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Maddaford S, Huot P. Glycine and clozapine: potential relevance for the treatment of Parkinson's disease. Neurodegener Dis Manag 2024. [PMID: 38602420 DOI: 10.2217/nmt-2024-0005] [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] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Affiliation(s)
- Shawn Maddaford
- Talon Pharmaceuticals Inc, Mississauga, Ontario, L5L 1Y3, Canada
| | - Philippe Huot
- Talon Pharmaceuticals Inc, Mississauga, Ontario, L5L 1Y3, Canada
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, Quebec, H3A 2B4, Canada
- Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, H3A 2B4, Canada
- Movement Disorder Clinic, Division of Neurology, Department of Neuroscience, McGill University Health Centre, Montreal, Quebec, H3A 2B4, Canada
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2
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Kamo H, Oyama G, Yamasaki Y, Nagayama T, Nawashiro R, Hattori N. A proof of concept: digital diary using 24-hour monitoring using wearable device for patients with Parkinson's disease in nursing homes. Front Neurol 2024; 15:1356042. [PMID: 38660090 PMCID: PMC11041395 DOI: 10.3389/fneur.2024.1356042] [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: 12/14/2023] [Accepted: 02/26/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction In the advanced stages of Parkinson's disease (PD), motor complications such as wearing-off and dyskinesia are problematic and vary daily. These symptoms need to be monitored precisely to provide adequate care for patients with advanced PD. Methods This study used wearable devices to explore biomarkers for motor complications by measuring multiple biomarkers in patients with PD residing in facilities and combining them with lifestyle and clinical assessments. Data on the pulse rate and activity index (metabolic equivalents) were collected from 12 patients over 30 days. Results The pulse rate and activity index during the off- and on-periods and dyskinesia were analyzed for two participants; the pulse rate and activity index did not show any particular trend in each participant; however, the pulse rate/activity index was significantly greater in the off-state compared to that in the dyskinesia and on-states, and this index in the dyskinesia state was significantly greater than that in the on-state in both participants. Conclusion These results suggest the pulse rate and activity index combination would be a useful indicator of wearing-off and dyskinesia and that biometric information from wearable devices may function as a digital diary. Accumulating more cases and collecting additional data are necessary to verify our findings.
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Affiliation(s)
- Hikaru Kamo
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Genko Oyama
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
- Department of Home Medical Care System, Based on Information and Communication Technology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Drug Development for Parkinson's Disease, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of PRO-Based Integrated Data Analysis in Neurological Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yui Yamasaki
- Sunwels Company Limited, Chiyoda-ku, Tokyo, Japan
| | | | | | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
- Department of Home Medical Care System, Based on Information and Communication Technology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Drug Development for Parkinson's Disease, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of PRO-Based Integrated Data Analysis in Neurological Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Research Institute of Disease of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Neurodegenerative Disorders Collaborative Laboratory, RIKEN Center for Brain Science, Saitama, Japan
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Gandhi SE, Zerenner T, Nodehi A, Lawton MA, Marshall V, Al-Hajraf F, Grosset KA, Morris HR, Hu MT, Ben-Shlomo Y, Grosset DG. Motor Complications in Parkinson's Disease: Results from 3343 Patients Followed for up to 12 Years. Mov Disord Clin Pract 2024. [PMID: 38587023 DOI: 10.1002/mdc3.14044] [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] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/26/2024] [Accepted: 03/19/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Motor complications are well recognized in Parkinson's disease (PD), but their reported prevalence varies and functional impact has not been well studied. OBJECTIVES To quantify the presence, severity, impact and associated factors for motor complications in PD. METHODS Analysis of three large prospective cohort studies of recent-onset PD patients followed for up to 12 years. The MDS-UPDRS part 4 assessed motor complications and multivariable logistic regression tested for associations. Genetic risk score (GRS) for Parkinson's was calculated from 79 single nucleotide polymorphisms. RESULTS 3343 cases were included (64.7% male). Off periods affected 35.0% (95% CI 33.0, 37.0) at 4-6 years and 59.0% (55.6, 62.3) at 8-10 years. Dyskinesia affected 18.5% (95% CI 16.9, 20.2) at 4-6 years and 42.1% (38.7, 45.5) at 8-10 years. Dystonia affected 13.4% (12.1, 14.9) at 4-6 years and 22.8% (20.1, 25.9) at 8-10 years. Off periods consistently caused greater functional impact than dyskinesia. Motor complications were more common among those with higher drug doses, younger age at diagnosis, female gender, and greater dopaminergic responsiveness (in challenge tests), with associations emerging 2-4 years post-diagnosis. Higher Parkinson's GRS was associated with early dyskinesia (0.026 ≤ P ≤ 0.050 from 2 to 6 years). CONCLUSIONS Off periods are more common and cause greater functional impairment than dyskinesia. We confirm previously reported associations between motor complications with several demographic and medication factors. Greater dopaminergic responsiveness and a higher genetic risk score are two novel and significant independent risk factors for the development of motor complications.
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Affiliation(s)
- Sacha E Gandhi
- School of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
| | - Tanja Zerenner
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Anahita Nodehi
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Michael A Lawton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Vicky Marshall
- Institute of Neurological Sciences, Glasgow, United Kingdom
| | - Falah Al-Hajraf
- Oxford Parkinson's Disease Centre, Nuffield Department of Clinical Neuroscience, Oxford University, Oxford, United Kingdom
- Department of Pharmacology and Toxicology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Katherine A Grosset
- School of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
| | - Huw R Morris
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Michele T Hu
- Oxford Parkinson's Disease Centre, Nuffield Department of Clinical Neuroscience, Oxford University, Oxford, United Kingdom
| | - Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Donald G Grosset
- School of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
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Sakata M, Miyamoto K, Koh J, Nagashima Y, Kondo T, Ito H. Japanese Mucuna pruriens (Hasshou beans) Showed Fast-acting and Long-lasting Effects in Parkinson's Disease. Intern Med 2024:3171-23. [PMID: 38462520 DOI: 10.2169/internalmedicine.3171-23] [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: 03/12/2024] Open
Abstract
Objective Mucuna pruriens (MP) is a legume whose seeds contain levodopa (LD), which has potential therapeutic effects against Parkinson's disease (PD). However, further research is needed to thoroughly evaluate its efficacy and safety for treating this condition. In this study, we analyzed the pharmacokinetics of MP grown in Japan and investigated its mechanism of action in PD. Methods MP seeds ground after roasting (containing 4.02% LD per MP powder) were used as the reagent and compared with an equivalent LD/carbidopa (CD) preparation. This clinical trial was conducted using a crossover design among PD patients attending our institution. Each patient received a single dose of 100/10 mg LD/CD tablets and 11 g of MP reagent. Results Among the seven patients with PD, MP prolonged the ON time 2-fold compared to LD/CD. The LD concentrations after MP intake were higher than those after LD/CD intake, whereas dyskinesia did not increase. An analysis of the LD metabolites showed that the 3-O-methyl-dopa/LD metabolic ratio was significantly lower after MP ingestion than after LD/CD ingestion, indicating that MP has a catechol-O-methyl transferase inhibitory effect. Conclusions This is the first report of a pharmacokinetic analysis conducted on actual patients with PD showing that MP significantly prolongs the ON time. The advantages of MP as a treatment for PD have been confirmed: it is inexpensive, as effective as LD, works faster and longer than LD, and does not increase dyskinesia.
