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Deutsch A, Burns J, Potelle J, Kessler A. Trends in the characteristics and outcomes of older patients with non-traumatic spinal cord injury treated in inpatient rehabilitation facilities: 2013-2018. J Spinal Cord Med 2024:1-11. [PMID: 38588027 DOI: 10.1080/10790268.2024.2335414] [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] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE To describe the characteristics and outcomes of older (≥ 65 years of age) patients with a non-traumatic spinal cord injury (NTSCI) treated in inpatient rehabilitation facilities (IRFs) between 2013 and 2018. DESIGN Observational study. SETTING IRFs in the United States. PARTICIPANTS 93,631 IRF Medicare stays for patients with NTSCI. INTERVENTIONS Not Applicable. MAIN OUTCOME MEASURES Length of stay, self-care and mobility function, discharge destination. RESULTS Between 2013 and 2018, the number of older (≥ 65 years of age) Medicare patients with a NTSCI treated in IRFs increased about 22.1 percent, from 14,149 to 17,275. In addition to the increase, patients' sociodemographic characteristics shifted to have a slightly higher percentage of patients aged 65-74 years, a slightly higher percentage of males, and slightly fewer patients who identified as Hispanic. There was also a trend of more patients in the higher acuity case-mix groups and comorbidities tiers, but the median length of stay remained 12 days across all years. The percent of patients discharged home or to a community-based setting varied from 73.7 to 75.2 without a trend, although discharge self-care and mobility function increased slightly across the years. CONCLUSIONS Between 2013 and 2018, the number of Medicare patients with NTSCI treated in IRFs increased by more than 22 percent. While patient complexity increased, the median length of stay remained 12 days across the years. Discharge self-care and mobility function increased slightly, and the percent of patients discharged home ranged from 73.7 to 75.2 across the years.
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Affiliation(s)
- Anne Deutsch
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Health Practice, RTI International, Waltham, Massachusetts, USA
| | - Jennifer Burns
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, USA
| | - John Potelle
- Health Practice, RTI International, Waltham, Massachusetts, USA
| | - Allison Kessler
- Health Practice, RTI International, Waltham, Massachusetts, USA
- Renee Crown Center for Spinal Cord Innovation, Shirley Ryan AbilityLab, Chicago, Illinois, USA
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Girone N, Benatti B, Bucca C, Cassina N, Vismara M, Dell'Osso B. Early-onset obsessive-compulsive disorder: Sociodemographic and clinical characterization of a large outpatient cohort. J Psychiatr Res 2024; 172:1-8. [PMID: 38340413 DOI: 10.1016/j.jpsychires.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/16/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Obsessive-compulsive disorder (OCD) is a prevalent and disabling condition characterized by a wide variety of phenotypic expressions. Several studies have reinforced the hypothesis of OCD heterogeneity by proposing subtypes based on predominant symptomatology, course, and comorbidities. Early-onset OCD (EO) could be considered a neurodevelopmental subtype of OCD, with evidence of distinct neurocircuits supporting disease progression. To deepen the heterogeneous nature of the disorder, we analyzed sociodemographic and clinical differences between the EO and late-onset (LO) subtypes in a large outpatient cohort. METHODS Two hundred and eighty-four patients diagnosed with OCD were consecutively recruited from the OCD Tertiary Clinic at Luigi Sacco University Hospital in Milan. Sociodemographic and clinical variables were analyzed for the entire sample and compared between the two subgroups (EO, age <18 years [n = 117,41.2 %]; LO: late-onset, age ≥18 years [n = 167, 58.8 %]). RESULTS The EO group showed a higher frequency of male gender (65 % vs 42.5 %, p < .001), and a higher prevalence of Tic and Tourette disorders (9.4 % vs 0 %, p < .001) compared to the LO group. Additionally, in the EO subgroup, a longer duration of untreated illness was observed (9.01 ± 9.88 vs 4.81 ± 7.12; p < .001), along with a lower presence of insight (13.8 % vs. 7.5 %, p < .05). CONCLUSIONS The early-onset OCD subtype highlights a more severe clinical profile compared to the LO group. Exploring distinct manifestations and developmental trajectories of OCD can contribute to a better definition of homogeneous subtypes, useful for defining targeted therapeutic strategies for treatment.
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Affiliation(s)
- Nicolaja Girone
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
| | - Beatrice Benatti
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy; "Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy.
| | - Chiara Bucca
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
| | - Niccolò Cassina
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
| | - Matteo Vismara
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
| | - Bernardo Dell'Osso
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy; "Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, USA
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Imarisio A, Yahyavi I, Avenali M, Di Maio A, Buongarzone G, Galandra C, Picascia M, Filosa A, Gasparri C, Monti MC, Rondanelli M, Pacchetti C, Errico F, Valente EM, Usiello A. Blood D-serine levels correlate with aging and dopaminergic treatment in Parkinson's disease. Neurobiol Dis 2024; 192:106413. [PMID: 38253208 DOI: 10.1016/j.nbd.2024.106413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/24/2024] Open
Abstract
We recently described increased D- and L-serine concentrations in the striatum of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated monkeys, the post-mortem caudate-putamen of human Parkinson's disease (PD) brains and the cerebrospinal fluid (CSF) of de novo living PD patients. However, data regarding blood D- and L-serine levels in PD are scarce. Here, we investigated whether the serum profile of D- and L-serine, as well as the other glutamate N-methyl-D-aspartate ionotropic receptor (NMDAR)-related amino acids, (i) differs between PD patients and healthy controls (HC) and (ii) correlates with clinical-demographic features and levodopa equivalent daily dose (LEDD) in PD. Eighty-three consecutive PD patients and forty-one HC were enrolled. PD cohort underwent an extensive clinical characterization. Serum levels of D- and L-serine, L-glutamate, L-glutamine, L-aspartate, L-asparagine and glycine were determined using High Performance Liquid Chromatography. In age- and sex-adjusted analyses, no differences emerged in the serum levels of D-serine, L-serine and other NMDAR-related amino acids between PD and HC. However, we found that D-serine and D-/Total serine ratio positively correlated with age in PD but not in HC, and also with PD age at onset. Moreover, we found that higher LEDD correlated with lower levels of D-serine and the other excitatory amino acids. Following these results, the addition of LEDD as covariate in the analyses disclosed a selective significant increase of D-serine in PD compared to HC (Δ ≈ 38%). Overall, these findings suggest that serum D-serine and D-/Total serine may represent a valuable biochemical signature of PD.
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Affiliation(s)
- Alberto Imarisio
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy; Neurogenetics Research Centre, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Isar Yahyavi
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania "Luigi Vanvitelli", 81100 Caserta, Italy; CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - Micol Avenali
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Anna Di Maio
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania "Luigi Vanvitelli", 81100 Caserta, Italy; CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - Gabriele Buongarzone
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Caterina Galandra
- Neurogenetics Research Centre, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Marta Picascia
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Asia Filosa
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, 27100 Pavia, Italy
| | - Maria Cristina Monti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Claudio Pacchetti
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Francesco Errico
- CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy; Department of Agricultural Sciences, University of Naples "Federico II", 80055 Portici, Italy
| | - Enza Maria Valente
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy; Neurogenetics Research Centre, IRCCS Mondino Foundation, 27100 Pavia, Italy.
| | - Alessandro Usiello
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania "Luigi Vanvitelli", 81100 Caserta, Italy; CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
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Wang K, Shafique S, Wang N, Walter SM, Xie X, Piamjariyakul U, Winstanley EL. Early-onset alcohol, tobacco, and illicit drug use with age at onset of hypertension: a survival analysis. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02596-9. [PMID: 38104055 DOI: 10.1007/s00127-023-02596-9] [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: 03/19/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE To examine the associations of age when first substance use and early-onset substance use before age 18 with age at onset (AAO) of hypertension. METHODS This study included 19,270 individuals with AAO of hypertension from the 2015-2019 National Survey on Drug Use and Health. Age when first use of 10 substance use variables included alcohol, daily cigarettes, cigars, smokeless tobacco, marijuana, cocaine, hallucinogens, lysergic acid diethylamide (LSD), inhalants, and methamphetamine use. The outcome was AAO of hypertension and variable cluster analysis was used to classify the exposures and outcome. Substance use status was classified into three categories: early-onset substance use (first used substance before age 18), late-onset substance use (first used substance after age 18), and never used. RESULTS The mean AAO of hypertension was 42.7 years. Age when first use of 10 substance use variables had significant correlations with AAO of hypertension (all p values < 0.001). Individuals with early-onset alcohol, cigars, smokeless tobacco, marijuana, hallucinogens, inhalants, cocaine, LSD, and methamphetamine use revealed significantly earlier onset of hypertension than those never used. Compared with never used substances, the Cox regression model showed that early-onset alcohol, smokeless tobacco, marijuana, inhalants, and methamphetamine use had an increased risk of AAO of hypertension [hazard ratio (HR) (95%CI) = 1.22 (1.13, 1.31), 1.36 (1.24, 1.49), 1.85 (1.75, 1.95), 1.41 (1.30, 1.52), and 1.27 (1.07,1.50), respectively]. CONCLUSION These findings suggest that intervention strategies or programs focusing on preventing early-onset substance use before age 18 may delay the onset of adult hypertension.
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Affiliation(s)
- Kesheng Wang
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA.
| | - Saima Shafique
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA
- Office of Research and Scholarly Activities, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA
| | - Nianyang Wang
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, 20742, USA
| | - Suzy Mascaro Walter
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA
| | - Xin Xie
- Department of Economics and Finance, College of Business and Technology, East Tennessee State University, Johnson City, TN, 37614, USA
| | - Ubolrat Piamjariyakul
- Office of Research and Scholarly Activities, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA
| | - Erin L Winstanley
- Department of Behavioral Medicine and Psychiatry, School of Medicine, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26506, USA
- Department of Neuroscience, West Virginia University, Morgantown, WV, 26506, USA
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Li C, Wei Q, Hou Y, Lin J, Ou R, Zhang L, Jiang Q, Xiao Y, Liu K, Chen X, Yang T, Song W, Zhao B, Wu Y, Shang H. Genome-wide analyses identify NEAT1 as genetic modifier of age at onset of amyotrophic lateral sclerosis. Mol Neurodegener 2023; 18:77. [PMID: 37872557 PMCID: PMC10594666 DOI: 10.1186/s13024-023-00669-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 10/16/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Patients with amyotrophic lateral sclerosis (ALS) demonstrate great heterogeneity in the age at onset (AAO), which is closely related to the course of disease. However, most genetic studies focused on the risk of ALS, while the genetic background underlying AAO of ALS is still unknown. METHODS To identify genetic determinants influencing AAO of ALS, we performed genome-wide association analysis using a Cox proportional hazards model in 2,841 patients with ALS (Ndiscovery = 2,272, Nreplication = 569) in the Chinese population. We further conducted colocalization analysis using public cis-eQTL dataset, and Mendelian randomization analysis to identify risk factors for AAO of ALS. Finally, functional experiments including dual-luciferase reporter assay and RT-qPCR were performed to explore the regulatory effect of the target variant. RESULTS The total heritability of AAO of ALS was ~ 0.24. One novel locus rs10128627 (FRMD8) was significantly associated with earlier AAO by ~ 3.15 years (P = 1.54E-08, beta = 0.31, SE = 0.05). This locus was cis-eQTL of NEAT1 in multiple brain tissues and blood. Colocalization analysis detected association signals at this locus between AAO of ALS and expression of NEAT1. Furthermore, functional exploration supported the variant rs10128627 was associated with upregulated expression of NEAT1 in cell models and patients with ALS. Causal inference suggested higher total cholesterol, low-density lipoprotein, and eosinophil were nominally associated with earlier AAO of ALS, while monocyte might delay the AAO. CONCLUSIONS Collective evidence from genetic, bioinformatic, and functional results suggested NEAT1 as a key player in the disease progression of ALS. These findings improve the current understanding of the genetic role in AAO of ALS, and provide a novel target for further research on the pathogenesis and therapeutic options to delay the disease onset.
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Affiliation(s)
- Chunyu Li
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Qianqian Wei
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Yanbing Hou
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Junyu Lin
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Ruwei Ou
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Lingyu Zhang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Qirui Jiang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Yi Xiao
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Kuncheng Liu
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Xueping Chen
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - TianMi Yang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Wei Song
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Bi Zhao
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Ying Wu
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China
| | - Huifang Shang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, National Clinical Research Center for Geriatric, Sichuan University, Chengdu, China.
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Gabbert C, Blöbaum L, Lüth T, König IR, Caliebe A, Koch S, Björn-Hergen L, Klein C, Trinh J. The combined effect of lifestyle factors and polygenic scores on age at onset in Parkinson's disease. medRxiv 2023:2023.08.25.23294466. [PMID: 37662355 PMCID: PMC10473779 DOI: 10.1101/2023.08.25.23294466] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Objective To investigate the association between a Parkinson's disease (PD)-specific polygenic score (PGS) and protective lifestyle factors on age at onset (AAO) in PD. Methods We included data from 4375 patients with idiopathic PD, 167 patients with GBA1-PD, and 3091 healthy controls of European ancestry from AMP-PD, PPMI, and Fox Insight cohorts. The PGS was calculated based on a previously proposed composition of 1805 variants. The association between PGS and lifestyle factors (i.e., coffee, tobacco, and aspirin) on AAO was assessed with linear and Cox proportional hazards models. Results The PGS showed a negative association with AAO (β=-1.07, p=6×10-7). The use of one, two, or three of the protective lifestyle factors showed a reduction in the hazard ratio by 21% (p=0.0001), 45% (p<2×10-16), and 55% (p<2×10-16), respectively, compared to no use. An additive effect of aspirin (β=7.61, p=8×10-7) and PGS (β=-1.63, p=0.0112) was found for AAO without an interaction (p=0.9789) in the linear regressions, and similar effects were seen for tobacco. Aspirin is shown to be a better predictor of AAO (R2=0.1740) compared to coffee and tobacco use (R2=0.0243, R2=0.0295) or the PGS (R2=0.0141). In contrast, no association between aspirin and AAO was found in GBA1-PD (p>0.05). Interpretation In our cohort, coffee, tobacco, aspirin, and PGS are independent predictors of PD AAO. Additionally, lifestyle factors seem to have a greater influence on AAO than common genetic risk variants with aspirin presenting the largest effect. External validation of our findings is needed.
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Affiliation(s)
- Carolin Gabbert
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Leonie Blöbaum
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Theresa Lüth
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Inke R. König
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
| | - Amke Caliebe
- Institute of Medical Informatics and Statistics, Kiel University, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Sebastian Koch
- Institute of Medical Informatics and Statistics, Kiel University, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Laabs Björn-Hergen
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Joanne Trinh
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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Brancati GE, Nunes A, Scott K, O'Donovan C, Cervantes P, Grof P, Alda M. Differential characteristics of bipolar I and II disorders: a retrospective, cross-sectional evaluation of clinical features, illness course, and response to treatment. Int J Bipolar Disord 2023; 11:25. [PMID: 37452256 PMCID: PMC10349025 DOI: 10.1186/s40345-023-00304-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The distinction between bipolar I and bipolar II disorder and its treatment implications have been a matter of ongoing debate. The aim of this study was to examine differences between patients with bipolar I and II disorders with particular emphasis on the early phases of the disorders. METHODS 808 subjects diagnosed with bipolar I (N = 587) or bipolar II disorder (N = 221) according to DSM-IV criteria were recruited between April 1994 and March 2022 from tertiary-level mood disorder clinics. Sociodemographic and clinical variables concerning psychiatric and medical comorbidities, family history, illness course, suicidal behavior, and response to treatment were compared between the bipolar disorder types. RESULTS Bipolar II disorder patients were more frequently women, older, married or widowed. Bipolar II disorder was associated with later "bipolar" presentation, higher age at first (hypo)mania and treatment, less frequent referral after a single episode, and more episodes before lithium treatment. A higher proportion of first-degree relatives of bipolar II patients were affected by major depression and anxiety disorders. The course of bipolar II disorder was typically characterized by depressive onset, early depressive episodes, multiple depressive recurrences, and depressive predominant polarity; less often by (hypo)mania or (hypo)mania-depression cycles at onset or during the early course. The lifetime clinical course was more frequently rated as chronic fluctuating than episodic. More patients with bipolar II disorder had a history of rapid cycling and/or high number of episodes. Mood stabilizers and antipsychotics were prescribed less frequently during the early course of bipolar II disorder, while antidepressants were more common. We found no differences in global functioning, lifetime suicide attempts, family history of suicide, age at onset of mood disorders and depressive episodes, and lithium response. CONCLUSIONS Differences between bipolar I and II disorders are not limited to the severity of (hypo)manic syndromes but include patterns of clinical course and family history. Caution in the use of potentially mood-destabilizing agents is warranted during the early course of bipolar II disorder.
