the advantages of adding a dopa decarboxylase inhibitor to treatment were discovered--reducing side effects and gaining better symptom control--and the first levodopa combination, carbidopa/levodopa, became commercially available in 1975. Since then, PD researchers have attempted to overcome complications with such techniques as continuous levodopa infusion and, most recently, long-acting levodopa combinations. A dopamine agonist, apomorphine, was used in 1970 as a means to overcome side effects and loss of levodopa efficacy. However, side effects and difficulty of administration limited its use. Dopamine agonists began to find a place in routine treatment of PD after the discovery of bromocriptine's benefits in PD in 1974. Since then, new approaches have been tried, such as dopamine agonist monotherapy and early therapy in combination with levodopa. The development of new dopamine agonists has led to characterization of dopamine receptor subtypes and agonists targeted to stimulation of specific receptors.
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Affiliation(s)
- E Tolosa
- Parkinson's Disease and Movement Disorder Unit, Neurology Service, University Hospital Clinic, Barcelona, Spain
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Muñoz E, Oliva R, Obach V, Martí MJ, Pastor P, Ballesta F, Tolosa E. Identification of Spanish familial Parkinson's disease and screening for the Ala53Thr mutation of the alpha-synuclein gene in early onset patients. Neurosci Lett 1997; 235:57-60. [PMID: 9389595 DOI: 10.1016/s0304-3940(97)00710-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We initiated the present work in order to determine if the Ala53Thr mutation of the alpha-synuclein gene previously described by Polymeropoulos et al. [Science, 276 (1997) 2045-2047] could be detected in Spanish early onset Parkinson's disease (PD) patients. Thirty-four PD patients were evaluated. Of these, 13 were considered early onset patients (six familial and seven sporadic) and were included in the genetic study. We detected the presence of genetic anticipation in four kindreds with early onset PD members. The Ala53Thr mutation of the alpha-synuclein gene was absent in all patients. The results do not support a role for this mutation in our patients with early onset PD and, in agreement with the results previously reported, indicate that the Ala53Thr mutation of the alpha-synuclein gene is a rare cause of PD.
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Affiliation(s)
- E Muñoz
- Neurology Service, Hospital Clínic i Provincial, Barcelona, Spain
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Esteban Muñoz J, Martí MJ, Marín C, Tolosa E. Long-term treatment with intermitent intranasal or subcutaneous apormorphine in patients with levodopa-related motor fluctuations. Clin Neuropharmacol 1997; 20:245-52. [PMID: 9197948 DOI: 10.1097/00002826-199706000-00009] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Twenty patients with idiopathic Parkinson's disease and disabling motor fluctuations were treated with intermittent subcutaneous (11 patients) or intranasal (nine patients) apomorphine for > 2 years. Apomorphine significantly reduced the mean daily "off" hours in both groups (p < 0.01) and improved "off" dystonia and end-of-dose and diphasic diskinesias. Unlike others authors, we found no difference between intranasal and subcutaneous' groups of treatment in the mean dose of apomorphine required to turn "on." Tolerance phenomenon to apomorphine could not be demonstrated in the follow-up period. Nasal crusting and vestibulitis observed in some patients treated intranasally were the more severe side effects and determined that some of them either switched to subcutaneous therapy or abandoned the treatment.
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Affiliation(s)
- J Esteban Muñoz
- Servei de Neurologia, Hospital Clínic i Provincial de Barcelona, Spain
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Saiz A, Vila N, Muñoz JE, Martí MJ, Graus F, Tolosa E. [Wolfram's syndrome: correlation of clinical signs and neurological images]. Neurologia 1995; 10:107-9. [PMID: 7695938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Wolfram's syndrome is defined by the association of diabetes mellitus, diabetes insipidus, optic atrophy and nerve deafness. Other neurological anomalies, such as ataxia, nystagmus, tonic pupil, dizziness, dysarthria, dysphagia and epilepsy are rarely described and tend to appear later than the primary manifestations. We describe a patient with Wolfram's syndrome whose magnetic resonance image (MRI) of the head showed brainstem and cerebellar atrophy years before the appearance of clinical signs of brainstem disfunction. We conclude that alterations in MRI precede neurological symptoms by several years in Wolfram's syndrome.
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Affiliation(s)
- A Saiz
- Servicio de Neurología, Hospital Clínic i Provincial, Barcelona
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Vila N, Martí MJ. [The restless legs syndrome and periodic sleep movements as the initial manifestation of iron-deficiency anemia]. Med Clin (Barc) 1994; 103:318-9. [PMID: 7967887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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42
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Sanz-Gallen P, Nogue S, Palomar M, Rodríguez M, Martí MJ, Munne P. [Acute poisoning caused by hydrogen sulphide: clinical features of 3 cases]. An Med Interna 1994; 11:392-4. [PMID: 7772687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We describe three cases of acute intoxication by hydrogen sulphide which were produced after remaining between 50 and 60 minutes inside a cellulose tank. The three patients had loss of conscience. One of the patients developed a persistent vegetative state; another patient recovered although with neurological post-anoxic sequelas and the third case completely recovered one week after his hospitalization. The patients underwent symptomatic treatment and the environmental concentrations of hydrogen sulphide were measured at the site of the accident. Finally, the application of preventive measures is stressed.