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Affiliation(s)
- Mayumi Sakata
- Department of Neurology, Wakayama Medical University, Japan
| | | | - Jinsoo Koh
- Department of Neurology, Wakayama Medical University, Japan
| | | | | | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Japan
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LeWitt PA, Stebbins GT, Christensen KV, Tan R, Pretorius A, Thomsen M. Buspirone and Zolmitriptan Combination for Dyskinesia: A Randomized, Controlled, Crossover Study. Mov Disord 2024; 39:613-618. [PMID: 38314643 DOI: 10.1002/mds.29713] [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: 11/13/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Preclinical evidence suggests that co-administration of the 5-HT1A agonist buspirone and the 5-HT1B/1D agonist zolmitriptan act synergistically to reduce dyskinesia to a greater extent than that achieved by either drug alone. OBJECTIVES Assess the therapeutic potential of a fixed-dose buspirone and zolmitriptan combination in Parkinson's disease (PD) patients with levodopa-induced dyskinesia. METHODS Single-center, randomized, placebo-controlled, two-way crossover study (NCT02439203) of a fixed-dose buspirone/zolmitriptan regimen (10/1.25 mg three times a day) in 30 patients with PD experiencing at least moderately disabling peak-effect dyskinesia. RESULTS Seven days of treatment with buspirone/zolmitriptan added to levodopa significantly reduced dyskinesia as assessed by Abnormal Involuntary Movement Scale scores versus placebo (mean treatment effect vs. placebo: -4.2 [-6.1, -2.3]) without significantly worsening Unified Parkinson's Disease Rating Scale (UPDRS) Part III (ON) scores (mean treatment effect vs. placebo: 0.6 [-0.1, 1.3]). No serious adverse events were reported. CONCLUSIONS In this proof-of-concept study, addition of buspirone/zolmitriptan to the patients' PD medication regimen significantly reduced dyskinesia severity without worsening motor function. © 2024 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Peter A LeWitt
- Department of Neurology, Wayne State University School of Medicine and Henry Ford Hospital, Detroit, Michigan, USA
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Riswanto Tan
- Bukwang Pharmaceutical Co., Ltd, Seoul, South Korea
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Kwan C, Frouni I, Bédard D, Hamadjida A, Nuara SG, Gourdon JC, Huot P. The 5-HT 2A/2C inverse agonist nelotanserin alleviates L-DOPA-induced dyskinesia in the MPTP-lesioned marmoset. Eur J Neurosci 2024; 59:1169-1176. [PMID: 37515363 DOI: 10.1111/ejn.16104] [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: 04/19/2023] [Revised: 06/15/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
Nelotanserin is a serotonin 2A and 2C (5-HT2A/2C) inverse agonist that was previously tested in the clinic for rapid-eye movement sleep behaviour disorder and psychosis in patients with Parkinson's disease (PD) dementia. Its effect on L-3,4-dihydroxyphenylalanine (L-DOPA)-induced dyskinesia has however not been investigated. As 5-HT2A antagonism/inverse agonism is a validated approach to alleviate dyskinesia, we undertook the current study to evaluate the anti-dyskinetic potential of nelotanserin in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned marmoset. Parkinsonism was induced in six common marmosets (Callithrix jacchus, three females and three males) that were then chronically treated with L-DOPA to induce dyskinesia. On experimental days, they were administered L-DOPA in combination with vehicle or nelotanserin (0.1, 0.3 and 1 mg/kg) subcutaneously, in a randomised fashion. Dyskinesia and parkinsonism were rated post hoc by a blinded observer. In comparison to vehicle, the addition of nelotanserin 0.3 and 1 mg/kg to L-DOPA diminished peak dose dyskinesia by 47% (P < 0.05) and 69% (P < 0.001). Nelotanserin 0.3 and 1 mg/kg also reduced the severity of global dyskinesia, by 40% (P < 0.01) and 55% (P < 0.001), when compared to vehicle. Nelotanserin 0.1 mg/kg did not alleviate peak dose or global dyskinesia severity. Nelotanserin had no impact on the anti-parkinsonian action of L-DOPA. Our results highlight that nelotanserin may represent an efficacious anti-dyskinetic drug and provide incremental evidence of the potential benefit of 5-HT2A/2C antagonism/inverse agonism for drug-induced dyskinesia in PD.
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Affiliation(s)
- Cynthia Kwan
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, Quebec, Canada
| | - Imane Frouni
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, Quebec, Canada
- Département de Pharmacologie et Physiologie, Université de Montréal, Montreal, Quebec, Canada
| | - Dominique Bédard
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, Quebec, Canada
| | - Adjia Hamadjida
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, Quebec, Canada
| | - Stephen G Nuara
- Comparative Medicine & Animal Resource Centre, McGill University, Montreal, Quebec, Canada
| | - Jim C Gourdon
- Comparative Medicine & Animal Resource Centre, McGill University, Montreal, Quebec, Canada
| | - Philippe Huot
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, Quebec, Canada
- Département de Pharmacologie et Physiologie, Université de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- Movement Disorder Clinic, Division of Neurology, Department of Neurosciences, McGill University Health Centre, Montreal, QC, Canada
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Milanowski J, Nuszkiewicz J, Lisewska B, Lisewski P, Szewczyk-Golec K. Adipokines, Vitamin D, and Selected Inflammatory Biomarkers among Parkinson's Disease Patients with and without Dyskinesia: A Preliminary Examination. Metabolites 2024; 14:106. [PMID: 38392998 PMCID: PMC10890066 DOI: 10.3390/metabo14020106] [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: 12/29/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Parkinson's disease (PD), a widely recognized neurodegenerative disorder, is characterized by a spectrum of symptoms including motor fluctuations and dyskinesia. Neuroinflammation and dysregulation of adipokines are increasingly implicated in the progression of PD. This preliminary study investigated the levels of inflammatory biomarkers and adipokines, namely interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), C-reactive protein (CRP), visfatin, progranulin, and 25(OH)-vitamin D in 52 PD patients, divided equally between those with and without dyskinesia and 26 healthy controls. Significant differences in the levels of IL-6, TNF-α, visfatin, and progranulin were noted between the groups. Patients with dyskinesia exhibited notably higher IL-6 levels compared to controls, and TNF-α was significantly elevated in both PD patient groups relative to the control group. Additionally, visfatin levels were higher in PD patients without dyskinesia as opposed to those with dyskinesia, and progranulin levels were elevated in the non-dyskinetic PD group compared to controls. The findings highlight the potential role of the examined biomarkers in the pathophysiology of PD. Changes in levels of the tested inflammatory biomarkers and adipokines might be associated with Parkinson's disease and its symptoms such as dyskinesia.
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Affiliation(s)
- Jan Milanowski
- Student Research Club of Medical Biology and Biochemistry, Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 24 Karłowicza St., 85-092 Bydgoszcz, Poland
| | - Jarosław Nuszkiewicz
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 24 Karłowicza St., 85-092 Bydgoszcz, Poland
| | - Beata Lisewska
- Medical Center "Neuromed", 14 Jana Biziela St., 85-163 Bydgoszcz, Poland
| | - Paweł Lisewski
- Medical Center "Neuromed", 14 Jana Biziela St., 85-163 Bydgoszcz, Poland
| | - Karolina Szewczyk-Golec
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 24 Karłowicza St., 85-092 Bydgoszcz, Poland
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Andaya PFJ, Diaz ABF. Unveiled: A Case of N-Methyl-D-Aspartate Receptor Antibody Encephalitis With Delayed Diagnosis of Ovarian Teratoma. Cureus 2024; 16:e54486. [PMID: 38516493 PMCID: PMC10954438 DOI: 10.7759/cureus.54486] [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] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
N-methyl-D-aspartate receptor (NMDAR) antibody encephalitis is an autoimmune syndrome with potentially fatal sequelae causing profound dysregulation of neurotransmission. Patients most often present with a constellation of neuropsychiatric signs and symptoms, including behavioral changes, motor disturbances, and seizures. Frequently, the development of anti-NMDAR antibodies has been linked to specific malignancies, although the exact event that triggers the production of these antibodies remains unknown. We present a case of a 25-year-old female who came into the emergency room with behavioral changes and fever. The patient had non-convulsive seizures, catatonia, and orofacial dyskinesias during the course of the admission and was treated as a case of autoimmune anti-NMDAR encephalitis. Cranial and abdominal MRI with contrast initially showed negative results, while the serum and cerebrospinal fluid studies were positive for anti-NMDAR antibodies. The patient was noted to have significant clinical improvement after being treated with high-dose intravenous steroid therapy followed by intravenous immunoglobulin (IVIg) and rituximab infusion. She was discharged stable with the resolution of neurologic symptoms four months after the diagnosis. On follow-up with her neurologist two years later, an abdominal CT scan was done and showed mature cystic teratoma. This is one of the few documented cases of anti-NMDAR encephalitis with a good response to medical treatment but had a delayed diagnosis of ovarian teratoma seen on surveillance work-up years after the diagnosis. A high index of suspicion is warranted for the diagnosis, and treatment should be started early as soon as there is clinical suspicion of the disease. Also, surveillance pelvic or abdominal imaging is important in patients who have negative initial screening but have high risks for teratomas.