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Affiliation(s)
- Giulio Emilio Brancati
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Abraham Nunes
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building (room 3088), Halifax, NS, B3H 2E2, Canada
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Katie Scott
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building (room 3088), Halifax, NS, B3H 2E2, Canada
| | - Claire O'Donovan
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building (room 3088), Halifax, NS, B3H 2E2, Canada
| | - Pablo Cervantes
- Department of Psychiatry, McGill University Health Centre, Montreal, QC, Canada
| | - Paul Grof
- Mood Disorders Center of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Martin Alda
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building (room 3088), Halifax, NS, B3H 2E2, Canada.
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Wang XM, Zhong SP, Li GF, Zhuge FY. Diabetes duration or age at onset and mortality in insulin-dependent diabetics: a systematic review and meta-analysis. Diabetol Metab Syndr 2023; 15:147. [PMID: 37393334 DOI: 10.1186/s13098-023-01113-x] [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: 05/27/2023] [Accepted: 06/15/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND This meta-analysis was conducted given the contradictory findings from studies on the influence of diabetes duration or age at onset on mortality in patients with insulin-dependent diabetes mellitus (IDDM). METHODS Electronic databases (PubMed, Embase, Cochrane, Web of Knowledge, Scopus, and CINHAL) were comprehensively searched to identify relevant studies until October 31, 2022. All of the selected articles contained statistics on hazard ratios, relative risks (RRs), or odds ratios, or data for estimating the association between diabetes duration or age at onset and total mortality in IDDM patients. Regardless the heterogeneity assessed by the I2 statistic, pooled RRs and 95% confidence intervals (CI) for total mortality were acquired via random effect meta-analysis with inverse variance weighting. RESULTS This meta-analysis finally included 19 studies involving 122, 842 individuals. Both age at onset and diabetes duration were positively associated with an increased mortality rate in IDDM patients. Specifically, the pooled RRs for age at onset and diabetes duration were 1.89 (95%CI 1.43-2.50) and 1.89 (95%CI 1.16-3.09) respectively. Subgroup analyses revealed that only prepubertal onset was associated with a greater survival advantage than pubertal or postpubertal onset. CONCLUSIONS The findings of this meta-analysis and systematic review suggest that a later age at onset or longer diabetes duration is associated with increased risk of total mortality in IDDM patients. However, this conclusion shall be interpreted with caution due to the possibility of residual confounding and be confirmed in the future by well-designed studies.
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Affiliation(s)
- Xing-Mu Wang
- Clinical Laboratory Center, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, Zhejiang, People's Republic of China
| | - Shu-Ping Zhong
- Department of Hospital Management, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, Zhejiang, People's Republic of China
| | - Gang-Feng Li
- Clinical Laboratory Center, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, Zhejiang, People's Republic of China
| | - Fu-Yuan Zhuge
- Department of Endocrine and Metabolism, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Yuecheng District, No.568, Zhongxing North Road, Shaoxing, Zhejiang, People's Republic of China.
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Puche-Larrubia MÁ, Ladehesa-Pineda L, López-Montilla MD, Barbarroja N, Escudero-Contreras A, Vazquez-Mellado J, Collantes-Estévez E, López-Medina C. Differences between early vs. late-onset of psoriatic arthritis: Data from the RESPONDIA and REGISPONSER registries. Joint Bone Spine 2023; 90:105563. [PMID: 36934781 DOI: 10.1016/j.jbspin.2023.105563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/01/2023] [Accepted: 02/15/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVES The objective was to evaluate the association between the age at onset of psoriatic arthritis (PsA) symptoms with the characteristics and burden of the disease. METHODS This was an observational and cross-sectional study that included a subgroup of 231 patients with PsA with < 10 years of disease duration from the REGISPONSER and RESPONDIA registries. Patients were divided into two groups according to the age of PsA symptom onset (early onset: ≤ 40-years-old and late onset: ≥ 60-years-old). The characteristics and burden of the disease were compared between the two groups, and multivariate logistic regression was performed to determine the factors independently associated with late-onset PsA. RESULTS Patients from the early-onset group showed a significantly lower prevalence of males [94 (62.3%) vs. 38 (86.4%)] and a higher prevalence of enthesitis [44 (24.6%) vs. 5 (9.8%)] and sacroiliitis [30 (16.8%) vs. 4 (7.7%)]. Additionally, the early-onset group showed lower scores on the BASFI [2.2 (2.2) vs. 3.3 (2.5)] and minor structural damage (BASRI) in both the spine [1.6 (2) vs. 2.9 (3)] and whole axial skeleton (total BASRI) [1.9 (2.4) vs. 3.4 (3.4)]. In contrast, no statistically significant differences were found between the groups in disease activity evaluated by the BASDAI and ASDAS. Logistic regression analysis showed that late-onset PsA was independently associated with being male (OR 4.4, 95% CI: 1.3, 16.3), greater structural damage (total BASRI) (OR 3.3, 95% CI: 1.3, 8.1), a higher frequency of arthritis in the upper limbs (OR 2.8, 95% CI: 1, 7.7), and greater loss of function (BASFI) (OR 1.3, 95% CI: 1, 1.6). CONCLUSIONS Patients with late-onset PsA showed different clinical characteristics and greater disease severity than those with early-onset PsA.
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Affiliation(s)
- María Ángeles Puche-Larrubia
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain; GC05 group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.
| | - Lourdes Ladehesa-Pineda
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain; GC05 group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain; Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - María Dolores López-Montilla
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain; GC05 group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain; Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Nuria Barbarroja
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain; GC05 group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain; Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain; GC05 group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain; Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | | | - Eduardo Collantes-Estévez
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain; GC05 group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain; Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Clementina López-Medina
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain; GC05 group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain; Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
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Erro R, Monfrini E, Di Fonzo A. Early-onset inherited dystonias versus late-onset idiopathic dystonias: Same or different biological mechanisms? Int Rev Neurobiol 2023; 169:329-346. [PMID: 37482397 DOI: 10.1016/bs.irn.2023.05.002] [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] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Dystonia syndromes encompass a heterogeneous group of movement disorders which might be differentiated by several clinical-historical features. Among the latter, age-at-onset is probably the most important in predicting the likelihood both for the symptoms to spread from focal to generalized and for a genetic cause to be found. Accordingly, dystonia syndromes are generally stratified into early-onset and late-onset forms, the former having a greater likelihood of being monogenic disorders and the latter to be possibly multifactorial diseases, despite being currently labeled as idiopathic. Nonetheless, there are several similarities between these two groups of dystonia, including shared pathophysiological and biological mechanisms. Moreover, there is also initial evidence of age-related modifiers of early-onset dystonia syndromes and of critical periods of vulnerability of the sensorimotor network, during which a combination of genetic and non-genetic insults is more likely to produce symptoms. Based on these lines of evidence, we reappraise the double-hit hypothesis of dystonia, which would accommodate both similarities and differences between early-onset and late-onset dystonia in a single framework.
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Affiliation(s)
- Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy.
| | - Edoardo Monfrini
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy; Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessio Di Fonzo
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
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11
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Wang Y, Han X, Li J, Zhang L, Liu Y, Jin R, Chen L, Chu X. Associations between the compositional patterns of blood volatile organic compounds and chronic respiratory diseases and ages at onset in NHANES 2003-2012. Chemosphere 2023; 327:138425. [PMID: 36931402 DOI: 10.1016/j.chemosphere.2023.138425] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/27/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND and Purpose Volatile organic compounds (VOCs) pose a serious respiratory hazard. This study evaluated the relationship between the compositional patterns of blood VOCs and the risk and age at onset of chronic respiratory diseases (CRDs), including asthma, emphysema and chronic bronchitis, with the objective of preventing or delaying CRDs. METHODS Participants from five cycles of the NHANES survey were included. Blood VOCs were clustered using k-means clustering. Differences in VOCs and age at onset between multiple groups were compared with the Kruskal‒Wallis test. Logistic regression and a generalized linear model were applied to examine the associations between different compositional patterns of blood VOCs and risk and age at onset of CRDs. RESULTS 12,386 participants were enrolled in this study. Three VOC compositional patterns were identified after clustering nine species of blood VOCs. The concentration of VOCs in pattern 2 was relatively low and stable. The concentrations of benzene, ethylbenzene, o-xylene, styrene, toluene and m-p-xylene in pattern 3 and the concentrations of 1,4-dichlorobenzene and MTBE in pattern 1 were significantly higher than those in pattern 2. After adjustment for covariates, the participants with VOC pattern 3 had an increased risk of asthma (OR = 1.23, 95% CI: 1.02, 1.49), emphysema (OR = 3.37, 95% CI: 2.24, 5.06) and chronic bronchitis (OR = 1.79, 95% CI: 1.30, 2.45). Meanwhile, VOC pattern 3 was negatively correlated with the age at onset of asthma (β = -5.61, 95% CI: 9.69, -1.52) and chronic bronchitis (β = -9.17, 95% CI: 13.96, -4.39). VOC pattern 1 was not associated with either risk or age at onset of the three CRDs after adjustment. CONCLUSIONS Changing the compositional pattern of blood VOCs by reducing certain species of VOCs may be a new strategy to lengthen the ages at onset of CRDs and effectively prevent them.
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Affiliation(s)
- Yuanyuan Wang
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, 150081, China
| | - Xinhao Han
- Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, Harbin 150081, China
| | - Jingkun Li
- Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, Harbin 150081, China
| | - Liuchao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, Harbin 150081, China
| | - Yu Liu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, 150081, China
| | - Ruifang Jin
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, 150081, China
| | - Liang Chen
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, 150081, China
| | - Xia Chu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, 150081, China; Heilongjiang Academy of Medical Sciences, Harbin, 150081, China.
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12
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Gheita TA, Raafat HA, El-Bakry SA, Elsaman A, El-Saadany HM, Hammam N, El-Gazzar II, Samy N, Elsaid NY, Al-Adle SS, Tharwat S, Ibrahim AM, Fawzy SM, Eesa NN, Shereef RE, Ismail F, Elazeem MIA, Abdelaleem EA, El-Bahnasawy A, Selim ZI, Gamal NM, Nassr M, Nasef SI, Moshrif AH, Elwan S, Abdel-Fattah YH, Amer MA, Mosad D, Mohamed EF, El-Essawi DF, Taha H, Salem MN, Fawzy RM, Ibrahim ME, Khalifa A, Abaza NM, Abdalla AM, El-Najjar AR, Azab NA, Fathi HM, El-Hadidi K, El-Hadidi T. Rheumatoid arthritis study of the Egyptian College of Rheumatology (ECR): nationwide presentation and worldwide stance. Rheumatol Int 2023; 43:667-676. [PMID: 36617362 PMCID: PMC9995404 DOI: 10.1007/s00296-022-05258-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 09/16/2022] [Accepted: 12/04/2022] [Indexed: 01/09/2023]
Abstract
To depict the spectrum of rheumatoid arthritis (RA) in Egypt in relation to other universal studies to provide broad-based characteristics to this particular population. This work included 10,364 adult RA patients from 26 specialized Egyptian rheumatology centers representing 22 major cities all over the country. The demographic and clinical features as well as therapeutic data were assessed. The mean age of the patients was 44.8 ± 11.7 years, disease duration 6.4 ± 6 years, and age at onset 38.4 ± 11.6 years; 209 (2%) were juvenile-onset. They were 8750 females and 1614 males (F:M 5.4:1). 8% were diabetic and 11.5% hypertensive. Their disease activity score (DAS28) was 4.4 ± 1.4 and health assessment questionnaire (HAQ) 0.95 ± 0.64. The rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) were positive in 73.7% and 66.7% respectively. Methotrexate was the most used treatment (78%) followed by hydroxychloroquine (73.7%) and steroids (71.3%). Biologic therapy was received by 11.6% with a significantly higher frequency by males vs females (15.7% vs 10.9%, p = 0.001). The least age at onset, F:M, RF and anti-CCP positivity were present in Upper Egypt (p < 0.0001), while the highest DAS28 was reported in Canal cities and Sinai (p < 0.0001). The HAQ was significantly increased in Upper Egypt with the least disability in Canal cities and Sinai (p = 0.001). Biologic therapy intake was higher in Lower Egypt followed by the Capital (p < 0.0001). The spectrum of RA phenotype in Egypt is variable across the country with an increasing shift in the F:M ratio. The age at onset was lower than in other countries.
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Affiliation(s)
- Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Hala A Raafat
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samah A El-Bakry
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Ahmed Elsaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hanan M El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Iman I El-Gazzar
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nermeen Samy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Nora Y Elsaid
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Suzan S Al-Adle
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samar Tharwat
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Amira M Ibrahim
- Rheumatology Department, Faculty of Medicine, Kafr El-Skeikh University, Kafr El-Shaikh, Egypt
| | - Samar M Fawzy
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nahla N Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rawhya El Shereef
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Faten Ismail
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mervat I Abd Elazeem
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Enas A Abdelaleem
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Amany El-Bahnasawy
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Zahraa I Selim
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Nada M Gamal
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Maha Nassr
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Samah I Nasef
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Abdel Hafeez Moshrif
- Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Shereen Elwan
- Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Egypt
| | - Yousra H Abdel-Fattah
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Marwa A Amer
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Doaa Mosad
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt
| | - Dina F El-Essawi
- Internal Medicine Department, Rheumatology Unit (NCRRT), Atomic Energy Authority (AEA), Cairo, Egypt
| | - Hanan Taha
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed N Salem
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Rasha M Fawzy
- Rheumatology Department, Faculty of Medicine, Benha University, Kalyoubia, Egypt
| | - Maha E Ibrahim
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Asmaa Khalifa
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Nouran M Abaza
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed M Abdalla
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Amany R El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Noha A Azab
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Khaled El-Hadidi
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tahsin El-Hadidi
- Rheumatology Department, Military Academy, Agouza Rheumatology Center, Giza, Egypt
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Sullivan AW, Johnson MK, Boes AD, Tranel D. Implications of age at lesion onset for neuropsychological outcomes: A systematic review focusing on focal brain lesions. Cortex 2023; 163:92-122. [PMID: 37086580 DOI: 10.1016/j.cortex.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 02/10/2023] [Accepted: 03/19/2023] [Indexed: 04/24/2023]
Abstract
Theories of the relation between age at lesion onset and outcomes posit different views of the young brain: resilient and plastic (i.e., the so-called "Kennard Principle"), or vulnerable (i.e., the Early Vulnerability Hypothesis). There is support for both perspectives in previous research and questions about the "best" or "worst" times to sustain brain injury remain. Here, we present a systematic review investigating the influence of age at focal brain lesion onset on cognitive functioning. This systematic review identifies and qualitatively synthesizes empirical studies from 1985 to 2021 that investigated age at lesion onset as a variable of interest associated with neuropsychological outcomes. A total of 45 studies were identified from PubMed, PsycINFO, and CINAHL databases. Almost all studies indicated that brain injury earlier in the developmental period predicts worse cognitive outcomes when compared to onset either later in the developmental period or in adulthood. More specifically, the overwhelming majority of studies support an "earlier is worse" model for domains of intellect, processing speed, attention and working memory, visuospatial and perceptual skills, and learning and memory. Relatively more variability in outcomes exists for domains of language and executive functioning. Outcomes for all domains are influenced by various other age and injury variables (e.g., lesion size, lesion laterality, chronicity, a history of epilepsy). Continued interdisciplinary understanding and communication about the influence of age at lesion onset on neuropsychological outcomes will aid in promoting the best possible outcomes for patients.
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Affiliation(s)
- Alyssa W Sullivan
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA.
| | - Marcie K Johnson
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA.
| | - Aaron D Boes
- Department of Neurology, University of Iowa, Iowa City, IA, USA; Department of Psychiatry, University of Iowa, Iowa City, IA, USA; Department of Pediatrics, University of Iowa, Iowa City, IA, USA.
| | - Daniel Tranel
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA; Department of Neurology, University of Iowa, Iowa City, IA, USA; Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA.