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Affiliation(s)
- P Sanz-Gallen
- Unidad de Toxicología Clínica, Hospital Clínico y Provincial de Barcelona
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43
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Tolosa ES, Valldeoriola F, Martí MJ. New and emerging strategies for improving levodopa treatment. Neurology 1994; 44:S35-44. [PMID: 8047259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Soon after the successful introduction of large oral doses of levodopa or of levodopa plus a decarboxylase inhibitor, such as carbidopa or benserazide, for the treatment of Parkinson's disease, it became evident that several disturbing side effects were limiting the therapeutic efficacy of this amino acid. This paper discusses novel practical approaches for the management of these levodopa-related complications. These approaches include therapeutic strategies for controlled delivery of levodopa to the brain (controlled-release preparations), rescue treatment with subcutaneous, intranasal, or sublingual administration of the dopamine agonist apomorphine, and the administration of an atypical neuroleptic, such as clozapine. Other approaches for prolonging the response of levodopa that are being used or investigated are also reviewed in this paper. These include the use of levodopa prodrugs and blocking the degradation in the brain with inhibitors of monoamine oxidase-B and catechol-O-methyltransferase.
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Affiliation(s)
- E S Tolosa
- Movement Disorders Unit, Hospital Clínic, University of Barcelona, Spain
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44
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Cardellach F, Martí MJ, Fernández-Solá J, Marín C, Hoek JB, Tolosa E, Urbano-Márquez A. Mitochondrial respiratory chain activity in skeletal muscle from patients with Parkinson's disease. Neurology 1993; 43:2258-62. [PMID: 8232939 DOI: 10.1212/wnl.43.11.2258] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Different abnormalities in mitochondrial electron transport chain activity have been demonstrated in muscle and other tissues of patients with idiopathic Parkinson's disease (PD). We studied eight Spanish patients with PD to evaluate the functional activity of the electron transport chain in muscle mitochondria from patients of this country. We found lower complex I activity (nmol.min-1.mg-1) in patients (245.8 +/- 42.8) than in controls (331.6 +/- 60.1) (p = 0.004) and lower complex IV activity in patients (46.1 +/- 9) than in controls (144.1 +/- 42.3) (p = 0.00001). Complex V activity was also decreased in two patients and complex II and III activities were normal in all of them. Although these results strongly suggest an alteration in mitochondrial DNA in PD, the various electron transport chain defects in different tissues seem to be nonspecific.
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Affiliation(s)
- F Cardellach
- Department of General Internal Medicine, Hospital Clinic i Provincial, Barcelona, Spain
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45
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Lima de Freitas M, Martí MJ. [Restless legs syndrome and periodic movements during sleep]. Neurologia 1993; 8:267. [PMID: 8240839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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46
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Marin C, Martí MJ, Tolosa E, Alvarez R, Montserrat LL, Santamaria J. Modification of muscle activity after BOTOX injections in spasmodic torticollis. Ann Neurol 1992; 32:411-2. [PMID: 1416815 DOI: 10.1002/ana.410320323] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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47
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Martí MJ, Tolosa E. [Botulinum toxin in dystonia]. Neurologia 1988; 3:63-7. [PMID: 3078758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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48
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Cases A, Martí MJ, Blesa R, Tolosa E. [One-and-a-half syndrome of ischemic vascular origin: apropos of 7 cases]. Neurologia 1988; 3:26-30. [PMID: 3273497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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49
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Martí MJ, Kulisevsky J, Tolosa E. [Treatment of dystonic blepharospasm and hemifacial spasm with botulinum toxin: preliminary studies]. Med Clin (Barc) 1987; 89:321-3. [PMID: 3320608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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50
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Mataix Verdú FJ, Salido G, Martí MJ, Gil A. [Study of infant milk formulas present on the Spanish market and its adaptation to the recommendations of the European Society of Gastroenterology and Pediatric Nutrition]. An Esp Pediatr 1987; 26:5-10. [PMID: 3826944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The aim of this study was to investigate energy as well as the protein and mineral composition of milk formulas available on the Spanish market. We studied 20 milk formulas, 14 of which were adapted milk formulas intended for feeding newborns during the first 4-6 months of life and the other 6 ones were follow-up milk formulas. Determinations of energy, total protein, osmolality, sodium, potassium, chloride, phosphorus and calcium were performed by adiabatic calorimetry, cryoscopy, flame photometry, photocolorimetry and flame atomic absorption spectrophotometry respectively. Experimental energy in all formulas was higher than that determined by nutrient contents and conversion factors. Three of the adapted formulas presented higher values of protein than those recommended by ESPGAN and some of them also high levels for sodium total electrolytes. However, the estimated renal solute load for each of the formulas was lower than the minimum renal concentration ability. All formulas, except one, showed normal values for calcium and the contents of phosphorus, were within normalcy. All the follow-up formulas agreed with the ESPGAN recommendations related with protein and mineral composition.
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