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Kozon K, Łysikowska W, Olszewski J, Milanowski Ł, Figura M, Mazurczak T, Hoffman-Zacharska D, Koziorowski D. ADCY5-related dyskinesia - case series with literature review. Neurol Neurochir Pol 2024:VM/OJS/J/97024. [PMID: 38230756 DOI: 10.5603/pjnns.97024] [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: 08/19/2023] [Revised: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024]
Abstract
INTRODUCTION ADCY5-related dyskinesia is a rare neurological disease caused by mutations in the gene encoding the adenylyl cyclase 5 (ADCY5) isoform, a protein that plays an important role in intracellular transmission. Variants in ADCY5 are associated with a spectrum of neurological disease encompassing dyskinesia, chorea, and dystonia. State of the-art. ADCY5 mutations result in clinically heterogeneous manifestations which comprise a range of core and less to highly variable symptoms. Due to the heterogeneous nature and difficulty in diagnosis of the disorder, available treatments are highly limited. CLINICAL IMPLICATIONS ADCY5-related dyskinesia was reported in 52 individuals in the literature over a five-year period (January 2017 to January 2022). We have listed all the symptoms and their frequency. The most common symptom reported in these patients was dystonia. Over 50% of patients developed dyskinesia and chorea. We report two cases of familial occurrence of symptomatic ADCY5-related dyskinesia. A 45-year-old patient presented with involuntary movements which had been occurring since childhood. The proband's neurological examination revealed dysarthria, involuntary myoclonic twitches, and choreic movements. The patient's 9-year-old son had developed involuntary movements, mainly chorea and dystonia. FUTURE DIRECTIONS This paper aims to summarise the recent literature on ADCY5-related neurological disorders and to present a new case of a Polish family with ADCY5 mutation. Genetic diagnostics are important in the context of possible future targeted treatments.
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Affiliation(s)
- Katarzyna Kozon
- Student Scientific Group, Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Weronika Łysikowska
- Student Scientific Group, Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Jakub Olszewski
- Student Scientific Group, Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Milanowski
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Monika Figura
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Mazurczak
- Clinic of Pediatric Neurology, Institute of Mother and Child, Warsaw, Poland
| | | | - Dariusz Koziorowski
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.
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10
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Du X, Wang X, Geng X. Dyskinesia-hyperpyrexia syndrome in Parkinson's disease triggered by overdose of levodopa - a case report and literature review. Front Neurol 2024; 14:1323717. [PMID: 38249748 PMCID: PMC10797022 DOI: 10.3389/fneur.2023.1323717] [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: 10/18/2023] [Accepted: 11/21/2023] [Indexed: 01/23/2024] Open
Abstract
Dyskinesia-hyperpyrexia syndrome, a rare medical emergency in Parkinson's disease, is first described in 2010. It is characterized by severe continuous dyskinesia associated with rhabdomyolysis, hyperthermia and subsequent alteration of the mental state. Gradual reduction of dopaminergic dose or DBS is recommended treatment. The prognosis is usually good, but sometimes fatal. But so far, this potentially fatal complication is not widely recognized by clinicians. In emergency, if clinicians fail to make prompt diagnosis and treatment, patients' conditions may get worse, and their lives may be threatened in serious cases.
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Affiliation(s)
- Xiangnan Du
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xuemei Wang
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaokun Geng
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
- China-America Institute of Neuroscience, Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
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11
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Ji M, Niu SQ, Mi HY, Jiang P, Li Y. Vinpocetine improves dyskinesia in Parkinson's disease rats by reducing oxidative stress and activating the Wnt/β-catenin signaling pathway. Chem Biol Drug Des 2024; 103:e14358. [PMID: 37749299 DOI: 10.1111/cbdd.14358] [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: 06/15/2023] [Revised: 08/21/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023]
Abstract
Parkinson's disease (PD) is the commonest neurodegenerative disorder. It reduces motor and cognitive function in patients. Vinpocetine (Vinp) has the effects of anti-inflammatory and antioxidant, and could improve cognitive function in patients. This study was aimed to investigating the therapeutic effects of Vinp on dyskinesia in a 6-Hydroxydopamine hydrobromide (6-OHDA)-induced PD rat model. We constructed a PD rat model by injecting 6-OHDA, and intervened with Vinp for 7 days. The motor function of the rats was evaluated by an open-field test and rotation test. Besides, H&E staining was applied to observe the changes of dopaminergic neurons in the striatum. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in the rat striatum were detected. We assessed the impact of Vinp on α-synuclein (α-Syn) and Wnt/β-catenin signaling pathway-related molecules by western blot and qRT-PCR. Rats in the PD group showed reduced horizontal movement frequency and number of squares crossed, increased contact time and rotation frequency, and reduced number of dopaminergic neurons accompanied by severe morphological damage. Vinp treatment increased the horizontal movement frequency and number of squares crossed, reduced the contact time, and rotation frequency in PD rats. Also, Vinp downregulated α-Syn protein expression and MDA level, while upregulated SOD activity in the striatum of PD rats. Furthermore, Vinp treatment activated the Wnt/β-catenin signaling pathway in the striatum of PD rats. In conclusion, Vinp improved the dyskinesia in 6-OHDA-induced PD rats by alleviating oxidative stress, and these effects may be associated with activating the Wnt/β-catenin signaling pathway.
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Affiliation(s)
- Meng Ji
- Department of Neurology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Shi-Qin Niu
- Department of Neurology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - He-Yin Mi
- Department of Neurology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Peng Jiang
- Department of Neurology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Yue Li
- Department of Neurology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
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12
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Alsalmi M, Al-Kassmy J, Kang W, Palayew M, Huot P. Levodopa-induced dyskinesia: do current clinical trials hold hope for future treatment? Expert Opin Pharmacother 2024; 25:1-3. [PMID: 38116733 DOI: 10.1080/14656566.2023.2298345] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/19/2023] [Indexed: 12/21/2023]
Affiliation(s)
- Mohammed Alsalmi
- Movement Disorder Clinic, Division of Neurology, Department of Neurosciences, McGill University Health Centre, Montreal, QC, Canada
| | - Jawad Al-Kassmy
- Royal College of Surgeons in Ireland, School of Medicine, Dublin, Ireland
| | - Woojin Kang
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, Canada
| | - Michael Palayew
- Royal College of Surgeons in Ireland, School of Medicine, Dublin, Ireland
| | - Philippe Huot
- Movement Disorder Clinic, Division of Neurology, Department of Neurosciences, McGill University Health Centre, Montreal, QC, Canada
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
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Cirillo R, Duperrier S, Parekh P, Millot M, Li Q, Thiolat ML, Morelli M, Xie J, Le Bars D, Redouté J, Bezard E, Sgambato V. Striatal Serotonin 4 Receptor is Increased in Experimental Parkinsonism and Dyskinesia. J Parkinsons Dis 2024; 14:261-267. [PMID: 38339940 DOI: 10.3233/jpd-230331] [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] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Alterations of serotonin type 4 receptor levels are linked to mood disorders and cognitive deficits in several conditions. However, few studies have investigated 5-HT4R alterations in movement disorders. We wondered whether striatal 5-HT4R expression is altered in experimental parkinsonism. We used a brain bank tissue from a rat and a macaque model of Parkinson's disease (PD). We then investigated its in vivo PET imaging regulation in a cohort of macaques. Dopaminergic depletion increases striatal 5-HT4R in the two models, further augmented after dyskinesia-inducing L-Dopa. Pending confirmation in PD patients, the 5-HT4R might offer a therapeutic target for dampening PD's symptoms.