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14
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Zhou L, Huang B, Wang J, Chau SW, Chan JW, Zhang J, Yu MW, Tsang JC, Li SX, Mok VC, Wing YK, Liu Y. Early- and late-onset of isolated rapid eye movement sleep behavior disorder: A retrospective cohort study. Sleep Med 2023; 105:1-8. [PMID: 36934616 DOI: 10.1016/j.sleep.2023.03.007] [Citation(s) in RCA: 2] [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: 12/13/2022] [Revised: 02/12/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE Age at onset of neurodegenerative disease has significant implications in differentiating disease profiles. We aimed to determine whether age at onset could identify clinical and neurodegenerative profiles in patients with isolated/idiopathic rapid eye movement sleep behavior disorder (iRBD) - a prodromal stage of α-synucleinopathies. METHODS In this retrospective cohort study, the time of the first episode of dream-enactment behaviors that the patient/bed-partners recalled at the time of the patient's first visit to sleep clinic was collected. The distribution of age at onset was examined and patients were dichotomized into early- and late-onset groups based on the intersection point of underlying two Gaussian distributions of onset age. RESULTS A total of 241 patients were included. The intersection of underlying two Gaussian models of onset age was 64.6 years, yielding 168 early- (median onset age: 58.0 years, range: 38.0-64.0) and 73 late-onset patients (median onset age: 70.0 years, range: 65.0-82.0). Among them, 154 of early- and 68 late-onset patients were followed-up. Late-onset patients had milder RBD symptoms, but worse sleep, cognition, olfactory and motor functions, and a higher risk of phenoconversion (adjusted hazard ratio (aHR) = 2.2, 95% confidence interval (CI) = 1.2-3.9), especially to probable dementia with Lewy bodies (DLB) (aHR = 8.9, 95% CI = 3.0-26.2), than early-onset patients. CONCLUSIONS Late-onset iRBD was associated with a higher level of neurodegenerative markers and a quicker phenoconversion, especially to probable DLB. Age at onset of iRBD could help identify clinical features and predict prognosis of iRBD.
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Affiliation(s)
- Li Zhou
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Bei Huang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jing Wang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Steven Wh Chau
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joey Wy Chan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jihui Zhang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Mandy Wm Yu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jessie Cc Tsang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Vincent Ct Mok
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Yun Kwok Wing
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yaping Liu
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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15
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Corponi F, Lefrere A, Leboyer M, Bellivier F, Godin O, Loftus J, Courtet P, Dubertret C, Haffen E, Llorca PM, Roux P, Polosan M, Schwan R, Samalin L, Olié E, Etain B, Seriès P, Belzeaux R. Definition of early age at onset in bipolar disorder according to distinctive neurodevelopmental pathways: insights from the FACE-BD study. Psychol Med 2023; 53:1-9. [PMID: 36852971 DOI: 10.1017/s003329172300020x] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Converging evidence suggests that a subgroup of bipolar disorder (BD) with an early age at onset (AAO) may develop from aberrant neurodevelopment. However, the definition of early AAO remains unprecise. We thus tested which age cut-off for early AAO best corresponds to distinguishable neurodevelopmental pathways. METHODS We analyzed data from the FondaMental Advanced Center of Expertise-Bipolar Disorder cohort, a naturalistic sample of 4421 patients. First, a supervised learning framework was applied in binary classification experiments using neurodevelopmental history to predict early AAO, defined either with Gaussian mixture models (GMM) clustering or with each of the different cut-offs in the range 14 to 25 years. Second, an unsupervised learning approach was used to find clusters based on neurodevelopmental factors and to examine the overlap between such data-driven groups and definitions of early AAO used for supervised learning. RESULTS A young cut-off, i.e. 14 up to 16 years, induced higher separability [mean nested cross-validation test AUROC = 0.7327 (± 0.0169) for ⩽16 years]. Predictive performance deteriorated increasing the cut-off or setting early AAO with GMM. Similarly, defining early AAO below 17 years was associated with a higher degree of overlap with data-driven clusters (Normalized Mutual Information = 0.41 for ⩽17 years) relatively to other definitions. CONCLUSIONS Early AAO best captures distinctive neurodevelopmental patterns when defined as ⩽17 years. GMM-based definition of early AAO falls short of mapping to highly distinguishable neurodevelopmental pathways. These results should be used to improve patients' stratification in future studies of BD pathophysiology and biomarkers.
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Affiliation(s)
- Filippo Corponi
- School of Informatics, University of Edinburgh, Edinburgh, UK
| | - Antoine Lefrere
- Assistance Publique Hôpitaux de Marseille, Pôle de Psychiatrie, Marseille, France
- Fondation FondaMental, Créteil, France
- Institut de neurosciences de la Timone UMR 7289, Aix-Marseille Université & CNRS, Marseille, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France
- Assistance publique des hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
- Translational NeuroPsychiatry Laboratory, Université Paris Est Créteil (UPEC), INSERM U955, IMRB, Paris, France
| | - Frank Bellivier
- Fondation FondaMental, Créteil, France
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
- Assistance publique des Hôpitaux de Paris, Groupe Hospitalo-universitaire AP-HP Nord, Hôpital Lariboisière, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Ophelia Godin
- Fondation FondaMental, Créteil, France
- Translational NeuroPsychiatry Laboratory, Université Paris Est Créteil (UPEC), INSERM U955, IMRB, Paris, France
| | - Josephine Loftus
- Fondation FondaMental, Créteil, France
- Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, France, Monaco
| | - Philippe Courtet
- Fondation FondaMental, Créteil, France
- IGF, Univ. Montpellier France, CNRS, INSERM, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France
- Assistance publique des hôpitaux de Paris, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
- Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Emmanuel Haffen
- Fondation FondaMental, Créteil, France
- Service de Psychiatrie, CIC-1431 INSERM, CHU de Besançon, France
- UR481 Neurosciences, UFC, Besançon, France
| | - Pierre Michel Llorca
- Fondation FondaMental, Créteil, France
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, UMR 6602 Institut Pascal (IP), Clermont-Ferrand, France
| | - Paul Roux
- Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d'adulte et d'addictologie, Le Chesnay, France
- DisAP-DevPsy-CESP, INSERM UMR1018, Université de Versailles Saint-Quentin-En-Yvelines, Université Paris-Saclay, Villejuif, France
| | - Mircea Polosan
- Fondation FondaMental, Créteil, France
- Grenoble Alpes University, Inserm U1216 Grenoble Institute of Neuroscience, CHU Grenoble Alpes, Grenoble, France
| | - Raymund Schwan
- Fondation FondaMental, Créteil, France
- Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
| | - Ludovic Samalin
- Fondation FondaMental, Créteil, France
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, UMR 6602 Institut Pascal (IP), Clermont-Ferrand, France
| | - Emilie Olié
- Fondation FondaMental, Créteil, France
- IGF, Univ. Montpellier France, CNRS, INSERM, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Bruno Etain
- Fondation FondaMental, Créteil, France
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
- Assistance publique des Hôpitaux de Paris, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Peggy Seriès
- School of Informatics, University of Edinburgh, Edinburgh, UK
| | - Raoul Belzeaux
- Pôle Universitaire de Psychiatrie, CHU de Montpellier, France
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Li DJ, Tsai SJ, Bai YM, Su TP, Chen TJ, Liang CS, Chen MH. Risks of major affective disorders following a diagnosis of premenstrual dysphoric disorder: A nationwide longitudinal study. Asian J Psychiatr 2023; 79:103355. [PMID: 36481566 DOI: 10.1016/j.ajp.2022.103355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/14/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022]
Abstract
Whether a history of premenstrual dysphoric disorder (PMDD) is associated with a subsequent risk of major affective disorders remains unclear. This study aimed to examine the risk of unipolar depression and bipolar disorder in women with PMDD compared with those without PMDD. This study used data from the Taiwan National Health Insurance Research Database. Women who were diagnosed with PMDD and had no history of any major affective disorder were included. The controls were women without PMDD matched for demographics and physical and psychiatric comorbidities. Cox regression was used to estimate the risk of unipolar depression and bipolar disorder. We included 8222 women with PMDD and 32,888 matched controls. After adjusting for potential confounders, we found that the women with PMDD were associated with a higher risk of unipolar depression [hazard ratio (HR) 2.58; 95 % confidence interval (CI), 2.23-2.98] and bipolar disorder (HR 2.50; 95 % CI 1.62-3.88) than the controls. The PMDD group had a younger age at the diagnosis of unipolar depression (37.11 vs 41.59 years) and bipolar disorder (35.59 vs 42.02 years, p = 0.002), and shorter duration between enrollment and onset of unipolar depression (2.97 vs 5.33 years, p < 0.001) and bipolar disorder (3.05 vs 5.57 years, p < 0.001). Our results showed a strong association between PMDD and major affective disorders. Healthcare workers should be aware of patients with PMDD and the risk of developing major affective mental disorders.
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17
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Pezzoli G, Cereda E, Amami P, Colosimo S, Barichella M, Sacilotto G, Zecchinelli A, Zini M, Ferri V, Bolliri C, Calandrella D, Bonelli MG, Cereda V, Reali E, Caronni S, Cassani E, Canesi M, del Sorbo F, Soliveri P, Zecca L, Klersy C, Cilia R, Isaias IU. Onset and mortality of Parkinson's disease in relation to type II diabetes. J Neurol 2023; 270:1564-1572. [PMID: 36436068 PMCID: PMC9971073 DOI: 10.1007/s00415-022-11496-y] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES There is growing evidence that Parkinson's disease and diabetes are partially related diseases; however, the association between the two, and the impact of specific treatments, are still unclear. We evaluated the effect of T2D and antidiabetic treatment on age at PD onset and on all-cause mortality. RESEARCH DESIGN AND METHODS The standardized rate of T2D was calculated for PD patients using the direct method and compared with subjects with essential tremor (ET) and the general Italian population. Age at onset and survival were also compared between patients without T2D (PD-noT2D), patients who developed T2D before PD onset (PD-preT2D) and patients who developed T2D after PD onset (PD-postT2D). RESULTS We designed a retrospective and prospective study. The T2D standardized ratio of PD (N = 8380) and ET (N = 1032) patients was 3.8% and 6.1%, respectively, while in the Italian general population, the overall prevalence was 5.3%. In PD-preT2D patients, on antidiabetic treatment, the onset of PD was associated with a + 6.2 year delay (p < 0.001) while no difference was observed in PD-postT2D. Occurrence of T2D before PD onset negatively affected prognosis (adjusted hazard ratio = 1.64 [95% CI 1.33-2.02]; p < 0.001), while no effect on survival was found in PD-postT2D subjects (hazard ratio = 0.86, [95% CI 0.53-1.39]; p = 0.54). CONCLUSIONS T2D, treated with any antidiabetic therapy before PD, is associated with a delay in its onset. Duration of diabetes increases mortality in PD-preT2D, but not in PD-postT2D. These findings prompt further studies on antidiabetic drugs as a potential disease-modifying therapy for PD.
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Affiliation(s)
- Gianni Pezzoli
- Parkinson Institute Milan, ASST-Pini-CTO, Via Bignami 1, Milan, Italy ,grid.479062.e0000 0004 6080 596XFondazione Grigioni per il Morbo di Parkinson, Milan, Italy
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy.
| | - Paolo Amami
- Parkinson Institute Milan, ASST-Pini-CTO, Via Bignami 1, Milan, Italy ,grid.479062.e0000 0004 6080 596XFondazione Grigioni per il Morbo di Parkinson, Milan, Italy
| | - Santo Colosimo
- grid.4708.b0000 0004 1757 2822University of Milan, Specialization School in Nutrition Science, Milan, Italy ,Clinical Nutrition Unit, ASST-Pini-CTO, Milan, Italy
| | | | - Giorgio Sacilotto
- Parkinson Institute Milan, ASST-Pini-CTO, Via Bignami 1, Milan, Italy
| | - Anna Zecchinelli
- Parkinson Institute Milan, ASST-Pini-CTO, Via Bignami 1, Milan, Italy
| | - Michela Zini
- Parkinson Institute Milan, ASST-Pini-CTO, Via Bignami 1, Milan, Italy
| | - Valentina Ferri
- grid.479062.e0000 0004 6080 596XFondazione Grigioni per il Morbo di Parkinson, Milan, Italy ,Clinical Nutrition Unit, ASST-Pini-CTO, Milan, Italy
| | - Carlotta Bolliri
- grid.479062.e0000 0004 6080 596XFondazione Grigioni per il Morbo di Parkinson, Milan, Italy ,Clinical Nutrition Unit, ASST-Pini-CTO, Milan, Italy
| | - Daniela Calandrella
- Parkinson Institute Milan, ASST-Pini-CTO, Via Bignami 1, Milan, Italy ,grid.479062.e0000 0004 6080 596XFondazione Grigioni per il Morbo di Parkinson, Milan, Italy
| | - Maria Grazia Bonelli
- grid.5326.20000 0001 1940 4177Programming and Grant Offices (UPGO), Italian National Research Council (CNR), Rome, Italy
| | - Viviana Cereda
- Parkinson Institute Milan, ASST-Pini-CTO, Via Bignami 1, Milan, Italy ,grid.479062.e0000 0004 6080 596XFondazione Grigioni per il Morbo di Parkinson, Milan, Italy
| | - Elisa Reali
- Parkinson Institute Milan, ASST-Pini-CTO, Via Bignami 1, Milan, Italy ,grid.479062.e0000 0004 6080 596XFondazione Grigioni per il Morbo di Parkinson, Milan, Italy
| | - Serena Caronni
- grid.479062.e0000 0004 6080 596XFondazione Grigioni per il Morbo di Parkinson, Milan, Italy ,Clinical Nutrition Unit, ASST-Pini-CTO, Milan, Italy
| | - Erica Cassani
- grid.479062.e0000 0004 6080 596XFondazione Grigioni per il Morbo di Parkinson, Milan, Italy ,Clinical Nutrition Unit, ASST-Pini-CTO, Milan, Italy ,grid.18887.3e0000000417581884Dietetic and Clinical Nutrition Unit, ASST-Fatebenefratelli-Sacco, University Hospital, Milan, Italy
| | - Margherita Canesi
- Parkinson Institute Milan, ASST-Pini-CTO, Via Bignami 1, Milan, Italy ,Department of Parkinson’s Disease, Movement Disorders and Brain Injury Rehabilitation, “Moriggia-Pelascini” General Hospital, Como, Italy
| | | | - Paola Soliveri
- Parkinson Institute Milan, ASST-Pini-CTO, Via Bignami 1, Milan, Italy
| | - Luigi Zecca
- grid.5326.20000 0001 1940 4177Institute of Biomedical Technologies, National Research Council of Italy, Segrate, Milan Italy
| | - Catherine Klersy
- grid.419425.f0000 0004 1760 3027Unit of Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberto Cilia
- grid.417894.70000 0001 0707 5492Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Ioannis U. Isaias
- grid.8379.50000 0001 1958 8658Department of Neurology, University Hospital of Würzburg and Julius Maximilian University of Würzburg, Würzburg, Germany
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Turrin M, Rizzo M, Bonato M, Bazzan E, Cosio MG, Semenzato U, Saetta M, Baraldo S. Differences Between Early- and Late-Onset Asthma: Role of Comorbidities in Symptom Control. J Allergy Clin Immunol Pract 2022; 10:3196-3203. [PMID: 35970446 DOI: 10.1016/j.jaip.2022.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 07/14/2022] [Accepted: 08/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Asthma can present in early childhood or de novo in adulthood. Our understanding of the burden of comorbidities in adult asthmatic patients stratified by age at onset is incomplete. OBJECTIVES To evaluate how different comorbidities may affect symptom control in two distinct groups of patients with early- and late-onset asthma (EOA and LOA, respectively) and to explore whether reported comorbidities are associated with lung function and inflammatory parameters. METHODS We conducted a cross-sectional study of 175 adult asthmatic patients (aged 57.5 ± 17.1 years) recruited at our university asthma clinic. We defined EOA as asthma onset less than 12 years, and LOA as onset greater than 40 years. The primary outcome was symptom control and main comorbidities evaluated were rhinitis, gastroesophageal reflux, obesity, cardiovascular conditions, and bronchiectasis. We used multivariable regression analysis to identify potential predictors of poor control in EOA and LOA. RESULTS Of 175 subjects, 77 had EOA (44%), 98 had LOA (56%), and comorbidities had a differential impact in the two groups. Rhinitis was more frequent in EOA (76 vs 53%; P = .02) and was associated with uncontrolled asthma (P < .001), reduced FEV1/FVC (P = .01), increased eosinophils (P = .003) and total IgE (P < .01). Conversely, in LOA, rhinitis was associated with more controlled asthma and higher FEV1/FVC (both P < .01). In EOA, only, IgE levels were directly related to blood eosinophils (r = 0.42; P <.001) and inversely to FEV1/FVC (r = -0.35; P = .002). Obesity was present in 20% of patients in both groups, but only in LOA was it associated with uncontrolled disease (P = .009), reduced FEV1/FVC (P = .009), and blood neutrophils (P = .03). In multivariable regression analysis, rhinitis in EOA and obesity in LOA were the risk factors most closely associated with poor control. Gastroesophageal reflux, cardiovascular comorbidities, and bronchiectasis did not affect control. CONCLUSIONS Early-onset persistent asthma and late-onset asthma are distinct phenotypes with different underlying inflammatory patterns and different comorbidities affecting symptom control.
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Affiliation(s)
- Martina Turrin
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova and Padova City Hospital, Padova, Italy
| | - Michele Rizzo
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova and Padova City Hospital, Padova, Italy
| | - Matteo Bonato
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova and Padova City Hospital, Padova, Italy
| | - Erica Bazzan
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova and Padova City Hospital, Padova, Italy
| | - Manuel G Cosio
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova and Padova City Hospital, Padova, Italy; Meakins-Christie Laboratories and Respiratory Division, McGill University, Montreal, Québec, Canada
| | - Umberto Semenzato
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova and Padova City Hospital, Padova, Italy
| | - Marina Saetta
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova and Padova City Hospital, Padova, Italy.
| | - Simonetta Baraldo
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova and Padova City Hospital, Padova, Italy
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Prasad S, Rakesh K, Kamble N, Holla VV, Mailankody P, Lenka A, Naduthota RM, Stezin A, Mahale R, Yadav R, Pal PK. Early onset of Parkinson's disease in India: Complicating the conundrum. Parkinsonism Relat Disord 2022; 105:111-113. [PMID: 36410307 DOI: 10.1016/j.parkreldis.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Shweta Prasad
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India; Department of Clinical Neurosciences, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India
| | - Kempaiah Rakesh
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India
| | - Vikram V Holla
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India
| | - Pooja Mailankody
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India
| | - Abhishek Lenka
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India; Department of Clinical Neurosciences, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India
| | - Rajini M Naduthota
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India
| | - Albert Stezin
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India; Department of Clinical Neurosciences, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India
| | - Rohan Mahale
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, Karnataka, India.
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20
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Huang J, Kockum I, Stridh P. Trends in the environmental risks associated with earlier onset in multiple sclerosis. Mult Scler Relat Disord 2022; 68:104250. [PMID: 36544313 DOI: 10.1016/j.msard.2022.104250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/27/2022] [Accepted: 10/16/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Several environmental and lifestyle factors relating to sunlight/vitamin D, body mass index (BMI), and smoking are associated with the risk of developing multiple sclerosis (MS). However, their relation to disease progression, particularly age at symptomatic onset, remains inconsistent, which may be the result of significant changes in human-environment interactions over the last century. This study investigates historical trends in the association between common MS environmental risk factors and age at disease onset. METHODS Using a narrative approach, we evaluated the current literature for published studies assessing the association between vitamin-D, BMI, and tobacco smoking exposures with the risk of early/pediatric-onset MS and direct correlations with age at MS onset using MEDLINE, EMBASE, and Web of Science. Measures were plotted by the average calendar year of disease onset for each cohort to examine trends over time. In total, 25, 9, and 11 articles were identified for vitamin D, BMI, and smoking-related exposures, respectively. RESULTS Higher sun exposure habits and residential solar radiation were associated with older age at onset. On the contrary, two studies observed a negative correlation between age at onset and serum 25-hydroxyvitamin D (25(OH)D) levels. Higher adolescent BMI was generally associated with younger age at onset, although genetic susceptibility for childhood obesity was not significantly associated. Tobacco smoking was associated with later disease onset, despite being a risk factor for MS. Association with age at onset was inflated for more recent studies relating to smoking, while often weaker for serum vitamin D and BMI. CONCLUSION Current findings indicate a likely association between age at onset and environmental risk factors, such as sun exposure, adolescent BMI, and tobacco smoking, in certain populations. However, findings are often inconsistent and assessment of the relationships and potential changes over time require further investigation.
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21
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Romero-Pinel L, Bau L, Matas E, León I, Muñoz-Vendrell A, Arroyo P, Masuet-Aumatell C, Martínez-Yélamos A, Martínez-Yélamos S. The age at onset of relapsing-remitting multiple sclerosis has increased over the last five decades. Mult Scler Relat Disord 2022; 68:104103. [PMID: 36029708 DOI: 10.1016/j.msard.2022.104103] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 03/02/2022] [Revised: 05/11/2022] [Accepted: 08/08/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patients with relapsing-remitting multiple sclerosis (RRMS) most commonly experience their first symptoms between 20 and 40 years of age. The objective of this study was to investigate how the age at which the first symptoms of RRMS occur has changed over the past decades. METHODS Patients who were followed up in our unit after an initial diagnosis of RRMS using the Poser or McDonald criteria and who experienced their first symptoms between January 1970 and December 2019 were included in the study. The cohort was divided into five groups according to the decade in which the first symptoms appeared. The age at disease onset was compared across decades. Changes in age were also determined after excluding patients with early-onset disease (<18 years of age) and those with late-onset disease (>50 years of age) to avoid bias. RESULTS The cohort included 1,622 patients with RRMS, 67.6% of whom were women. Among them, 5.9% and 4% had early-onset and late-onset disease, respectively. The mean age ± standard deviation at onset was 31.11 ± 9.82 years, with no differences between men and women. The mean ages at onset were 23.79 ± 10.19 years between 1970 and 1979, 27.86 ± 9.22 years between 1980 and 1989, 30.07 ± 9.32 years between 1990 and 1999, 32.12 ± 9.47 between 2000 and 2009, and 34.28 ± 9.83 years between 2010 and 2019. The ages at disease onset were progressively higher in the later decades; this trend was statistically significant (p < 0.001), with a Pearson linear correlation coefficient R of 0.264 and R2 of 0.070 (p < 0.001). The results were similar when analysing men and women separately. We conducted an analysis of 1,460 patients (mean age at onset: 31.10 ± 7.99 years), after excluding patients with early-onset and late-onset disease. In this specific subgroup, the mean ages at disease onset were 28.38 ± 8.17 years between 1970 and 1979, 29.22 ± 7.51 years between 1980 and 1989, 30.06 ± 8.02 years between 1990 and 1999, 31.46 ± 7.77 years between 2000 and 2009, and 33.37 ± 7.97 years between 2010 and 2019. The trend was also statistically significant (p < 0.001), with a Pearson linear correlation coefficient R of 0.193 and R2 of 0.037 (p < 0.001). CONCLUSION Our data showed that the age at RRMS onset has increased over the past decades.
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Affiliation(s)
- Lucía Romero-Pinel
- Multiple Sclerosis Unit, Department of Neurology. Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Laura Bau
- Multiple Sclerosis Unit, Department of Neurology. Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Elisabet Matas
- Multiple Sclerosis Unit, Department of Neurology. Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Isabel León
- Multiple Sclerosis Unit, Department of Neurology. Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Albert Muñoz-Vendrell
- Multiple Sclerosis Unit, Department of Neurology. Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Pablo Arroyo
- Multiple Sclerosis Unit, Department of Neurology. Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Masuet-Aumatell
- Department of Epidemiology and Preventive Medicine. Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Antonio Martínez-Yélamos
- Multiple Sclerosis Unit, Department of Neurology. Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Departament de Ciències Clíniques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Sergio Martínez-Yélamos
- Multiple Sclerosis Unit, Department of Neurology. Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Departament de Ciències Clíniques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
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22
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Baan EJ, de Roos EW, Engelkes M, de Ridder M, Pedersen L, Berencsi K, Prieto-Alhambra D, Lapi F, Van Dyke MK, Rijnbeek P, Brusselle GG, Verhamme KMC. Characterization of Asthma by Age of Onset: A Multi-Database Cohort Study. J Allergy Clin Immunol Pract 2022; 10:1825-1834.e8. [PMID: 35398554 DOI: 10.1016/j.jaip.2022.03.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Asthma can occur at any age but the differences in patient characteristics between childhood-, adult-, and late-onset asthma are not well understood. OBJECTIVE To investigate differences in patients' characteristics by age at asthma onset. METHODS From 5 European electronic databases, we created a cohort encompassing adult patients with doctor-diagnosed asthma in 2008 to 2013. Patients were categorized based on their age at asthma onset: childhood-onset (age at onset < 18 y), adult-onset (age at onset 18-40 y), and late-onset asthma (age at onset ≥ 40 y). Comorbidities were assessed at study entry. For each characteristic and comorbidity, odds ratios and age- and sex-adjusted odds ratios (ORadj) comparing asthma-onset categories were estimated per database and combined in a meta-analysis using a random effect model. RESULTS In total, 586,436 adult asthma patients were included, 81,691 had childhood-onset, 218,184 adult-onset, and 286,561 late-onset asthma. Overall, 7.3% had severe asthma. Subjects with adult-onset compared with childhood-asthma had higher risks for overweight/obesity (ORadj 1.4; 95% CI 1.1-1.8) and lower risks for atopic disorders (ORadj 0.8; 95% CI 0.7-0.95). Patients with late-onset compared with adult-onset asthma had higher risks for nasal polyposis (ORadj 1.8; 95% CI 1.2-2.6), overweight/obesity (ORadj 1.3; 95% CI 1.2-1.4), gastroesophageal reflux disease (ORadj 1.4; 95% CI 1.2-1.7), and diabetes (ORadj 2.3; 95% CI 1.8-2.9). A significant association between late-onset asthma and uncontrolled asthma was observed (ORadj 2.8; 95% CI 1.7-4.5). CONCLUSIONS This international study demonstrates clear differences in comorbidities between childhood-, adult-, and late-onset asthma phenotypes in adults. Furthermore, patients with late-onset asthma had more frequent uncontrolled asthma.
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Affiliation(s)
- Esmé J Baan
- Department of Medical Informatics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Emmely W de Roos
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Marjolein Engelkes
- Department of Medical Informatics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maria de Ridder
- Department of Medical Informatics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lars Pedersen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Klara Berencsi
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Musculoskeletal Pharmaco- and Device Epidemiology, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Dani Prieto-Alhambra
- Department of Medical Informatics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands; GREMPAL Research Group, Idiap Jordi Gol Primary Care Research Institute, CIBERFES ISCIII, Universitat Autonoma de Barcelona, Barcelona, Spain; Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Francesco Lapi
- Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Melissa K Van Dyke
- Epidemiology, Value Evidence and Outcomes, Global R&D, GSK, Collegeville, Pennsylvania, USA
| | - Peter Rijnbeek
- Department of Medical Informatics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Guy G Brusselle
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Respiratory Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Katia M C Verhamme
- Department of Medical Informatics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Bioanalysis, Ghent University, Ghent, Belgium.
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Benatti B, Girone N, Celebre L, Vismara M, Hollander E, Fineberg NA, Stein DJ, Nicolini H, Lanzagorta N, Marazziti D, Pallanti S, van Ameringen M, Lochner C, Karamustafalioglu O, Hranov L, Figee M, Drummond LM, Grant JE, Denys D, Fontenelle LF, Menchon JM, Zohar J, Rodriguez CI, Dell'Osso B. The role of gender in a large international OCD sample: A Report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) Network. Compr Psychiatry 2022; 116:152315. [PMID: 35483201 DOI: 10.1016/j.comppsych.2022.152315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/10/2021] [Revised: 03/08/2022] [Accepted: 04/09/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Obsessive-compulsive disorder (OCD) is characterized by a range of phenotypic expressions. Gender may be a relevant factor in mediating the disorder's heterogeneity. The aim of the present report was to explore a large multisite clinical sample of OCD patients, hypothesizing existing demographic, geographical and clinical differences between male and female patients with OCD. METHODS Socio-demographic and clinical variables of 491 adult OCD outpatients recruited in the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) network were investigated with a retrospective analysis on a previously gathered set of data from eleven countries worldwide. Patients were assessed through structured clinical interviews, the Yale- Brown Obsessive-Compulsive Scale (Y-BOCS), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Self-rating Depression Scale (SDS). RESULTS Among females, adult onset (>18 years old) was significantly over-represented (67% vs. 33%, p < 0.005), and females showed a significantly older age at illness onset compared with males (20.85 ± 10.76 vs. 17.71 ± 8.96 years, p < 0.005). Females also had a significantly lower education level than males (13.09 ± 4.02 vs. 13.98 ± 3.85 years; p < 0.05), a significantly higher rate of being married (50.8% vs. 33.5%; p < 0.001) and a higher rate of living with a partner (47.5% vs. 37.6%; p < 0.001) than males. Nonetheless, no significant gender differences emerged in terms of the severity of OCD symptoms nor in the severity of comorbid depressive symptoms. No predictive effect of gender was found for Y-BOCS, MADRS and SDS severity. DISCUSSION/CONCLUSIONS Our findings showed significant differences between genders in OCD. A sexually dimorphic pattern of genetic susceptibility may have a crucial role to OCD clinical heterogeneity, potentially requiring different specific therapeutic strategies. Further research is warranted to validate gender as an important determinant of the heterogeneity in OCD.
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Affiliation(s)
- Beatrice Benatti
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; CRC 'Aldo Ravelli' for Neuro-technology and Experimental Brain Therapeutics, University of Milan, Milan, Italy.
| | - Nicolaja Girone
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
| | - Laura Celebre
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
| | - Matteo Vismara
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; CRC 'Aldo Ravelli' for Neuro-technology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - Eric Hollander
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York, NY, USA
| | - Naomi A Fineberg
- University of Hertfordshire, School of Life and Medical Sciences and Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, United Kingdom
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Humberto Nicolini
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico; Carracci Medical Group, Mexico City, Mexico
| | | | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Stefano Pallanti
- Department of Psychiatry, University of Florence, Institute of Neurosciences, Florence, Italy
| | - Michael van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Christine Lochner
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | | | - Luchezar Hranov
- University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sveti Naum, Sofia, Bulgaria
| | - Martin Figee
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Lynne M Drummond
- National Services for OCD/BDD, St. George's, National Health Service Trust, London, United Kingdom
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, IL, USA
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Leonardo F Fontenelle
- Turner Institute for Brain and Mental Health, Monash University, VIC, Australia; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Jose M Menchon
- Psychiatry Unit at the Hospital Universitari de Bellvitge-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - Joseph Zohar
- Post-Trauma Center, Research Foundation by the Sheba Medical Center, Tel Aviv University, Sackler School of Medicine, Israel
| | - Carolyn I Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Bernardo Dell'Osso
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; CRC 'Aldo Ravelli' for Neuro-technology and Experimental Brain Therapeutics, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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Iannuzzelli K, Shi R, Carter R, Huynh R, Morgan O, Kuo SH, Bang J, Mills KA, Baranano K, Zee DS, Moukheiber E, Roda R, Butala A, Marvel C, Joyce M, Li X, Wang J, Rosenthal LS. The association between educational attainment and SCA 3 age of onset and disease course. Parkinsonism Relat Disord 2022; 98:99-102. [PMID: 35635856 PMCID: PMC10498785 DOI: 10.1016/j.parkreldis.2022.02.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 02/15/2022] [Accepted: 02/27/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The number of trinucleotide CAG repeats is inversely correlated with the age at onset (AAO) of motor symptoms in individuals with Spinocerebellar Ataxia type 3 (SCA 3) and may be responsible for 50%-60% of the variability in AAO. Drawing from a social determinants of health model, we sought to determine if educational attainment further contributes to the AAO and motor symptom progression of SCA 3. METHODS We performed a retrospective chart review in which twenty individuals met criteria for inclusion and had been seen by an ataxia specialist at our hospital between January 2005 and July 2019. AAO of motor symptoms and Scale for Assessment and Rating of Ataxia (SARA) scores were used as primary outcome measures. RESULTS Using a linear regression, we found that having greater CAG repeat length and greater than 16 years of education results in an earlier AAO. The importance of the CAG repeat length on AAO, however, is greater amongst individuals with lower education. Using a linear mixed model evaluating SARA score over time with AAO, we found that less than 16 years of education is associated with faster progression of the disease. CONCLUSION In our group of SCA 3 patients, level of education correlated with both the AAO and SARA scores. Though our findings need to be confirmed with a larger cohort, our study suggests that level of education can have a strong influence on health outcomes in SCA 3 and possibly other groups of patients with ataxia.