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Affiliation(s)
- Rossella Cirillo
- Institut des Sciences Cognitives Marc Jeannerod (ISCMJ), Unité Mixte de Recherche 5229 du Centre National de la Recherche Scientifique (CNRS), Bron, France
- Universitè de Lyon 1, Lyon, France
| | - Sandra Duperrier
- Institut des Sciences Cognitives Marc Jeannerod (ISCMJ), Unité Mixte de Recherche 5229 du Centre National de la Recherche Scientifique (CNRS), Bron, France
- Universitè de Lyon 1, Lyon, France
| | - Pathik Parekh
- Institut des Sciences Cognitives Marc Jeannerod (ISCMJ), Unité Mixte de Recherche 5229 du Centre National de la Recherche Scientifique (CNRS), Bron, France
- Universitè de Lyon 1, Lyon, France
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Monserrato, Italy
| | - Mathilde Millot
- Institut des Sciences Cognitives Marc Jeannerod (ISCMJ), Unité Mixte de Recherche 5229 du Centre National de la Recherche Scientifique (CNRS), Bron, France
- Universitè de Lyon 1, Lyon, France
| | - Qin Li
- Motac Beijing Services, Beijing, China
| | - Marie-Laure Thiolat
- Universitè de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux, France
- CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Micaela Morelli
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Monserrato, Italy
| | - Jing Xie
- Institut des Sciences Cognitives Marc Jeannerod (ISCMJ), Unité Mixte de Recherche 5229 du Centre National de la Recherche Scientifique (CNRS), Bron, France
- Institut du Vieillissement, Centrede Recherche Clinique Vieillissement Cerveau Fragilité, Hôpital des Charpennes, Villeurbanne, France
| | | | | | - Erwan Bezard
- Motac Beijing Services, Beijing, China
- Universitè de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux, France
- CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Véronique Sgambato
- Institut des Sciences Cognitives Marc Jeannerod (ISCMJ), Unité Mixte de Recherche 5229 du Centre National de la Recherche Scientifique (CNRS), Bron, France
- Universitè de Lyon 1, Lyon, France
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14
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Dias CMV, Leal DAB, Brys I. Levodopa-induced dyskinesia is preceded by increased levels of anxiety and motor impairment in Parkinson's disease patients. Int J Neurosci 2023; 133:1319-1325. [PMID: 35603453 DOI: 10.1080/00207454.2022.2079501] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
Introduction: Dopamine replacement therapy with levodopa is the gold standard treatment of Parkinson's disease (PD); however long-term levodopa use is associated with abnormal involuntary movements known as levodopa-induced dyskinesia (LID) in most patients. LID is not preventable and represents the major limitation of PD treatment.Objective: This study was aimed to find clinical and behavioral features that could be used to identify, years in advance, PD patients that are at high risk of developing LID in the future. Method: Data from PD patients enrolled in The Parkinson's progression markers initiative (PPMI, Michael J. Fox Foundation) that developed dyskinesia during their participation in the study were compared with those who did not, and with healthy controls.Result: LID was preceded byhigher levels of trait anxiety and increased motor impairment in PD patients. Additionally, younger age at PD diagnosis, earlier need for dopaminergic therapy and higher initial levodopa dose, were associated with future development of dyskinesia.Conclusion: These findings suggest that easily detectable clinical and behavioral alterations may help to identify PD patients that are more susceptible to develop LID.
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Affiliation(s)
- Carla M V Dias
- Research Group in Neuroscience and Experimental Psychology, Petrolina, Pernambuco, Brazil
- Postgraduate Program in Psychology, Federal University of Vale do São Francisco (UNIVASF), Petrolina, Brazil
| | - Denisson A B Leal
- Research Group in Neuroscience and Experimental Psychology, Petrolina, Pernambuco, Brazil
- Postgraduate Program in Health and Biological Sciences, Federal University of Vale do São Francisco (UNIVASF), Petrolina, Brazil
| | - Ivani Brys
- Research Group in Neuroscience and Experimental Psychology, Petrolina, Pernambuco, Brazil
- Postgraduate Program in Psychology, Federal University of Vale do São Francisco (UNIVASF), Petrolina, Brazil
- Postgraduate Program in Health and Biological Sciences, Federal University of Vale do São Francisco (UNIVASF), Petrolina, Brazil
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Pogorelov VM, Martini ML, Jin J, Wetsel WC, Caron MG. Dopamine-Depleted Dopamine Transporter Knockout (DDD) Mice: Dyskinesia with L-DOPA and Dopamine D1 Agonists. Biomolecules 2023; 13:1658. [PMID: 38002340 PMCID: PMC10669682 DOI: 10.3390/biom13111658] [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: 10/02/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
L-DOPA is the mainstay of treatment for Parkinson's disease (PD). However, over time this drug can produce dyskinesia. A useful acute PD model for screening novel compounds for anti-parkinsonian and L-DOPA-induced dyskinesia (LID) are dopamine-depleted dopamine-transporter KO (DDD) mice. Treatment with α-methyl-para-tyrosine rapidly depletes their brain stores of DA and renders them akinetic. During sensitization in the open field (OF), their locomotion declines as vertical activities increase and upon encountering a wall they stand on one leg or tail and engage in climbing behavior termed "three-paw dyskinesia". We have hypothesized that L-DOPA induces a stereotypic activation of locomotion in DDD mice, where they are unable to alter the course of their locomotion, and upon encountering walls engage in "three-paw dyskinesia" as reflected in vertical counts or beam-breaks. The purpose of our studies was to identify a valid index of LID in DDD mice that met three criteria: (a) sensitization with repeated L-DOPA administration, (b) insensitivity to a change in the test context, and (c) stimulatory or inhibitory responses to dopamine D1 receptor agonists (5 mg/kg SKF81297; 5 and 10 mg/kg MLM55-38, a novel compound) and amantadine (45 mg/kg), respectively. Responses were compared between the OF and a circular maze (CM) that did not hinder locomotion. We found vertical counts and climbing were specific for testing in the OF, while oral stereotypies were sensitized to L-DOPA in both the OF and CM and responded to D1R agonists and amantadine. Hence, in DDD mice oral stereotypies should be used as an index of LID in screening compounds for PD.
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Affiliation(s)
- Vladimir M. Pogorelov
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 354 Sands Building, 303 Research Drive, Durham, NC 27710, USA
| | - Michael L. Martini
- Mount Sinai Center for Therapeutics Discovery, Departments of Pharmacological Sciences and Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.L.M.); (J.J.)
| | - Jian Jin
- Mount Sinai Center for Therapeutics Discovery, Departments of Pharmacological Sciences and Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.L.M.); (J.J.)