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Affiliation(s)
| | - Rosa Shi
- Department of Arts and Sciences, Johns Hopkins University, United States
| | - Reece Carter
- Department of Arts and Sciences, Johns Hopkins University, United States
| | - Rachel Huynh
- Department of Medicine, Utah Health Sciences, United States
| | - Owen Morgan
- Department of Neurology, Johns Hopkins School of Medicine, United States
| | - Sheng-Han Kuo
- Department of Neurology, Columbia University, United States; Initiative for Columbia Ataxia and Tremor, Columbia University, United States
| | - Jee Bang
- Department of Neurology, Johns Hopkins School of Medicine, United States
| | - Kelly A Mills
- Department of Neurology, Johns Hopkins School of Medicine, United States
| | - Kristin Baranano
- Department of Neurology, Johns Hopkins School of Medicine, United States
| | - David S Zee
- Department of Neurology, Johns Hopkins School of Medicine, United States
| | - Emile Moukheiber
- Department of Neurology, Johns Hopkins School of Medicine, United States
| | - Ricardo Roda
- Department of Neurology, Johns Hopkins School of Medicine, United States
| | - Ankur Butala
- Department of Neurology, Johns Hopkins School of Medicine, United States
| | - Cherie Marvel
- Department of Neurology, Johns Hopkins School of Medicine, United States
| | - Michelle Joyce
- Department of Neurology, Johns Hopkins School of Medicine, United States
| | - Ximin Li
- Johns Hopkins Bloomberg School of Public Health, United States
| | - Jiangxia Wang
- Johns Hopkins Bloomberg School of Public Health, United States
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins School of Medicine, United States.
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Wang M, Liu D, Yang S, Li Y, Lian X. Smoking, alcohol consumption, and age at onset of Huntington's disease: a Mendelian randomization study. Parkinsonism Relat Disord 2022; 97:34-8. [PMID: 35299068 DOI: 10.1016/j.parkreldis.2022.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/16/2022] [Accepted: 02/20/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Smoking and alcohol consumption have been associated with earlier age at onset (AAO) of Huntington's disease (HD) in observational studies. We conducted this Mendelian randomization (MR) study to evaluate whether these associations are causal. METHODS We selected genetic instruments for lifetime smoking (n = 462,690) and alcohol consumption (n = 941,280) based on two large genome-wide association studies (GWAS). The summary-level data for residual AAO of HD were derived from a GWAS meta-analysis carried out by the Genetic Modifiers of Huntington's disease Consortium (n = 9,064 HD patients). We conducted univariable and multivariable MR analyses to evaluate the independent impact of smoking and alcohol consumption on AAO of HD. RESULTS Genetically predicted lifetime smoking was causally related to an earlier AAO of HD in the univariable MR analyses (β = -2.16 years per standard deviation (SD) increase in lifetime smoking index, 95% confidence interval (CI) = -3.70 to -0.63, P = 0.006). This association persisted significant in the multivariable MR analyses after adjusting for alcohol consumption (β = -2.04 years per SD increase in lifetime smoking index, 95% CI = -3.85 to -0.22, P = 0.028). However, no significant association was found between alcohol consumption and AAO of HD. CONCLUSIONS This study suggests that genetically predicted smoking is causally related to an earlier AAO of HD.
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Kettunen JLT, Rantala E, Dwivedi OP, Isomaa B, Sarelin L, Kokko P, Hakaste L, Miettinen PJ, Groop LC, Tuomi T. A multigenerational study on phenotypic consequences of the most common causal variant of HNF1A-MODY. Diabetologia 2022; 65:632-643. [PMID: 34951657 PMCID: PMC8894160 DOI: 10.1007/s00125-021-05631-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/04/2021] [Indexed: 12/17/2022]
Abstract
AIMS/HYPOTHESIS Systematic studies on the phenotypic consequences of variants causal of HNF1A-MODY are rare. Our aim was to assess the phenotype of carriers of a single HNF1A variant and genetic and clinical factors affecting the clinical spectrum. METHODS We conducted a family-based multigenerational study by comparing heterozygous carriers of the HNF1A p.(Gly292fs) variant with the non-carrier relatives irrespective of diabetes status. During more than two decades, 145 carriers and 131 non-carriers from 12 families participated in the study, and 208 underwent an OGTT at least once. We assessed the polygenic risk score for type 2 diabetes, age at onset of diabetes and measures of body composition, as well as plasma glucose, serum insulin, proinsulin, C-peptide, glucagon and NEFA response during the OGTT. RESULTS Half of the carriers remained free of diabetes at 23 years, one-third at 33 years and 13% even at 50 years. The median age at diagnosis was 21 years (IQR 17-35). We could not identify clinical factors affecting the age at conversion; sex, BMI, insulin sensitivity or parental carrier status had no significant effect. However, for 1 SD unit increase of a polygenic risk score for type 2 diabetes, the predicted age at diagnosis decreased by 3.2 years. During the OGTT, the carriers had higher levels of plasma glucose and lower levels of serum insulin and C-peptide than the non-carriers. The carriers were also leaner than the non-carriers (by 5.0 kg, p=0.012, and by 2.1 kg/m2 units of BMI, p=2.2 × 10-4, using the first adult measurements) and, possibly as a result of insulin deficiency, demonstrated higher lipolytic activity (with medians of NEFA at fasting 621 vs 441 μmol/l, p=0.0039; at 120 min during an OGTT 117 vs 64 μmol/l, p=3.1 × 10-5). CONCLUSIONS/INTERPRETATION The most common causal variant of HNF1A-MODY, p.(Gly292fs), presents not only with hyperglycaemia and insulin deficiency, but also with increased lipolysis and markedly lower adult BMI. Serum insulin was more discriminative than C-peptide between carriers and non-carriers. A considerable proportion of carriers develop diabetes after young adulthood. Even among individuals with a monogenic form of diabetes, polygenic risk of diabetes modifies the age at onset of diabetes.
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Affiliation(s)
- Jarno L T Kettunen
- Folkhälsan Research Center, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
| | | | - Om P Dwivedi
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Bo Isomaa
- Folkhälsan Research Center, Helsinki, Finland
| | | | - Paula Kokko
- Folkhälsan Research Center, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
| | - Liisa Hakaste
- Folkhälsan Research Center, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
| | - Päivi J Miettinen
- New Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Molecular Neurology, and Biomedicum Stem Cell Center, University of Helsinki, Helsinki, Finland
| | - Leif C Groop
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Lund University Diabetes Center, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Tiinamaija Tuomi
- Folkhälsan Research Center, Helsinki, Finland.
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland.
- Department of Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland.
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland.
- Lund University Diabetes Center, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
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27
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Gabbert C, König IR, Lüth T, Kolms B, Kasten M, Vollstedt EJ, Balck A, Grünewald A, Klein C, Trinh J. Coffee, smoking and aspirin are associated with age at onset in idiopathic Parkinson's disease. J Neurol 2022. [PMID: 35235000 DOI: 10.1007/s00415-022-11041-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/16/2022]
Abstract
Parkinson’s disease (PD) is a progressive neurodegenerative disorder. Genetic modifiers, environmental factors and gene–environment interactions have been found to modify PD risk and disease progression. The objective of this study was to evaluate the association of smoking, caffeine and anti-inflammatory drugs with age at onset (AAO) in a large PD cohort. A total of 35,963 American patients with idiopathic PD (iPD) from the Fox Insight Study responded to health and lifestyle questionnaires. We compared the median AAO between different groups using the non-parametric Mann–Whitney U test. Non-parametric Spearman’s correlation was used for correlation assessments and regression analysis was used to assess interaction between variables. We found that smoking (p < 0.0001), coffee drinking (p < 0.0001) and aspirin intake (p < 0.0001) show an exploratory association with AAO in PD, that was further supported by multivariate regression models. The association of aspirin with PD AAO was replicated in another cohort (EPIPARK) (n = 237 patients with PD).
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Chen R, Liu S, Tang L, Yu X, Meng Z, Hu Y, Li J, Liang X. On the knowledge of solitary juvenile xanthogranuloma of the eyelid: a case series and literature review. Graefes Arch Clin Exp Ophthalmol 2022; 260:2339-45. [PMID: 35084531 DOI: 10.1007/s00417-022-05560-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/01/2022] [Accepted: 01/11/2022] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Solitary eyelid juvenile xanthogranuloma (JXG) is extremely rare, and there is limited literature on its clinical features and treatment outcomes. Here, we present a case series and comprehensive review of the literature on patients with isolated eyelid JXG. METHODS We systematically extracted data from our institution's records of isolated eyelid JXG cases and conducted a search for additional cases from the literature utilising the PubMed, Wanfang, and Chinese National Knowledge Infrastructure (CNKI) databases. Patients with JXG were analysed with respect to age, sex, clinical presentation, therapy, and outcome. Group comparisons were performed. RESULTS Thirty-two patients (including 13 at our institution and 19 from prior publications) were identified. The median age at first presentation was higher in current patients than in the patients from the published cases (median 9 years, range 1.2 to 47.0 years; median 2 years, range 0.5 months to 46.0 years, respectively, P = 0.014). Of the patients who had known characteristics, no significant differences were observed between the two groups in terms of sex, affected eye, eyelid site, type of cutaneous involvement, or duration of symptoms (each P > 0.05). Seventeen (54.8%) patients were male. The most common lesion location was the upper eyelid (n = 10, 62.5%). Twenty-four (75.0%) cutaneous lesions had full-thickness skin involvement; 8 (25.0%) subcutaneous masses had a chalazion-like appearance. Histologically, the JXG masses were characterised by Touton giant cells with inflammatory cells. Additionally, there was no significant difference in treatment modalities between the two groups (P = 0.072), and 24 (75.0%) patients underwent surgical excision. The overall recurrence-free survival was 3.6 to 52.8 (median 27.0) months in the current patients. For published cases with available follow-up information, there was no recurrence in 10 cases and improvement in 1 case, with a median follow-up of 9.5 months. CONCLUSION Solitary eyelid JXG is a rare clinical entity and should be included in the differential diagnosis of eyelid mass lesions in patients of all age groups. Surgical excision is often selected for efficient treatment and to obtain an excisional biopsy.
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Motazedi E, Cheng W, Thomassen JQ, Frei O, Rongve A, Athanasiu L, Bahrami S, Shadrin A, Ulstein I, Stordal E, Brækhus A, Saltvedt I, Sando SB, O’Connell KS, Hindley G, van der Meer D, Bergh S, Nordestgaard BG, Tybjærg-Hansen A, Bråthen G, Pihlstrøm L, Djurovic S, Frikke-Schmidt R, Fladby T, Aarsland D, Selbæk G, Seibert TM, Dale AM, Fan CC, Andreassen OA. Using Polygenic Hazard Scores to Predict Age at Onset of Alzheimer's Disease in Nordic Populations. J Alzheimers Dis 2022; 88:1533-1544. [PMID: 35848024 PMCID: PMC10022308 DOI: 10.3233/jad-220174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Polygenic hazard scores (PHS) estimate age-dependent genetic risk of late-onset Alzheimer's disease (AD), but there is limited information about the performance of PHS on real-world data where the population of interest differs from the model development population and part of the model genotypes are missing or need to be imputed. OBJECTIVE The aim of this study was to estimate age-dependent risk of late-onset AD using polygenic predictors in Nordic populations. METHODS We used Desikan PHS model, based on Cox proportional hazards assumption, to obtain age-dependent hazard scores for AD from individual genotypes in the Norwegian DemGene cohort (n = 2,772). We assessed the risk discrimination and calibration of Desikan model and extended it by adding new genotype markers (the Desikan Nordic model). Finally, we evaluated both Desikan and Desikan Nordic models in two independent Danish cohorts: The Copenhagen City Heart Study (CCHS) cohort (n = 7,643) and The Copenhagen General Population Study (CGPS) cohort (n = 10,886). RESULTS We showed a robust prediction efficiency of Desikan model in stratifying AD risk groups in Nordic populations, even when some of the model SNPs were missing or imputed. We attempted to improve Desikan PHS model by adding new SNPs to it, but we still achieved similar risk discrimination and calibration with the extended model. CONCLUSION PHS modeling has the potential to guide the timing of treatment initiation based on individual risk profiles and can help enrich clinical trials with people at high risk to AD in Nordic populations.
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Affiliation(s)
- Ehsan Motazedi
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
| | - Weiqiu Cheng
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
| | - Jesper Q. Thomassen
- Department of Clinical Biochemistry, Copenhagen University Hospital – Rigshospitalet, 2100 Copenhagen, Denmark
| | - Oleksandr Frei
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
- Center for Bioinformatics, Department of Informatics, University of Oslo, PO box 1080, Blindern, 0316 Oslo, Norway
| | - Arvid Rongve
- Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
| | - Lavinia Athanasiu
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
| | - Shahram Bahrami
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
| | - Alexey Shadrin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
| | - Ingun Ulstein
- Department of Geriatric Medicine, Oslo University Hospital, Ullevål, 0424 Oslo, Norway
| | - Eystein Stordal
- Department of Neuromedicine and Movement Science (INB), NTNU, Faculty of Medicine and Health Sciences, N-7491 Trondheim, Norway
- Clinic of Psychiatry, Namsos Hospital, 7801 Namsos, Norway
| | - Anne Brækhus
- Department of Geriatric Medicine, Oslo University Hospital, Ullevål, 0424 Oslo, Norway
- Department of Neurology, Oslo University Hospital, 0424 Oslo, Norway
| | - Ingvild Saltvedt
- Department of Neuromedicine and Movement Science (INB), NTNU, Faculty of Medicine and Health Sciences, N-7491 Trondheim, Norway
- Department of geriatric medicine, Clinic of Medicine, St. Olavs Hospital, Trondheim university hospital, Trondheim, Norway
| | - Sigrid B. Sando
- Department of Neuromedicine and Movement Science (INB), NTNU, Faculty of Medicine and Health Sciences, N-7491 Trondheim, Norway
- University Hospital of Trondheim, Department of Neurology and Clinical Neurophysiology, Postboks 3250 Torgarden, N-7006 Trondheim, Norway
| | - Kevin S. O’Connell
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
| | - Guy Hindley
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AB
| | - Dennis van der Meer
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
- School for Mental Health and Neuroscience, Maastricht University, the Netherlands
| | - Sverre Bergh
- Research center for Age-related Functional Decline and Disease, Innlandet Hospital Trust, 2381 Brumunddal, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, 3103 Tønsberg, Norway
| | - Børge G. Nordestgaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital – Herlev Gentofte, 2730 Herlev, Denmark
| | - Anne Tybjærg-Hansen
- Department of Clinical Biochemistry, Copenhagen University Hospital – Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Geir Bråthen
- Department of Neuromedicine and Movement Science (INB), NTNU, Faculty of Medicine and Health Sciences, N-7491 Trondheim, Norway
- University Hospital of Trondheim, Department of Neurology and Clinical Neurophysiology, Postboks 3250 Torgarden, N-7006 Trondheim, Norway
| | - Lasse Pihlstrøm
- Department of Neurology, Oslo University Hospital, 0424 Oslo, Norway
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Copenhagen University Hospital – Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Tormod Fladby
- Department of Neuromedicine and Movement Science (INB), NTNU, Faculty of Medicine and Health Sciences, N-7491 Trondheim, Norway
- Klinikk for indremedisin og lab fag (AHUSKIL), Akershus University Hospital, 1478 Lørenskog, Norway
| | - Dag Aarsland
- Department of Old-Age Psychiatry, Stavanger University Hospital, 4011 Stavanger, Norway
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, PO Box P070, De Crespigny Park, London SE5 8AF
| | - Geir Selbæk
- Department of Geriatric Medicine, Oslo University Hospital, Ullevål, 0424 Oslo, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, 3103 Tønsberg, Norway
- Faculty of Medicine, University of Oslo, PO BOX 1078 Blindern, 0316 Oslo, Norway
| | - Tyler M. Seibert
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA 92093, USA
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
- Department of Radiation Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA
| | - Anders M. Dale
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA 92093, USA
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Chun C. Fan
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA 92093, USA
- Department of Cognitive Science, University of California San Diego, La Jolla, CA, USA
- Population Neuroscience and Genetics Lab, University of California San Diego, La Jolla, CA, USA
| | - Ole A. Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway
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Quednow BB, Steinhoff A, Bechtiger L, Ribeaud D, Eisner M, Shanahan L. High Prevalence and Early Onsets: Legal and Illegal Substance Use in an Urban Cohort of Young Adults in Switzerland. Eur Addict Res 2022; 28:186-198. [PMID: 34864731 DOI: 10.1159/000520178] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 03/09/2021] [Accepted: 10/05/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Debates about the legalization of illegal substances (e.g., cannabis) continue around the globe. A key consideration in these debates is the adequate protection of young people, which could be informed by current prevalence and age-of-onset patterns. For Switzerland, such information is limited, which is particularly true for women, despite advanced political efforts to legalize cannabis. The objective of the current study was to investigate substance use prevalence rates and ages of onset in a community-representative sample of female and male young adults in Switzerland. METHODS Data came from the Zurich Project on the Social Development from Childhood to Adulthood (z-proso). In 2018, participants (N = 1,180, 50.8% females) were ∼20 years old. Lifetime and past-year use of alcohol, tobacco, cannabinoids, stimulants, hallucinogens, opioids, and benzodiazepines were assessed with an extensive substance use questionnaire. Additionally, ages of onsets of the respective substances were estimated by averaging participants' self-reported ages of onsets from ages 13 to 20 (max. 4 assessments). RESULTS 57% of 20-year-olds had used cannabinoids, 16% stimulants, 15% opioids (mostly codeine), and 8% hallucinogens in the past year. Males had higher prevalence than females for most drugs; nevertheless, females' prevalence rates were notably high. Legal substance use was typically initiated 1.3-2.7 years before legal selling age. Thus, almost half of the sample had consumed alcohol and tobacco by age 14. More than 40% of the total sample had smoked cannabis by age 16. Males initiated use of legal substances and cannabis earlier than females. DISCUSSION Our recent community-representative data suggested unexpectedly high levels and early onsets of substance use compared to a previous Swiss surveys and also the European average. Drug policy debates should consider urban substance use patterns when considering legalization efforts.
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Affiliation(s)
- Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Annekatrin Steinhoff
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland.,Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland.,Department of Psychology, University of Zurich, Zurich, Switzerland
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Raposo M, Bettencourt C, Melo ARV, Ferreira AF, Alonso I, Silva P, Vasconcelos J, Kay T, Saraiva-Pereira ML, Costa MD, Vilasboas-Campos D, Bettencourt BF, Bruges-Armas J, Houlden H, Heutink P, Jardim LB, Sequeiros J, Maciel P, Lima M. Novel Machado-Joseph disease-modifying genes and pathways identified by whole-exome sequencing. Neurobiol Dis 2021; 162:105578. [PMID: 34871736 DOI: 10.1016/j.nbd.2021.105578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/08/2021] [Accepted: 12/02/2021] [Indexed: 11/17/2022] Open
Abstract
Machado-Joseph disease (MJD/SCA3) is a neurodegenerative polyglutamine disorder exhibiting a wide spectrum of phenotypes. The abnormal size of the (CAG)n at ATXN3 explains ~55% of the age at onset variance, suggesting the involvement of other factors, namely genetic modifiers, whose identification remains limited. Our aim was to find novel genetic modifiers, analyse their epistatic effects and identify disease-modifying pathways contributing to MJD variable expressivity. We performed whole-exome sequencing in a discovery sample of four age at onset concordant and four discordant first-degree relative pairs of Azorean patients, to identify candidate variants which genotypes differed for each discordant pair but were shared in each concordant pair. Variants identified by this approach were then tested in an independent multi-origin cohort of 282 MJD patients. Whole-exome sequencing identified 233 candidate variants, from which 82 variants in 53 genes were prioritized for downstream analysis. Eighteen disease-modifying pathways were identified; two of the most enriched pathways were relevant for the nervous system, namely the neuregulin signaling and the agrin interactions at neuromuscular junction. Variants at PARD3, NFKB1, CHD5, ACTG1, CFAP57, DLGAP2, ITGB1, DIDO1 and CERS4 modulate age at onset in MJD, with those identified in CFAP57, ACTG1 and DIDO1 showing consistent effects across cohorts of different geographical origins. Network analyses of the nine novel MJD modifiers highlighted several important molecular interactions, including genes/proteins previously related with MJD pathogenesis, namely between ACTG1/APOE and VCP/ITGB1. We describe novel pathways, modifiers, and their interaction partners, providing a broad molecular portrait of age at onset modulation to be further exploited as new disease-modifying targets for MJD and related diseases.
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Affiliation(s)
- Mafalda Raposo
- Instituto de Biologia Molecular e Celular (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Faculdade de Ciências e Tecnologia, Universidade dos Açores, Ponta Delgada, Portugal.
| | - Conceição Bettencourt
- Department of Neurodegenerative Disease and Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, UK.
| | - Ana Rosa Vieira Melo
- Instituto de Biologia Molecular e Celular (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Faculdade de Ciências e Tecnologia, Universidade dos Açores, Ponta Delgada, Portugal
| | - Ana F Ferreira
- Instituto de Biologia Molecular e Celular (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Faculdade de Ciências e Tecnologia, Universidade dos Açores, Ponta Delgada, Portugal.
| | - Isabel Alonso
- Instituto de Biologia Molecular e Celular (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal
| | - Paulo Silva
- Instituto de Biologia Molecular e Celular (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal.
| | - João Vasconcelos
- Departamento de Neurologia, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal
| | - Teresa Kay
- Departamento de Genética Clínica, Hospital D. Estefânia, Lisboa, Portugal
| | - Maria Luiza Saraiva-Pereira
- Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Brazil; Serviço de Genética Médica/Centro de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - Marta D Costa
- Instituto de Investigação em Ciências da Vida e Saúde (ICVS), Escola de Medicina, Universidade do Minho, Braga, Portugal; ICVS/3B's - Laboratório Associado, Braga/Guimarães, Portugal.
| | - Daniela Vilasboas-Campos
- Instituto de Investigação em Ciências da Vida e Saúde (ICVS), Escola de Medicina, Universidade do Minho, Braga, Portugal; ICVS/3B's - Laboratório Associado, Braga/Guimarães, Portugal
| | - Bruno Filipe Bettencourt
- Serviço Especializado de Epidemiologia e Biologia Molecular (SEEBMO), Hospital de Santo Espírito da Ilha Terceira (HSEIT), Angra do Heroísmo, Azores, Portugal
| | - Jácome Bruges-Armas
- Serviço Especializado de Epidemiologia e Biologia Molecular (SEEBMO), Hospital de Santo Espírito da Ilha Terceira (HSEIT), Angra do Heroísmo, Azores, Portugal; CHRC - Comprehensive Health Research Centre, Faculdade de Ciências Médicas & CEDOC - Chronic Diseases Research Center, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Henry Houlden
- Department of Molecular Neuroscience, Institute of Neurology, University College London and Neurogenetics Unit, National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom, London.
| | - Peter Heutink
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.
| | - Laura Bannach Jardim
- Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Serviço de Genética Médica/Centro de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - Jorge Sequeiros
- Instituto de Biologia Molecular e Celular (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal.
| | - Patrícia Maciel
- Instituto de Investigação em Ciências da Vida e Saúde (ICVS), Escola de Medicina, Universidade do Minho, Braga, Portugal; ICVS/3B's - Laboratório Associado, Braga/Guimarães, Portugal.
| | - Manuela Lima
- Instituto de Biologia Molecular e Celular (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Faculdade de Ciências e Tecnologia, Universidade dos Açores, Ponta Delgada, Portugal.
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Zheng H, Luo G, Yao S, Wang S, Guo G, Quan D, Gao J. Predictors for 12-month long-term outcome in patients with obsessive-compulsive disorder: The influence of duration of untreated illness and age at onset. J Psychiatr Res 2021; 144:202-207. [PMID: 34700207 DOI: 10.1016/j.jpsychires.2021.10.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/04/2021] [Accepted: 10/18/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND It remains unknown whether the duration of untreated illness (DUI) may play a critical role in clinical improvement of patients with obsessive-compulsive disorder (OCD). Using a relatively large sample of subjects with OCD, this study investigated the potential impact of the DUI on patients' clinical course and long-term treatment response. METHODS Two hundred and seven patients with OCD recruited by the OCD outpatient clinic of our university hospital participated in the study. The sample was divided into two groups according to the median DUI (DUI≤3 years and DUI >3 years). Patients were treated with selective serotonin reuptake inhibitors or venlafaxine for 48 weeks in open-label conditions. Treatment response and other clinical variables were analysed. RESULTS The total sample showed a mean (SD) DUI of 4.07 (3.5) years, and the mean (SD) illness duration was 6.27 (6.5) years. More than half of the patients had not been treated before (56.5% for OCD). With a median of 3 years as cutoff DUI, response rates were found to be significantly higher in subjects with a short DUI (p < 0.001). Regression analyses showed that a short (≤3 years) DUI and later age at onset predicted better response and higher Y-BOCS scores percentage changes at the endpoint of 48 weeks (β = -1.11, p = 0.003). In addition, there was no correlation between DUI and age of onset in the total patients (r = -0.13, p>0.05). CONCLUSIONS This preliminary study suggests associations between a shorter duration of untreated OCD and favourable long-term outcomes, and a longer DUI with a worse clinical course.
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Affiliation(s)
- Huirong Zheng
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China; South China University of Technology School of Medicine, Guangzhou, China.
| | - Guowei Luo
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Shantou University Medical College, Shantou, China
| | - Siyu Yao
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shibin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guangquan Guo
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Dongming Quan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Junling Gao
- Centre of Buddhist Studies, Department of Medicine, University of Hong Kong, Hong Kong, China
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Wang M, Cornelis MC, Zhang Z, Liu D, Lian X. Mendelian randomization study of coffee consumption and age at onset of Huntington's disease. Clin Nutr 2021; 40:5615-5618. [PMID: 34656958 PMCID: PMC10547005 DOI: 10.1016/j.clnu.2021.09.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 09/04/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND & AIM The association between habitual coffee or caffeine consumption and age at onset (AAO) of Huntington's disease (HD) is unclear. We employed Mendelian randomization to investigate the causal relationship between coffee consumption and AAO of HD. METHODS The instrumental variable including 14 independent genetic variants associated with coffee consumption was selected from a genome-wide association study (GWAS) meta-analysis of 375,833 individuals of European ancestry. Genetic association estimates for AAO of HD were obtained from the Genetic Modifiers of Huntington's Disease Consortium GWAS meta-analysis including 9064 HD patients of European ancestry. The inverse variance weighted method was used to evaluate the causal estimate and a comprehensive set of analyses tested the robustness of our results. RESULTS Genetically predicted higher coffee consumption was associated with an earlier AAO of HD (β = -1.84 years, 95% confidence interval = -3.47 to -0.22, P = 0.026). Results were robust to potential pleiotropy and weak instrument bias. CONCLUSIONS This genetic study suggests high coffee consumption is associated with an earlier AAO of HD. Coffee is widely consumed and thus our findings, if confirmed, offers a potential way to delay the onset of this debilitating autosomal dominant disease.
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Affiliation(s)
- Mengmeng Wang
- Department of Neurology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Marilyn C Cornelis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Zhizhong Zhang
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Dandan Liu
- Department of Geriatrics, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xuegan Lian
- Department of Neurology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
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Vaingankar JA, Chong SA, Abdin E, Shafie S, Chua BY, Shahwan S, Verma S, Subramaniam M. Early age of onset of mood, anxiety and alcohol use disorders is associated with sociodemographic characteristics and health outcomes in adults: results from a cross-sectional national survey. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1835-1846. [PMID: 33791821 DOI: 10.1007/s00127-021-02070-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 03/10/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This cross-sectional study investigated distribution, sociodemographic correlates, and health outcomes in early versus late age of onset (AOO) of mood, anxiety, and alcohol use disorders in Singapore. METHODS The Composite International Diagnostic Interview established lifetime diagnoses of major depressive, bipolar, generalized anxiety, obsessive compulsive and alcohol use disorders in a representative sample of residents aged 18 years and over (n = 6126). The AOO of the individual and any mental disorders were classified into early and late onset using median values as cut-offs. Data included socio-demographic and health background, health utility score, and productivity losses. Multivariable logistic regression analysis was conducted to assess sociodemographic correlates of early versus late AOO of any mental disorder while linear regression analysis investigated the associations between AOO of individual disorders with health utility score and productivity loss. RESULTS Respondents' mean (SD) age was 45.6 (16.5) years, comprising 50.5% women and majority of Chinese ethnicity (75.8%). The median AOO for any of the five studied disorders was 21 years (IQR: 15-29). Lowest AOO was observed for obsessive compulsive disorder (Median: 14, IQR: 11-26). Those aged 35 years and over (versus 18-34) were less likely to have earlier AOO [35-49 years (OR: 0.287; 95% CI: 0.154-0.534); 50-64 years (OR:0.156; 95% CI: 0.068-0.361) and 65 and over (OR:0.112; 95% CI:0.027-0.461)], while Malay ethnicity (versus Chinese) (OR: 2.319; 95% CI: 1.384-3.885) and being never married (versus married) (OR: 2.731; 95% CI: 1.493-4.993) were more likely to have early AOO for any mental disorder. Sample with early (versus late) AOO had a lower health utility score (β = - 0.06,95% CI: - 0.08 to - 0.03) and higher number of days cut down on the type of work (β = 1.61,95% CI: 0.12-3.10) in those with any mental disorders. CONCLUSION This study showed that half of the adults with mood, anxiety or alcohol use disorders in Singapore experienced their illness onset by 21 years of age. Early AOO is associated with sociodemographic background and poor health outcomes. Prevention, early detection, and interventions to improve health outcomes in mental disorders should consider the sociodemographic profile and age at first onset of symptoms in the population.
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Affiliation(s)
- Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.,Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
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Goldstein LH, Robinson EJ, Mellers JDC, Stone J, Carson A, Chalder T, Reuber M, Eastwood C, Landau S, McCrone P, Moore M, Mosweu I, Murray J, Perdue I, Pilecka I, Richardson MP, Medford N. Psychological and demographic characteristics of 368 patients with dissociative seizures: data from the CODES cohort. Psychol Med 2021; 51:2433-2445. [PMID: 32389147 PMCID: PMC8506352 DOI: 10.1017/s0033291720001051] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND We examined demographic, clinical, and psychological characteristics of a large cohort (n = 368) of adults with dissociative seizures (DS) recruited to the CODES randomised controlled trial (RCT) and explored differences associated with age at onset of DS, gender, and DS semiology. METHODS Prior to randomisation within the CODES RCT, we collected demographic and clinical data on 368 participants. We assessed psychiatric comorbidity using the Mini-International Neuropsychiatric Interview (M.I.N.I.) and a screening measure of personality disorder and measured anxiety, depression, psychological distress, somatic symptom burden, emotional expression, functional impact of DS, avoidance behaviour, and quality of life. We undertook comparisons based on reported age at DS onset (<40 v. ⩾40), gender (male v. female), and DS semiology (predominantly hyperkinetic v. hypokinetic). RESULTS Our cohort was predominantly female (72%) and characterised by high levels of socio-economic deprivation. Two-thirds had predominantly hyperkinetic DS. Of the total, 69% had ⩾1 comorbid M.I.N.I. diagnosis (median number = 2), with agoraphobia being the most common concurrent diagnosis. Clinical levels of distress were reported by 86% and characteristics associated with maladaptive personality traits by 60%. Moderate-to-severe functional impairment, high levels of somatic symptoms, and impaired quality of life were also reported. Women had a younger age at DS onset than men. CONCLUSIONS Our study highlights the burden of psychopathology and socio-economic deprivation in a large, heterogeneous cohort of patients with DS. The lack of clear differences based on gender, DS semiology and age at onset suggests these factors do not add substantially to the heterogeneity of the cohort.