| | - William C. Wetsel
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 354 Sands Building, 303 Research Drive, Durham, NC 27710, USA
- Department of Cell Biology, Duke University Medical Center, Durham, NC 27710, USA;
- Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Marc G. Caron
- Department of Cell Biology, Duke University Medical Center, Durham, NC 27710, USA;
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Liu Z, Zhou Y, Gao Y, Hu X. Editorial: Insights into the use of deep brain stimulation as a treatment for Parkinson's disease and related conditions. Front Neurosci 2023; 17:1322091. [PMID: 38033545 PMCID: PMC10684966 DOI: 10.3389/fnins.2023.1322091] [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] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Affiliation(s)
- Zhi Liu
- Neurosurgery Department, The First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Yi Zhou
- Department of Neurology, 980 Hospital of PLA Joint Logistics Support Forces, Shijiazhuang, Hebei, China
| | - Ya Gao
- Neuroscience Institute, Dietrich College of Humanities and Social Sciences, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Xiaofei Hu
- Department of Nuclear Medicine, Southwest Hospital, Army Medical University, Chongqing, China
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Reichmann H. Real-world considerations regarding the use of the combination of levodopa, carbidopa, and entacapone (Stalevo ® ) in Parkinson's disease. Eur J Neurol 2023; 30 Suppl 2:15-20. [PMID: 37489705 DOI: 10.1111/ene.15992] [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] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/22/2023] [Indexed: 07/26/2023]
Abstract
An important aim in long-term levodopa therapy is to prolong the duration of symptomatic efficacy of each dose without increasing peak plasma concentrations above the threshold for the emergence of dyskinesias. One strategy is to enhance levodopa delivery to the brain by co-administering it with inhibitors of peripheral dopa-decarboxylase and catechol-O-methyltransferase (COMT). Levodopa, carbidopa and entacapone (LCE), available in a range of fixed-dose combinations as the branded formulation Stalevo® (Orion Pharma), has been developed to address this requirement and has been in general use for 20 years, having first been evaluated in randomized controlled trials. Experience with LCE has established that improved levodopa pharmacokinetics achieved with dual-enzyme inhibition are translated into improved clinical efficacy, including the possibility of reducing total levodopa dosage with no loss of therapeutic effect. The ease and tolerability of switching to LCE has been affirmed in the SIMCOM trial and by personal experience detailed in this review. Some 300,000 patient-years of safety data are available for LCE, including trial data for up to 5 years. Most adverse effects associated with LCE are attributable to the levodopa component rather than the enzyme inhibitors. The hepatotoxicity observed with the class comparator tolcapone has not been observed with entacapone, the COMT inhibitor in LCE, and there is no formal requirement to monitor liver function during LCE therapy. Other common side effects include diarrhoea, which is one of the more prominent non-dopaminergic adverse events, and urine discolouration, which is harmless but about which patients may require reassurance.
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Affiliation(s)
- Heinz Reichmann
- Department of Neurology, Technical University Dresden, Dresden, Germany
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18
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Liang Y, Li B, Ou D, Li G, Zeng H. Neurosyphilis with oral‑facial‑lingual dyskinesia: A case report. Exp Ther Med 2023; 26:520. [PMID: 37854505 PMCID: PMC10580249 DOI: 10.3892/etm.2023.12219] [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: 03/01/2023] [Accepted: 08/31/2023] [Indexed: 10/20/2023] Open
Abstract
The present study describes the case of a 52-year-old male patient who presented with subacute onset dysarthria and oral-facial-lingual dyskinesia, with normal blood glucose and acanthocyte levels, and no history of drug use. The patient tested negative for autoimmune encephalitis-related antibodies and paraneoplastic-related antibodies. The level of cerebrospinal fluid (CSF) protein was slightly elevated, and the Treponema pallidum hemagglutination assay and rapid plasma reagin test were positive in both serum and CSF samples. After 1 month of treatment with doxycycline, the patient's oral-facial-lingual dyskinesia was significantly improved, suggesting the diagnosis of neurosyphilis.
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Affiliation(s)
- Yingfang Liang
- Department of Comprehensive Internal Medicine, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530022, P.R. China
| | - Bixun Li
- Department of Comprehensive Internal Medicine, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530022, P.R. China
| | - Danyan Ou
- Department of Comprehensive Internal Medicine, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530022, P.R. China
| | - Guoliang Li
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Hao Zeng
- Department of Spine and Osteopathy Surgery, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi 530022, P.R. China
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Basoya S, Kumar S, Wanjari A. Cerebral Palsy: A Narrative Review on Childhood Disorder. Cureus 2023; 15:e49050. [PMID: 38116360 PMCID: PMC10728574 DOI: 10.7759/cureus.49050] [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: 10/22/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023] Open
Abstract
Cerebral palsy, one of the most common reasons for infirmity in children and young people in developed countries, refers to several neurological diseases that impact movement and coordination. Central nervous system damage received during the first stages of brain development can cause cerebral palsy, a non-progressive condition that manifests as impairments of movement and posture. Two cases per 1000 are reported, and the causes include those mentioned for high-risk infants. Mental retardation, sensory deficiencies, failure to thrive, seizures, and behavioral or emotional issues are some of the associated difficulties. To enable interdisciplinary intervention, early identification is crucial. The result varies depending on the topography, severity, and presence of concomitant abnormalities in cerebral palsy. Cerebral palsy is caused by a static injury to the cerebral motor cortex that happens before, during, or within five years after birth. Various circumstances can influence the disease, including cerebral anoxia, cerebral hemorrhage, infection, and hereditary disorders. Interventions for children are typically provided as part of multidisciplinary rehabilitation programs. Musculoskeletal complaints are common, and pain is a significant underreported symptom.
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Affiliation(s)
- Sakshi Basoya
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sunil Kumar
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anil Wanjari
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Morales-Casado MI, García-Meléndez DD, Diezma-Martín A, López-Ariztegui N. Effectiveness and safety of safinamide in the Toledo Movement Disorders Unit. Rev Neurol 2023; 77:S1-S7. [PMID: 37882094 PMCID: PMC10831716 DOI: 10.33588/rn.77s03.2023212] [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: 10/04/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION The management of motor fluctuations in Parkinson's disease (PD) can be challenging, and current therapeutic options include the use of monoamine oxidase B inhibitors (MAO-B inhibitors), among others. The aim of this study was to evaluate the effectiveness and safety of safinamide in the clinical practice carried out in the Toledo Movement Disorders Unit. PATIENTS AND METHODS This is a retrospective study in which data were collected at baseline and at six months from PD patients who were started on safinamide as an add-on therapy with a stable dose of levodopa in line with standard clinical practice. An analysis was performed by subgroups: patients who were given low-dose safinamide and patients who previously received rasagiline. RESULTS Ninety patients (47 previously received rasagiline) completed the six-month follow-up. A statistically significant decrease in morning akinesia, nocturnal akinesia, wearing off, unpredictable off phenomenon and Unified Parkinson's Disease Rating Scale-III was observed both in those who previously received rasagiline and in those treated with low doses of safinamide. No variation was found in the dyskinesias. The adverse events described were mild, with generalised weakness, dizziness, nausea, headache and alopecia. CONCLUSIONS Safinamide has been shown to be effective and safe in improving motor fluctuations, motor symptoms and the subjective perception of disease severity in PD patients previously receiving rasagiline and in those receiving low-dose safinamide, all of which is accompanied by a good safety profile.
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Affiliation(s)
| | | | - A Diezma-Martín
- Complejo Hospitalario Universitario de Toledo, Toledo, España
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21
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Reis‐Carneiro D, Velon AG, Araújo R. Clebopride-Associated Movement Disorders. Mov Disord Clin Pract 2023; 10:1562-1563. [PMID: 37868913 PMCID: PMC10585958 DOI: 10.1002/mdc3.13866] [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] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/20/2023] [Accepted: 08/05/2023] [Indexed: 10/24/2023] Open
Affiliation(s)
- Diogo Reis‐Carneiro
- Neurology DepartmentCentro Hospitalar e Universitário de CoimbraCoimbraPortugal
- Faculty of MedicineUniversity of CoimbraCoimbraPortugal
| | - Ana Graça Velon
- Neurology DepartmentCentro Hospitalar de Trás‐os‐Montes e Alto DouroVila RealPortugal
| | - Rui Araújo
- Department of NeurologyCentro Hospitalar Universitário São JoãoPortoPortugal
- Department of Clinical Neurosciences and Mental Health, Faculty of MedicineUniversity of PortoPortoPortugal
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Kambey PA, Liu WY, Wu J, Tang C, Buberwa W, Saro A, Nyalali AMK, Gao D. Amphiregulin blockade decreases the levodopa-induced dyskinesia in a 6-hydroxydopamine Parkinson's disease mouse model. CNS Neurosci Ther 2023; 29:2925-2939. [PMID: 37101388 PMCID: PMC10493657 DOI: 10.1111/cns.14229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/09/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Levodopa (L-DOPA) is considered the most reliable drug for treating Parkinson's disease (PD) clinical symptoms. Regrettably, long-term L-DOPA therapy results in the emergence of drug-induced abnormal involuntary movements (AIMs) in most PD patients. The mechanisms underlying motor fluctuations and dyskinesia induced by L-DOPA (LID) are still perplexing. METHODS Here, we first performed the analysis on the microarray data set (GSE55096) from the gene expression omnibus (GEO) repository and identified the differentially expressed genes (DEGs) using linear models for microarray analysis (Limma) R packages from the Bioconductor project. 12 genes (Nr4a2, Areg, Tinf2, Ptgs2, Pdlim1, Tes, Irf6, Tgfb1, Serpinb2, Lipg, Creb3l1, Lypd1) were found to be upregulated. Six genes were validated on quantitative polymerase chain reaction and subsequently, Amphiregulin (Areg) was selected (based on log2 fold change) for further experiments to unravel its involvement in LID. Areg LV_shRNA was used to knock down Areg to explore its therapeutic role in the LID model. RESULTS Western blotting and immunofluorescence results show that AREG is significantly expressed in the LID group relative to the control. Dyskinetic movements in LID mice were alleviated by Areg knockdown, and the protein expression of delta FOSB, the commonly attributable protein in LID, was decreased. Moreover, Areg knockdown reduced the protein expression of P-ERK. In order to ascertain whether the inhibition of the ERK pathway (a common pathway known to mediate levodopa-induced dyskinesia) could also impede Areg, the animals were injected with an ERK inhibitor (PD98059). Afterward, the AIMs, AREG, and ERK protein expression were measured relative to the control group. A group treated with ERK inhibitor had a significant decrease of AREG and phosphorylated ERK protein expression relative to the control group. CONCLUSION Taken together, our results indicate unequivocal involvement of Areg in levodopa-induced dyskinesia, thus a target for therapy development.