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Affiliation(s)
- Laura H. Goldstein
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Emily J. Robinson
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
- King's College London, School of Population Health and Environmental Sciences, UK
| | | | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Alan Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Trudie Chalder
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Markus Reuber
- Academic Neurology Unit, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK
| | - Carole Eastwood
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Sabine Landau
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Paul McCrone
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Michele Moore
- Centre for Social Justice and Global Responsibility, School of Law and Social Sciences, London South Bank University, London, UK
| | - Iris Mosweu
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Joanna Murray
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Iain Perdue
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Izabela Pilecka
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Mark P. Richardson
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Nick Medford
- South London and Maudsley NHS Foundation Trust, London, UK
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Martins AC, Rieck M, Leotti VB, Saraiva-Pereira ML, Jardim LB. Variants in Genes of Calpain System as Modifiers of Spinocerebellar Ataxia Type 3 Phenotype. J Mol Neurosci 2021; 71:1906-1913. [PMID: 34191270 DOI: 10.1007/s12031-021-01877-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
Calpain-mediated proteolysis has been proposed to modulate the pathogenesis of spinocerebellar ataxia type 3, also known as Machado-Joseph disease (SCA3/MJD), a disorder due to a CAG repeat expansion (CAGexp) at ATXN3. We aimed to investigate if single-nucleotide polymorphisms (SNPs) at calpain gene CAPN2 and at calpastatin gene CAST modulate the age at onset (AO) and disease progression in SCA3/MJD. A total of 287 SCA3/MJD symptomatic subjects (151 families) were included. AO was analyzed and controlled by the CAG repeat length of expanded allele and family. Candidate polymorphisms were chosen based on the literature and on a priori criteria. The CAG repeat length and SNPs were genotyped according to standard methods. AO of carriers of AA and AG + GGrs1559085 genotypes in CAST and with the median value of 75 repeats at the expanded allele were 34.23 (33.07-35.38) and 36.42 years (34.50-38.34), respectively (p = 0.049, mixed model treating the expanded CAG repeat size as fixed effect and family as random effect). Carriers of haplotype Crs27852/Grs1559085 had mean AO of 37.23 (12.76) and 33.42 years (12.20) (p = 0.047, Student's t test). Our data suggest an association between allele Grs1559085 and haplotype Crs27852/Grs1559085 at CAST and variations in the AO of SCA3/MJD subjects, independent from the effects of the CAGexp and family. The present results support the potential role of calpain cleavage pathway over modulation of SCA3/MJD phenotype.
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Affiliation(s)
- Ana Carolina Martins
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Mariana Rieck
- Laboratório de Identificação Genética, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Vanessa Bielefeldt Leotti
- Departamento de Estatística, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Luiza Saraiva-Pereira
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-003, Brazil.,Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Laura Bannach Jardim
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. .,Laboratório de Identificação Genética, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. .,Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-003, Brazil. .,Departamento de Medicina Interna, FAMED, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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Liu Z, Yuan Y, Wang M, Ni J, Li W, Huang L, Hu Y, Liu P, Hou X, Hou X, Du J, Weng L, Zhang R, Niu Q, Tang J, Jiang H, Shen L, Tang B, Wang J. Mutation spectrum of amyotrophic lateral sclerosis in Central South China. Neurobiol Aging 2021:S0197-4580(21)00202-5. [PMID: 34275688 DOI: 10.1016/j.neurobiolaging.2021.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/31/2021] [Accepted: 06/12/2021] [Indexed: 02/08/2023]
Abstract
To analyze the mutational spectrum of known ALS causative genes in China ALS patients. We comprehensively analyzed 51 ALS causative genes by combining different sequencing technologies in 753 unrelated ALS patients from Central South China. The mean age at onset (AAO) was 53.7±11.4 years. The AAO was earlier in the autosomal dominant (AD) ALS patients than in the sporadic ALS (sALS) patients. Bulbar onset was more frequent in females than in males. SOD1 was the most frequently mutated gene in the AD-ALS and the sALS patients, followed by the ATXN2 and FUS genes in the AD-ALS patients and the NEK1 and CACNA1H genes in the sALS patients. Patients with RDVs in the SOD1 or FUS genes had an earlier AAO than the mean AAO of all the patients, while the patients with RDVs in the NEK1 gene showed later onset. SOD1 gene was the most commonly mutated gene in ALS patients in China, followed by ATXN2 and NEK1. The phenotype might be determined synergistically by sex and genetic variants.
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Baykara B, Koc D, Resmi H, Akan P, Tunca Z, Ozerdem A, Ceylan D, Yalcın NG, Binici NC, Guney SA, Mesman E, Hillegers MHJ, Emiroglu NI. Brain-derived neurotrophic factor in bipolar disorder: Associations with age at onset and illness duration. Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110075. [PMID: 32798619 DOI: 10.1016/j.pnpbp.2020.110075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/14/2020] [Revised: 07/21/2020] [Accepted: 08/11/2020] [Indexed: 01/09/2023]
Abstract
Bipolar disorder (BD) is a heterogeneous disorder that contains neurodevelopmental differences. Defining homogeneous subgroups of BD patients by using age at onset (AAO) as a specifier may promote the classification of biomarkers. This study compares peripheral BDNF levels between pediatric and adult BD patients to investigate the associations between BDNF levels, AAO, and illness duration. We enrolled two groups of euthymic patients, those with pediatric BD (n = 39) and those with adult BD (n = 31), as well as a group of healthy controls (HCs) (n = 90). Participants were assessed using clinical measures and BDNF serum levels were obtained using ELISA. We observed that BDNF levels were comparable between adult BD and HCs, but were clearly lower in pediatric BD than in HCs. In adult BD with AAO ≥30 years, BDNF levels were significantly higher than in adult BD with AAO <30 years. In pediatric BD, patients with prepubertal-onset had higher BDNF levels than those with pubertal-onset. BDNF levels demonstrated the accuracy of being able to distinguish pediatric BD from healthy controls in a receiver operating characteristic (ROC) curve analysis (area under the curve [AUC] = 0.792). In adult BD, higher BDNF levels were associated with later disease onset, but this was not the case in pediatric BD. Finally, reduced BDNF levels were associated with illness duration in adult BD. The findings indicate that BDNF levels in BD patients are associated with AAO. BDNF may, therefore, potentially serve as a developmental marker in BD, when AAO is taken into account.
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Affiliation(s)
- Burak Baykara
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
| | - Dogukan Koc
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey.
| | - Halil Resmi
- Department of Biochemistry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Pınar Akan
- Department of Biochemistry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Zeliha Tunca
- Department of Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Aysegul Ozerdem
- Department of Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Neurosciences, Dokuz Eylul University, Health Sciences Institute, Izmir, Turkey
| | - Deniz Ceylan
- Department of Psychiatry, Izmir University of Economics, Faculty of Medicine, Izmir, Turkey
| | - Neslihan Gurz Yalcın
- Department of Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Nagihan Cevher Binici
- Department of Child and Adolescent Psychiatry, University of Health Sciences Dr. Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Sevay Alsen Guney
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
| | - Esther Mesman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands
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Kang HJ, Kim KT, Park Y, Yoo KH, Kim JW, Lee JY, Kim SW, Shin IS, Kim JH, Kim JM. Genetic markers for depressive disorders with earlier age at onset. Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110176. [PMID: 33189858 DOI: 10.1016/j.pnpbp.2020.110176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/25/2020] [Revised: 10/25/2020] [Accepted: 11/09/2020] [Indexed: 12/30/2022]
Abstract
Age at onset has been considered a potential indicator of underlying genetic risk in depression research. However, the variants associated with earlier age at onset of depressive disorder have not been elucidated. To evaluate the genetic architecture of depression onset, whole-exome sequencing of samples from 1000 patients with depressive disorder was performed. Cox proportional hazard models with false discovery rate-adjusted P-values were used to estimate the hazard ratios; carriers and non-carriers of individual coding variants were compared in terms of age at onset of depression with adjustment for sociodemographic and clinical characteristics. The clinical relevance of the candidate variants was also examined. Whole-exome sequencing revealed four variants in the CCL14, FYB, GPRASP1, and CTNND2 genes associated with an increased risk of depressive disorder with earlier age at onset. Although no individual variant was associated with any clinical characteristic except AAO, together they were associated with younger AAO, younger age at visit for treatment, and recurrent and atypical depression. Our data suggest novel candidate genes for depressive disorder with earlier age at onset. These genes could serve as markers allowing early identification of patients at risk of depression, and thus earlier intervention.
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Affiliation(s)
- Hee-Ju Kang
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ki-Tae Kim
- Department of Laboratory Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Yoomi Park
- Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Hun Yoo
- Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ju-Wan Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Yeon Lee
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju Han Kim
- Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jae-Min Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
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40
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Mehanna R, Zhu L, Bejjani C. Are functional movement disorder phenotypes or age at onset correlated with perfectionism or history of abuse? Clin Park Relat Disord 2021; 4:100099. [PMID: 34316675 PMCID: PMC8299986 DOI: 10.1016/j.prdoa.2021.100099] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/21/2021] [Accepted: 05/28/2021] [Indexed: 10/28/2022] Open
Abstract
Objective To assess if the phenotype or age at onset of Functional Movement Disorders (FMD) vary as a function of presence of a perfectionism or history of abuse. Detecting such a potential association might help guide future research into the pathophysiology of FMD. Methods Charts of all patients diagnosed with FMD by a movement disorder specialist using the commonly accepted clinical diagnostic criteria for FMD seen at a tertiary center over 8 years were reviewed. Data collected were sex, age at the onset of the first FMD, phenotype of the first predominant FMD, history of perfectionism and history of childhood abuse (physical, sexual, emotional, or neglect). Statistical analyses were performed as appropriate. Results 68 patients with FMD were identified from which 12 were excluded for incomplete documentation. 56 patients were included in the analysis, 43 (76.8%) were women, with average age at onset 41.5y (range 13-74.4). The most frequent predominant initial FMD phenotypes were tremor (39%), dystonia (20.3%) and gait disorders (20.3%).Perfectionism was reported in 30 (53.6%) patients and history of abuse in 27 (48.2%).There was no significant correlation between each of the FMD phenotypes and perfectionism or history of childhood abuse. There was also no correlation between the age at symptoms onset and perfectionism or history of abuse. Conclusion We could not demonstrate a significant correlation between FMD phenotype or age at onset and perfectionist personality trait or history of abuse. Factors leading to the development of one specific FMD phenotype rather than another are still to be elucidated.
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Affiliation(s)
- Raja Mehanna
- Department of Neurology, University of Texas Health Science Center at Houston, 6410 Fannin St, Houston, TX 77030, USA
| | - Liang Zhu
- Center of Clinical and Translational Science, University of Texas Health Science Center at Houston, 7000 Fannin St, Houston, TX 77030, USA
| | - Carla Bejjani
- Department of Psychiatry, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
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41
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Gheita TA, Noor RA, Abualfadl E, Abousehly OS, El-Gazzar II, El Shereef RR, Senara S, Abdalla AM, Khalil NM, ElSaman AM, Tharwat S, Nasef SI, Mohamed EF, Noshy N, El-Essawi DF, Moshrif AH, Fawzy RM, El-Najjar AR, Hammam N, Ismail F, ElKhalifa M, Samy N, Hassan E, Abaza NM, ElShebini E, Fathi HM, Salem MN, Abdel-Fattah YH, Saad E, Abd Elazim MI, Eesa NN, El-Bahnasawy AS, El-Hammady DH, El-Shanawany AT, Ibrahim SE, Said EA, El-Saadany HM, Selim ZI, Fawzy SM, Raafat HA. Adult systemic lupus erythematosus in Egypt: The nation-wide spectrum of 3661 patients and world-wide standpoint. Lupus 2021; 30:1526-1535. [PMID: 33951965 DOI: 10.1177/09612033211014253] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to present the epidemiology, clinical manifestations and treatment pattern of systemic lupus erythematosus (SLE) in Egyptian patients over the country and compare the findings to large cohorts worldwide. Objectives were extended to focus on the age at onset and gender driven influence on the disease characteristics. PATIENTS AND METHOD This population-based, multicenter, cross-sectional study included 3661 adult SLE patients from Egyptian rheumatology departments across the nation. Demographic, clinical, and therapeutic data were assessed for all patients. RESULTS The study included 3661 patients; 3296 females and 365 males (9.03:1) and the median age was 30 years (17-79 years), disease duration 4 years (0-75 years) while the median age at disease onset was 25 years (4-75 years). The overall estimated prevalence of adult SLE in Egypt was 6.1/100,000 population (1.2/100,000 males and 11.3/100,000 females).There were 316 (8.6%) juvenile-onset (Jo-SLE) and 3345 adult-onset (Ao-SLE). Age at onset was highest in South and lowest in Cairo (p < 0.0001). CONCLUSION SLE in Egypt had a wide variety of clinical and immunological manifestations, with some similarities with that in other nations and differences within the same country. The clinical characteristics, autoantibodies and comorbidities are comparable between Ao-SLE and Jo-SLE. The frequency of various clinical and immunological manifestations varied between gender. Additional studies are needed to determine the underlying factors contributing to gender and age of onset differences.
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Affiliation(s)
- Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rasha Abdel Noor
- Internal Medicine Department, Rheumatology Unit, Tanta University, Gharbia, Egypt
| | - Esam Abualfadl
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.,Qena/Luxor Hospitals, Qena, Egypt
| | - Osama S Abousehly
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Iman I El-Gazzar
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rawhya R El Shereef
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Soha Senara
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Ahmed M Abdalla
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed M ElSaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Samar Tharwat
- Rheumatology Unit, Internal Medicine, Mansoura University, Dakahlia, Egypt
| | - Samah I Nasef
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt
| | - Nermeen Noshy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Dina F El-Essawi
- Internal Medicine Department, Rheumatology Unit, Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt
| | - Abdel Hafeez Moshrif
- Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assuit, Egypt
| | - Rasha M Fawzy
- Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Egypt
| | - Amany R El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt.,Rheumatology Department, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Faten Ismail
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Marwa ElKhalifa
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nermeen Samy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Eman Hassan
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nouran M Abaza
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Emad ElShebini
- Internal Medicine Department, Rheumatology Unit, Menoufiya University, Menoufiya, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Mohamed N Salem
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Yousra H Abdel-Fattah
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ehab Saad
- Rheumatology Department, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mervat I Abd Elazim
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Nahla N Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amany S El-Bahnasawy
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Dina H El-Hammady
- Rheumatology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Amira T El-Shanawany
- Rheumatology Department, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
| | - Soha E Ibrahim
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Emtethal A Said
- Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Egypt
| | - Hanan M El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Egypt
| | - Zahraa I Selim
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Samar M Fawzy
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hala A Raafat
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Lindell N, Bladh M, Carlsson A, Josefsson A, Aakesson K, Samuelsson U. Size for gestational age affects the risk for type 1 diabetes in children and adolescents: a Swedish national case-control study. Diabetologia 2021; 64:1113-1120. [PMID: 33544169 PMCID: PMC8012313 DOI: 10.1007/s00125-021-05381-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/11/2020] [Indexed: 10/26/2022]
Abstract
AIM/HYPOTHESIS Environmental factors are believed to contribute to the risk of developing type 1 diabetes. The aim of this study was to investigate how size for gestational age affects the risk of developing childhood type 1 diabetes. METHODS Using the Swedish paediatric diabetes quality register and the Swedish medical birth register, children with type 1 diabetes diagnosed between 2000 and 2012 (n = 9376) were matched with four control children (n = 37,504). Small for gestational age (SGA) and large for gestational age (LGA) were defined according to Swedish national standards. Data were initially analysed using Pearson's χ2 and thereafter by single and multiple logistic regression models. RESULTS An equal proportion of children were born appropriate for gestational age, but children with type 1 diabetes were more often born LGA and less often born SGA than control children (4.7% vs 3.5% and 2.0% vs 2.6%, respectively, p < 0.001). In the multiple logistic regression analysis, being born LGA increased (adjusted OR 1.16 [95% CI 1.02, 1.32]) and SGA decreased (adjusted OR 0.76 [95% CI 0.63, 0.92]) the risk for type 1 diabetes, regardless of maternal BMI and diabetes. CONCLUSIONS/INTERPRETATION Size for gestational age of Swedish children affects the risk of type 1 diabetes, with increased risk if the child is born LGA and decreased risk if the child is born SGA. Being born LGA is an independent risk factor for type 1 diabetes irrespective of maternal BMI and diabetes. Thus, reducing the risk for a child being born LGA might to some extent reduce the risk for type 1 diabetes.
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Affiliation(s)
- Nina Lindell
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden.