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Affiliation(s)
- Piniel Alphayo Kambey
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and AnatomyXuzhou Medical UniversityXuzhouChina
- Organization of African Academic Doctors (OAAD)NairobiKenya
| | - Wen Ya Liu
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and AnatomyXuzhou Medical UniversityXuzhouChina
| | - Jiao Wu
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and AnatomyXuzhou Medical UniversityXuzhouChina
| | - Chuanxi Tang
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and AnatomyXuzhou Medical UniversityXuzhouChina
| | - Wokuheleza Buberwa
- Department of PediatricsThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Adonira Saro
- Department of Anatomy and Neurobiology, School of Basic Medical ScienceCentral South UniversityChangshaChina
| | - Alphonce M. K. Nyalali
- Department of Neurosurgery, Shandong Cancer Hospital and InstituteShandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Dianshuai Gao
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and AnatomyXuzhou Medical UniversityXuzhouChina
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Rissardo JP, Medeiros Araujo de Matos U, Fornari Caprara AL. Gabapentin-Associated Movement Disorders: A Literature Review. Medicines (Basel) 2023; 10:52. [PMID: 37755242 PMCID: PMC10536490 DOI: 10.3390/medicines10090052] [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] [Received: 06/24/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Gabapentin (GBP)-induced movement disorders (MDs) are under-recognized adverse drug reactions. They are commonly not discussed with patients, and their sudden occurrence can lead to misdiagnosis. This literature review aims to evaluate the clinical-epidemiological profile, pathological mechanisms, and management of GBP-associated MD. METHODS Two reviewers identified and assessed relevant reports in six databases without language restriction between 1990 and 2023. RESULTS A total of 99 reports of 204 individuals who developed a MD associated with GBP were identified. The MDs encountered were 135 myoclonus, 22 dyskinesias, 7 dystonia, 3 akathisia, 3 stutterings, 1 myokymia, and 1 parkinsonism. The mean and median ages were 54.54 (SD: 17.79) and 57 years (age range: 10-89), respectively. Subjects were predominantly male (53.57%). The mean and median doses of GBP when the MD occurred were 1324.66 (SD: 1117.66) and 1033 mg/daily (GBP dose range: 100-9600), respectively. The mean time from GBP-onset to GBP-associated MD was 4.58 weeks (SD: 8.08). The mean recovery time after MD treatment was 4.17 days (SD: 4.87). The MD management involved GBP discontinuation. A total of 82.5% of the individuals had a full recovery in the follow-up period. CONCLUSIONS Myoclonus (GRADE A) and dyskinesia (GRADE C) were the most common movement disorders associated with GBP.
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Remz MA, Wong JK, Hilliard JD, Tholanikunnel T, Rawls AE, Okun MS. Identification and Management of Persistent Stimulation-Induced Dyskinesia Associated with STN DBS: The See-Saw Dilemma. Tremor Other Hyperkinet Mov (N Y) 2023; 13:28. [PMID: 37663531 PMCID: PMC10473163 DOI: 10.5334/tohm.780] [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: 06/01/2023] [Accepted: 08/05/2023] [Indexed: 09/05/2023] Open
Abstract
Clinical vignette A 73-year-old woman with Parkinson's disease (PD) underwent implantation of bilateral subthalamic nucleus deep brain stimulators (STN-DBS) to address bilateral upper extremity medication-refractory tremor. Post-operatively, she experienced a "see-saw effect" where small increases in stimulation resulted in improvement in one symptom (tremor) with concurrent worsening in another (dyskinesia). Clinical dilemma SID is usually considered a positive predictor of DBS outcome. However, there are cases where SID cannot be optimized. Lead location and pre-operative characteristics may contribute to this adverse effect. If the combination of programming and medication adjustments fails to resolve SID, what can be done to "rescue" the outcome? Clinical solution Management of SID requires a gradual and steadfast programming approach. Post-operative lead localization can guide advanced programming and decision-making. Rescue surgical interventions may be considered. Gap in knowledge In cases where SID is persistent despite deploying persistent optimization strategies, there is limited guidance on next steps.
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Affiliation(s)
- Matthew A. Remz
- Fixel Institute for Neurological Diseases Campus, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Joshua K. Wong
- Fixel Institute for Neurological Diseases Campus, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Justin D. Hilliard
- Fixel Institute for Neurological Diseases Campus, University of Florida, Gainesville, FL, USA
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Tracy Tholanikunnel
- Fixel Institute for Neurological Diseases Campus, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Ashley E. Rawls
- Fixel Institute for Neurological Diseases Campus, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Michael S. Okun
- Fixel Institute for Neurological Diseases Campus, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
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Rissardo JP, Vora N, Mathew B, Kashyap V, Muhammad S, Fornari Caprara AL. Overview of Movement Disorders Secondary to Drugs. Clin Pract 2023; 13:959-976. [PMID: 37623268 PMCID: PMC10453030 DOI: 10.3390/clinpract13040087] [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: 07/16/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023] Open
Abstract
Drug-induced movement disorders affect a significant percentage of individuals, and they are commonly overlooked and underdiagnosed in clinical practice. Many comorbidities can affect these individuals, making the diagnosis even more challenging. Several variables, including genetics, environmental factors, and aging, can play a role in the pathophysiology of these conditions. The Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Statistical Classification of Diseases and Related Health Problems (ICD) are the most commonly used classification systems in categorizing drug-induced movement disorders. This literature review aims to describe the abnormal movements associated with some medications and illicit drugs. Myoclonus is probably the most poorly described movement disorder, in which most of the reports do not describe electrodiagnostic studies. Therefore, the information available is insufficient for the diagnosis of the neuroanatomical source of myoclonus. Drug-induced parkinsonism is rarely adequately evaluated but should be assessed with radiotracers when these techniques are available. Tardive dyskinesias and dyskinesias encompass various abnormal movements, including chorea, athetosis, and ballism. Some authors include a temporal relationship to define tardive syndromes for other movement disorders, such as dystonia, tremor, and ataxia. Antiseizure medications and antipsychotics are among the most thoroughly described drug classes associated with movement disorders.
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Affiliation(s)
| | - Nilofar Vora
- Medicine Department, Terna Speciality Hospital and Research Centre, Navi Mumbai 400706, India;
| | - Bejoi Mathew
- Medicine Department, Sri Devaraj Urs Medical College, Kolar Karnataka 563101, India;
| | - Vikas Kashyap
- Medicine Department, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India;
| | - Sara Muhammad
- Neurology Department, Mayo Clinic, Rochester, MN 55906, USA;
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Dhar SK, Jafri AD, Fatima K, Samant S, Samal S, Maiti S. Study of Involuntary Limb Movements as a Presenting Feature in Nonketotic Hyperglycemia. Cureus 2023; 15:e43579. [PMID: 37719546 PMCID: PMC10503595 DOI: 10.7759/cureus.43579] [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] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
Background Hyperglycaemia can rarely manifest as hemichorea/hemiballismus, which subsides with adequate control of blood sugar. Our study accounted for patients with abnormal, involuntary limb movements with high blood sugar, excluding other conditions leading to or mimicking such a clinical appearance. It is very important to identify such patients as chorea secondary to an underlying etiology like hyperglycemia, which can be cured. Material & methods This study was done in IMS & SUM Hospital for a duration of one year, from March 2019 to February 2020, with a total of 11 cases with abnormal limb movements with a blood sugar of 250 mg% and above. Results In this study, 36.36%( n=4) of patients were female, and 63.63% (n=7) were males. The mean age of the patients at presentation was 66.5 years. Eighteen point one percent (18.1%; n=2) of the patients showed hemiballismus, 36.3% (n=4) showed hemichorea, 18.1% (n=2) showed hemiathetosis, 9.1% (n=1) showed myoclonus, and 18.1% (n=2) showed hemiballismus with hemichorea. The mean duration to correct hyperglycemia was found to be 34 hours and the mean duration to correct abnormal limb movements was 90.54 hours. Eighty-one point eight percent (81.8%; n=9) of patients showed basal ganglia changes on brain imaging.
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Affiliation(s)
- Srikant K Dhar
- Department of Medicine, Institute of Medical Sciences (IMS) and SUM Hospital, Bhubaneshwar, IND
| | - Asif D Jafri
- Department of Medicine, SUM Ultimate Hospital, Bhubaneshwar, IND
| | - Kaneez Fatima
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Swati Samant
- Department of Ophthalmology, Institute of Medical Sciences (IMS) and SUM Hospital, Bhubaneswar, IND
| | - Sonam Samal
- Department of Medicine, Institute of Medical Sciences (IMS) and SUM Hospital, Bhubaneswar, IND
| | - Sourav Maiti
- Department of Medicine, Institute of Medical Sciences (IMS) and SUM Hospital, Bhubaneswar, IND
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Qu Y, Zhang T, Duo Y, Chen L, Li X. Identification and quantitative assessment of motor complications in Parkinson's disease using the Parkinson's KinetiGraph™. Front Aging Neurosci 2023; 15:1142268. [PMID: 37593376 PMCID: PMC10427502 DOI: 10.3389/fnagi.2023.1142268] [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: 01/11/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
Introduction Effective management and therapies for the motor complications of Parkinson's disease (PD) require appropriate clinical evaluation. The Parkinson's KinetiGraph™ (PKG) is a wearable biosensor system that can record the motion characteristics of PD objectively and remotely. Objective The study aims to investigate the value of PKG in identifying and quantitatively assessing motor complications including motor fluctuations and dyskinesia in the Chinese PD population, as well as the correlation with the clinical scale assessments. Methods Eighty-four subjects with PD were recruited and continuously wore the PKG for 7 days. Reports with 7-day output data were provided by the manufacturer, including the fluctuation scores (FS) and dyskinesia scores (DKS). Specialists in movement disorders used the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-IV (MDS-UPDRS IV), the wearing-off questionnaire 9 (WOQ-9), and the unified dyskinesia rating scale (UDysRS) for the clinical assessment of motor complications. Spearman correlation analyses were used to evaluate the correlation between the FS and DKS recorded by the PKG and the clinical scale assessment results. Receiver operating characteristic (ROC) curves were generated to analyze the sensitivity and specificity of the FS and DKS scores in the identification of PD motor complications. Results The FS was significantly positively correlated with the MDS-UPDRS IV motor fluctuation (items 4.3-4.5) scores (r = 0.645, p < 0.001). ROC curve analysis showed a maximum FS cut-off value of 7.5 to identify motor fluctuation, with a sensitivity of 74.3% and specificity of 87.8%. The DKS was significantly positively correlated with the UDysRS total score (r = 0.629, p < 0.001) and the UDysRS III score (r = 0.634, p < 0.001). ROC curve analysis showed that the maximum DKS cut-off value for the diagnosis of dyskinesia was 0.7, with a sensitivity of 83.3% and a specificity of 83.3%. Conclusion The PKG assessment of motor complications in the PD population analyzed in this study has a significant correlation with the clinical scale assessment, high sensitivity, and high specificity. Compared with clinical evaluations, PKG can objectively, quantitatively, and remotely identify and assess motor complications in PD, providing a good objective recording for managing motor complications.
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Affiliation(s)
- Yan Qu
- Department of Neurology, Affiliated Dalian Municipal Friendship Hospital of Dalian Medical University, Dalian, China
| | - Tingting Zhang
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yunyan Duo
- Department of Neurology, Affiliated Dalian Municipal Friendship Hospital of Dalian Medical University, Dalian, China
| | - Liling Chen
- Department of Neurology, Affiliated Dalian Municipal Friendship Hospital of Dalian Medical University, Dalian, China
| | - Xiaohong Li
- Department of Neurology, Affiliated Dalian Municipal Friendship Hospital of Dalian Medical University, Dalian, China
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Lopez-Lopez A, Valenzuela R, Rodriguez-Perez AI, Guerra MJ, Labandeira-Garcia JL, Muñoz A. Interactions between Angiotensin Type-1 Antagonists, Statins, and ROCK Inhibitors in a Rat Model of L-DOPA-Induced Dyskinesia. Antioxidants (Basel) 2023; 12:1454. [PMID: 37507992 PMCID: PMC10376833 DOI: 10.3390/antiox12071454] [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] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Statins have been proposed for L-DOPA-induced dyskinesia (LID) treatment. Statin anti-dyskinetic effects were related to the inhibition of the Ras-ERK pathway. However, the mechanisms responsible for the anti-LID effect are unclear. Changes in cholesterol homeostasis and oxidative stress- and inflammation-related mechanisms such as angiotensin II and Rho-kinase (ROCK) inhibition may be involved. The nigra and striatum of dyskinetic rats showed increased levels of cholesterol, ROCK, and the inflammatory marker IL-1β, which were reduced by the angiotensin type-1 receptor (AT1) antagonist candesartan, simvastatin, and the ROCK inhibitor fasudil. As observed for LID, angiotensin II-induced, via AT1, increased levels of cholesterol and ROCK in the rat nigra and striatum. In cultured dopaminergic neurons, angiotensin II increased cholesterol biosynthesis and cholesterol efflux without changes in cholesterol uptake. In astrocytes, angiotensin induced an increase in cholesterol uptake, decrease in biosynthesis, and no change in cholesterol efflux, suggesting a neuronal accumulation of cholesterol that is reduced via transfer to astrocytes. Our data suggest mutual interactions between angiotensin/AT1, cholesterol, and ROCK pathways in LID, which are attenuated by the corresponding inhibitors. Interestingly, these three drugs have also been suggested as neuroprotective treatments against Parkinson's disease. Therefore, they may reduce dyskinesia and the progression of the disease using common mechanisms.