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| | - Marie Bladh
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Annelie Carlsson
- Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Ann Josefsson
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Karin Aakesson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Pediatrics, Ryhov County Hospital, Jönköping, Sweden
| | - Ulf Samuelsson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Pediatrics, Linköping University, Linköping, Sweden
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Liu M, Luo YJ, Gu HY, Wang YM, Liu MH, Li K, Li J, Zhuang S, Shen Y, Jin H, Chen J, Mao CJ, Liu CF. Sex and onset-age-related features of excessive daytime sleepiness and night-time sleep in patients with Parkinson's disease. BMC Neurol 2021; 21:165. [PMID: 33874914 PMCID: PMC8054359 DOI: 10.1186/s12883-021-02192-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/07/2021] [Indexed: 12/20/2022] Open
Abstract
Background The clinical characteristics of Parkinson’s disease (PD) differ between men and women, and late- and early-onset patients, including motor symptoms and some nonmotor symptoms, such as cognition, anxiety, and depression. Objective To explore the features of excessive daytime sleepiness (EDS) and night-time sleep quality in PD patients of different sexes and age at onset (AAO). Methods Demographic data and clinical characteristics of 586 PD patients were collected. Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were used to investigate the daytime drowsiness and nocturnal sleep. Multivariate logistic regression analysis was used to explore the risk factors of EDS and poor night-time sleep quality. Results Sleep disorders were common in PD patients. EDS was more prominent in men than in women. There was no significant difference in ESS scores between late-onset PD (LOPD) and early-onset PD. LOPD patients had a higher probability of poor night-time sleep quality. Male sex, disease duration, and depression were risk factors for EDS. In all patients of both sexes and all AAO, depression was a risk factor for poor night-time sleep. Conclusion More attention should be paid to sleep disorders of PD patients, especially male LOPD patients. Depression is a common risk factor for EDS and poor sleep quality in PD patients.
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Affiliation(s)
- Ming Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Ya-Jun Luo
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Han-Ying Gu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Yi-Ming Wang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Man-Hua Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Kai Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Jiao Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Sheng Zhuang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Yun Shen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Hong Jin
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Jing Chen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Cheng-Jie Mao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China.
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China.,Department of Neurology, Suqian First Hospital, Suqian, China
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Li Q, Jing Y, Lun P, Liu X, Sun P. Association of gender and age at onset with glucocerebrosidase associated Parkinson's disease: a systematic review and meta-analysis. Neurol Sci 2021; 42:2261-71. [PMID: 33837876 DOI: 10.1007/s10072-021-05230-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 04/06/2021] [Indexed: 12/17/2022]
Abstract
Glucocerebrosidase (GBA) gene has been proved to be a risk factor for the development of Parkinson's disease (PD). However, the gender effect in the prevalence of GBA-associated PD (GBA-PD) is still controversial. And there is no conclusion whether the age at onset (AAO) of PD is different between carriers and non-carriers of GBA. To clarify the association between gender and AAO in GBA-PD, we conducted a systematic review and meta-analysis. PubMed, Web of Science, and Embase were retrieved to obtain potentially related studies. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to determine the association between gender and GBA-PD. And the weighted mean difference (WMD) with 95% CIs was employed to assess the difference of AAO between carriers and non-carriers of GBA. A total of twenty-eight studies involving 16,488 PD patients were included in this meta-analysis. The results showed the prevalence of female patients was higher in GBA-PD [OR: 1.19, (95% CI, 1.07-1.32), P = 0.001]. Meanwhile, GBA carriers had younger age at PD onset than GBA non-carriers [WMD: 2.87, (95% CI, 2.48-3.27), P < 0.001]. Results of subgroup analysis showed the prevalence of women in GBA-PD was higher than men in North American and European PD patients, while the gender difference was not significant in other areas around the world, suggesting an ethnic specificity of gender effect for GBA-PD. Our results indicate the higher female prevalence with ethnic specificity and younger AAO of GBA carriers in GBA-PD.
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Sanwald S, Widenhorn-Müller K, Schönfeldt-Lecuona C, Montag C, Kiefer M. Factors related to age at depression onset: the role of SLC6A4 methylation, sex, exposure to stressful life events and personality in a sample of inpatients suffering from major depression. BMC Psychiatry 2021; 21:167. [PMID: 33765975 PMCID: PMC7995700 DOI: 10.1186/s12888-021-03166-6] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/12/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND An early onset of depression is associated with higher chronicity and disability, more stressful life events (SLEs), higher negative emotionality as described by the primary emotion SADNESS and more severe depressive symptomatology compared to depression onset later in life. Additionally, methylation of the serotonin transporter gene (SLC6A4) is associated with SLEs and depressive symptoms. METHODS We investigated the relation of SLEs, SLC6A4 methylation in peripheral blood, the primary emotions SADNESS and SEEKING (measured by the Affective Neuroscience Personality Scales) as well as depressive symptom severity to age at depression onset in a sample of N = 146 inpatients suffering from major depression. RESULTS Depressed women showed higher SADNESS (t (91.05) = - 3.17, p = 0.028, d = - 0.57) and higher SLC6A4 methylation (t (88.79) = - 2.95, p = 0.02, d = - 0.55) compared to men. There were associations between SLEs, primary emotions and depression severity, which partly differed between women and men. The Akaike information criterion (AIC) indicated the selection of a model including sex, SLEs, SEEKING and SADNESS for the prediction of age at depression onset. SLC6A4 methylation was not related to depression severity, age at depression onset or SLEs in the entire group, but positively related to depression severity in women. CONCLUSIONS Taken together, we provide further evidence that age at depression onset is associated with SLEs, personality and depression severity. However, we found no associations between age at onset and SLC6A4 methylation. The joint investigation of variables originating in biology, psychology and psychiatry could make an important contribution to understanding the development of depressive disorders by elucidating potential subtypes of depression.
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Affiliation(s)
- Simon Sanwald
- Department of Psychiatry and Psychotherapy III, Ulm University, Ulm, Germany.
| | | | | | - Christian Montag
- Institute of Psychology and Education, Department of Molecular Psychology, Ulm University, Ulm, Germany
| | - Markus Kiefer
- Department of Psychiatry and Psychotherapy III, Ulm University, Ulm, Germany
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46
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Ferraro PM, Cabona C, Meo G, Rolla-Bigliani C, Castellan L, Pardini M, Inglese M, Caponnetto C, Roccatagliata L. Age at symptom onset influences cortical thinning distribution and survival in amyotrophic lateral sclerosis. Neuroradiology 2021; 63:1481-1487. [PMID: 33660067 DOI: 10.1007/s00234-021-02681-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/25/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE The lifetime risk of developing amyotrophic lateral sclerosis (ALS) increases in the elderly, and greater age at symptom onset has been identified as a negative prognostic factor in the disease. However, the underlying neurobiological mechanisms are still poorly investigated. We hypothesized that older age at symptom onset would have been associated with greater extra-motor cortical damage contributing to worse prognosis, so we explored the relationship between age at symptom onset, cortical thinning (CT) distribution, and clinical markers of disease progression. METHODS We included 26 ALS patients and 29 healthy controls with T1-weighted magnetic resonance imaging (MRI). FreeSurfer 6.0 was used to identify regions of cortical atrophy (CA) in ALS, and to relate age at symptom onset to CT distribution. Linear regression analyses were then used to investigate whether MRI metrics of age-related damage were predictive of clinical progression. MRI results were corrected using the Monte Carlo simulation method, and regression analyses were further corrected for disease duration. RESULTS ALS patients exhibited significant CA mainly encompassing motor regions, but also involving the cuneus bilaterally and the right superior parietal cortex (p < 0.05). Older age at symptom onset was selectively associated with greater extra-motor (frontotemporal) CT, including pars opercularis bilaterally, left middle temporal, and parahippocampal cortices (p < 0.05), and CT of these regions was predictive of shorter survival (p = 0.004, p = 0.03). CONCLUSION More severe frontotemporal CT contributes to shorter survival in older ALS patients. These findings have the potential to unravel the neurobiological mechanisms linking older age at symptom onset to worse prognosis in ALS.
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Affiliation(s)
- Pilar M Ferraro
- Department of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Corrado Cabona
- Department of Neurophysiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giuseppe Meo
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Lucio Castellan
- Department of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Matilde Inglese
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Claudia Caponnetto
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luca Roccatagliata
- Department of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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Abstract
BACKGROUND Familial clustering of age at onset would have implications for both personalized screening and aetiology, but has not been studied for breast cancer. METHODS We prospectively studied a cohort of 23 145 sisters to explore whether their breast cancer risk changed near the age at diagnosis of a previously affected older sister. Using an age-time-dependent variable in a Cox regression model, we estimated hazard ratios for breast cancer when participants were near their sister's diagnosis age, relative to similarly aged women whose sister was diagnosed at a very different age. To rule out a correlation driven by young-onset familial cancer, we separately investigated women who had enrolled at age 50 or older. RESULTS Of the 23 145 women, 1412 developed breast cancer during follow-up (median 9.5 years). The estimated hazard ratio was 1.80 (95% confidence interval: 1.18, 2.74) at their sister's age at diagnosis, suggesting a substantial increase in risk compared with women of the same age but whose sister was diagnosed at a very different age. Restriction to women who enrolled at or after age 50 produced similar results. CONCLUSIONS This familial clustering suggests that there may be important genetic and/or early environmental risk factors that influence the timing of breast cancer, even when onset is late in life. Personalized screening might need to account for the age at which a sister was earlier diagnosed with breast cancer.
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Affiliation(s)
- Ann Von Holle
- National Institute of Environmental Health Sciences, POB 12233, Research Triangle, NC, USA
| | - Katie M O’Brien
- National Institute of Environmental Health Sciences, POB 12233, Research Triangle, NC, USA
| | - Dale P Sandler
- National Institute of Environmental Health Sciences, POB 12233, Research Triangle, NC, USA
| | - Clarice R Weinberg
- National Institute of Environmental Health Sciences, POB 12233, Research Triangle, NC, USA
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Perrini F, Matrone M, de Bartolomeis A, Montano A, Amici E, Callovini G, Cuomo I, de Persis S, Lombardozzi G, Battagliese G, Porrari R, Kotzalidis GD, De Filippis S. Developmental trajectories in psychiatric disorders: does substance/alcohol use moderate the effects of affective temperaments as moderators of age at onset? A study in post-acute, hospitalized patients with psychotic or DSM-5 bipolar or major depressive disorders. J Addict Dis 2021; 39:373-387. [PMID: 33587024 DOI: 10.1080/10550887.2021.1886568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Age-at-onset (AAO) affects psychiatric disorder outcome; substance (SUDs) or alcohol use disorders (AUDs) may influence their onset. Affective temperaments may affect early AAO and drug-use proneness. Objectives: To investigate whether SUD/AUD moderated temperamental effects in determining AAO of mental disorders. Methods: We included 300 post-acute inpatients with schizophrenia-spectrum and other psychotic (SSOPDs), major depressive (MDD) or bipolar (BD) disorders (168 men; mean age, 40.63 years ± 11.82 men, 43.21 years ± 12.69 women) with (N = 110) or without (N = 190) SUD/AUD. Patients completed cross-sectionally TEMPS-A. We carried moderation analysis with each regression-significant TEMPS temperament as independent variable, SUD/AUD presence/absence as dichotomous moderator, and AAO as dependent variable. Significance was set at p < 0.05. Results: AAO was lower in patients with SUD/AUD diagnosis than in patients without (23.74 ± 10.09 vs. 27.73 ± 10.35, respectively, p = 0.001, η2 = 0.034). SUD/AUD patients scored higher on the hyperthymic (10.22 ± 4.08, p < 0.001, η2 = 0.069) and irritable (8.26 ± 4.69, p < 0.01, η2 = 0.026) temperaments than nonSUD/AUD patients. Moderation analysis showed only direct effects of irritable (β = -0.55, p < 0.005) and hyperthymic (β = -0.95, p < 0.001) temperaments on AAO and no significant SUD/AUD and interaction effects. Limitations. Cross-sectional design. Conclusions: When irritable and hyperthymic traits prevail over other temperaments, AAO is earlier in SSOPDs, MDD, and BD. SUD/AUD presence/absence does not moderate the relationship between temperament and AAO.
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Affiliation(s)
- Filippo Perrini
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,Istituto A.T. Beck-Diagnostic Centre, Research and Training in Cognitive-Behavioral Psychotherapy, Rome, Italy
| | - Marta Matrone
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Naples, Italy
| | - Andrea de Bartolomeis
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Naples, Italy
| | - Antonella Montano
- Istituto A.T. Beck-Diagnostic Centre, Research and Training in Cognitive-Behavioral Psychotherapy, Rome, Italy
| | - Emanuela Amici
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy
| | - Gemma Callovini
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,Department of Mental Health, ASL Rieti, Rieti, Italy
| | - Ilaria Cuomo
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,Istituto Penitenziario Regina Coeli, ASL RM1, Rome, Italy
| | | | | | - Gemma Battagliese
- Centro di Riferimento Alcologico della Regione Lazio, RM1, Rome, Italy
| | - Raffaella Porrari
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,Centro di Riferimento Alcologico della Regione Lazio, RM1, Rome, Italy
| | - Georgios D Kotzalidis
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
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Soni A, Singh P, Kumar S, Shah R, Batra L, Verma M. Role of age at onset in the clinical presentation of bipolar disorder in Indian population. Ind Psychiatry J 2021; 30:41-46. [PMID: 34483523 PMCID: PMC8395538 DOI: 10.4103/ipj.ipj_8_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/30/2020] [Revised: 10/29/2020] [Accepted: 04/21/2021] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine any association of age at onset (AAO) with clinical presentation of bipolar disorder (BD) and family history of illness. MATERIALS AND METHODS A hospital-based cross-sectional observational study was conducted including 162 patients having a diagnosis of BD current episode manic. Individuals were divided into three subgroups according to AAO, i.e., early-onset BD (EOBD) (AAO ≤21 years), intermediate-onset BD (AAO - 22-34 years), and late-onset BD (AAO ≥35 years). The subgroups were compared on clinical variables; items of the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D), and Scale for the Assessment of Positive Symptoms (SAPS); and family history of illness. RESULTS The early-onset group had significantly more episodes per year than the other groups (P < 0.001). The prevalence of family history of mood disorder was also significantly higher in the early-onset group than the other subgroups. AAO was found to be significantly associated with different items of YMRS, HAM-D, and SAPS. The early-onset group had higher rating on irritability, motor activity-energy, sexual interest, depressed mood, delusions, and thought disorders, whereas the late-onset group had higher rating on elevated mood. CONCLUSION EOBD can be considered as a specific phenotype of BD, which is more homogenous, severe, and inheritable form of illness.
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Affiliation(s)
- Ajitabh Soni
- Department of Psychiatry, P.D.U. Medical College, Churu, Rajasthan, India
| | - Paramjeet Singh
- Department of Psychiatry, S.M.S. Medical College, Jaipur, Rajasthan, India
| | - Sunil Kumar
- Department of Psychiatry, S.M.S. Medical College, Jaipur, Rajasthan, India
| | - Raghav Shah
- Department of Psychiatry, S.M.S. Medical College, Jaipur, Rajasthan, India
| | - Lalit Batra
- Department of Psychiatry, S.M.S. Medical College, Jaipur, Rajasthan, India
| | - Manoj Verma
- Department of Community Medicine, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
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Chatterjee K, Dwivedi A, Singh R. Age at first drink and severity of alcohol dependence. Med J Armed Forces India 2021; 77:70-74. [PMID: 33487869 PMCID: PMC7809520 DOI: 10.1016/j.mjafi.2019.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 05/20/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Early age at first drink (AFD) has been linked to early onset and increased severity of alcohol dependence in various studies. Few Indian studies on AFD have shown a negative correlation between AFD and severity of alcohol dependence. Our study aimed to explore this relationship in patients with alcohol dependence syndrome (ADS) diagnosed using ICD-10 criteria. METHODS One hundred fifty-one consecutive patients freshly diagnosed with ADS were included in the study, which was conducted at the psychiatry unit of a tertiary care, multispecialty hospital. The Addiction Severity Index (ASI) was used to assess severity of alcohol dependence. RESULTS Mean AFD was 24.85 years (range = 13-40 years). Median ASI score was 36 (range = 21 to 57). The study yielded a weak negative correlation (ρ = -.105) between AFD and ASI, which was statistically not significant. CONCLUSIONS We found no correlation between AFD and severity of alcohol dependence at detection in Indian Armed Forces personnel, which is contrary to what has been reported worldwide and in previous Indian studies. Delayed initiation of alcohol use among those enrolling in the Indian Armed Forces and early detection of alcohol dependence within the military environment are possible explanations.
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Affiliation(s)
- K. Chatterjee
- Consultant & Professor and Head (Psychiatry), INHS Asvini, Colaba, Mumbai, India
| | - A.K. Dwivedi
- Graded Specialist (Psychiatry), Base Hospital, Delhi Cantt, India
| | - R. Singh
- Classified Specialist (Psychiatry), Command Hospital (Southern Command), Pune 411040, India
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