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Affiliation(s)
- Andrea Lopez-Lopez
- Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Rita Valenzuela
- Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Ana Isabel Rodriguez-Perez
- Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - María J Guerra
- Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Jose Luis Labandeira-Garcia
- Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Ana Muñoz
- Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
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Vekhande C, Hamed M, Tremain G, Mah J, Shetty A, Lazarescu A, Suchowersky O. Levodopa-Carbidopa Intestinal Gel for Parkinson's Disease over 11 years: One Center's "Real-World" Experience. Can J Neurol Sci 2023:1-8. [PMID: 37462070 DOI: 10.1017/cjn.2023.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND Levodopa-carbidopa intestinal gel (LCIG) therapy has been shown to be a safe and effective treatment for advanced Parkinson's disease (PD). Limited data are available regarding long-term benefits and complications in Canada. Objective of the study was to review long-term experience and clinical outcomes in PD patients with LCIG therapy over 11 years in a multidisciplinary University clinic setting. METHODS Chart review was done on PD patients with LCIG from 2011 to 2022. Data collected: dosing, UPDRS-III motor scores, OFF times, hours with dyskinesias, MoCA, complications, discontinuation reasons, and nursing time requirements. RESULTS Thirty-three patients received LCIG therapy with a mean follow-up of 3.25±2.09 years. UPDRS-III scores showed reduction of 15% from baseline (mean 35.9) up to 4 years (mean 30.4). Daily OFF time improved from baseline (mean 7.1 ± 3.13 hours) up to 5 years (mean 3.3 ± 2.31 hours; -53.5%; p < 0.048), and dyskinesias remained stable. Nursing time averaged 22 hours per patient per year after PEG-J insertion and titration. Most common complications were PEG-J tube dislodgement and stoma site infection (0-3zero to three events/patient/year). Serious side effects were seen in four (12%) patients resulting in hospitalization and/or death. Nine patients (27.2%) discontinued the treatment due to lack of improved efficacy over oral therapy or development of dementia and 10 (30%) died of causes unrelated to LCIG infusion. CONCLUSION Patients on LCIG showed improved motor function over 5-year follow-up. Serious complications were uncommon. Dedicated nursing time is required by LCIG-trained nurses in a multidisciplinary setting for optimum management.
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Affiliation(s)
- Chetan Vekhande
- Department of Medicine (Neurology), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Moath Hamed
- Department of Neuroscience, NYP Brooklyn, Methodist Hospital, New York, NY, USA
| | - Genise Tremain
- Movement Disorders Program, Kaye Edmonton Clinic, Alberta Heath Services, Edmonton, AB, Canada
| | - Jennifer Mah
- Movement Disorders Program, Kaye Edmonton Clinic, Alberta Heath Services, Edmonton, AB, Canada
| | - Aakash Shetty
- Department of Medicine (Neurology), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Adriana Lazarescu
- Department of Medicine (Gastroenterology), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Oksana Suchowersky
- Department of Medicine (Neurology), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Movement Disorders Program, Kaye Edmonton Clinic, Alberta Heath Services, Edmonton, AB, Canada
- Department of Pediatrics, Psychiatry and Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Menon PJ, Nilles C, Silveira‐Moriyama L, Yuan R, de Gusmao CM, Münchau A, Carecchio M, Grossman S, Grossman G, Méneret A, Roze E, Pringsheim T. Scoping Review on ADCY5-Related Movement Disorders. Mov Disord Clin Pract 2023; 10:1048-1059. [PMID: 37476318 PMCID: PMC10354615 DOI: 10.1002/mdc3.13796] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/29/2023] [Accepted: 05/04/2023] [Indexed: 07/22/2023] Open
Abstract
Background Adenylyl cyclase 5 (ADCY5)-related movement disorder (ADCY5-RMD) is a rare, childhood-onset disease resulting from pathogenic variants in the ADCY5 gene. The clinical features, diagnostic options, natural history, and treatments for this disease are poorly characterized and have never been established through a structured approach. Objective This scoping review attempts to summarize all available clinical literature on ADCY5-RMD. Methods Eighty-seven articles were selected for inclusion in this scoping review. The majority of articles identified were case reports or case series. Results These articles demonstrate that patients with ADCY5-RMD suffer from permanent and/ or paroxysmal hyperkinetic movements. The paroxysmal episodes can be worsened by environmental triggers, in particular the sleep-wake transition phase in the early morning. Occurrence of nocturnal paroxysmal dyskinesias and perioral twitches are highly suggestive of the diagnosis when present. In the majority of patients intellectual capacity is preserved. ADCY5-RMD is considered a non-progressive disorder, with inter-individual variations in evolution with aging. Somatic mosaicism, mode of inheritance and the location of the mutation within the protein can influence phenotype. Conclusions The current evidence for therapeutic options for ADCY5-RMD is limited: caffeine, benzodiazepines and deep brain stimulation have been consistently reported to be useful in case reports and case series.
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Affiliation(s)
- Poornima Jayadev Menon
- Sorbonne University, APHP—Salpêtrière Hospital, CNRS, INSERM, Paris Brain InstituteParisFrance
- School of Postgraduate StudiesRoyal College of Surgeons in IrelandDublinIreland
| | - Christelle Nilles
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryABCanada
| | | | - Ruiyi Yuan
- Sorbonne University, APHP—Salpêtrière Hospital, CNRS, INSERM, Paris Brain InstituteParisFrance
| | - Claudio M. de Gusmao
- Department of NeurologyUniversity of Campinas (UNICAMP)CampinasBrazil
- Boston Children's HospitalBostonMAUSA
| | | | - Miryam Carecchio
- Center for the Study of Neurodegeneration (CESNE) and Department of NeuroscienceUniversity of PaduaPaduaItaly
| | | | | | - Aurélie Méneret
- Sorbonne University, APHP—Salpêtrière Hospital, CNRS, INSERM, Paris Brain InstituteParisFrance
| | - Emmanuel Roze
- Sorbonne University, APHP—Salpêtrière Hospital, CNRS, INSERM, Paris Brain InstituteParisFrance
| | - Tamara Pringsheim
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryABCanada
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Hemmeter L, Bien CG, Bien CI, Tipold A, Neßler J, Bathen‐Nöthen A, Matiasek K, Dahlhoff M, Rusbridge C, Rotter Black C, Rentmeister K, Volk HA, Fischer A. Investigation of the presence of specific neural antibodies in dogs with epilepsy or dyskinesia using murine and human assays. J Vet Intern Med 2023; 37:1409-1417. [PMID: 37232512 PMCID: PMC10365065 DOI: 10.1111/jvim.16744] [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: 09/15/2022] [Accepted: 05/07/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Autoimmune mechanisms represent a novel category for causes of seizures and epilepsies in humans, and LGI1-antibody associated limbic encephalitis occurs in cats. HYPOTHESIS/OBJECTIVES To investigate the presence of neural antibodies in dogs with epilepsy or dyskinesia of unknown cause using human and murine assays modified for use in dogs. ANIMALS Fifty-eight dogs with epilepsy of unknown cause or suspected dyskinesia and 57 control dogs. METHODS Serum and CSF samples were collected prospectively as part of the diagnostic work-up. Clinical data including onset and seizure/episode type were retrieved from the medical records. Screening for neural antibodies was done with cell-based assays transfected with human genes for typical autoimmune encephalitis antigens and tissue-based immunofluorescence assays on mouse hippocampus slices in serum and CSF samples from affected dogs and controls. The commercial human und murine assays were modified with canine-specific secondary antibody. Positive controls were from human samples. RESULTS The commercial assays used in this study did not provide unequivocal evidence for presence of neural antibodies in dogs including one dog with histopathologically proven limbic encephalitis. Low titer IgLON5 antibodies were present in serum from one dog from the epilepsy/dyskinesia group and in one dog from the control group. CONCLUSION AND CLINICAL IMPORTANCE Specific neural antibodies were not detected using mouse and human target antigens in dogs with epilepsy and dyskinesia of unknown origin. These findings emphasize the need for canine-specific assays and the importance of control groups.
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Affiliation(s)
- Lea Hemmeter
- Section of Neurology, Centre for Clinical Veterinary MedicineLMU MunichMunichGermany
| | - Christian G. Bien
- Department of Epileptology (Krankenhaus Mara)Bielefeld University, Medical SchoolBielefeldGermany
- Laboratory KroneBad SalzuflenGermany
| | | | - Andrea Tipold
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary Medicine Hannover FoundationHannoverGermany
| | - Jasmin Neßler
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary Medicine Hannover FoundationHannoverGermany
| | | | - Kaspar Matiasek
- Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary MedicineLMU MunichMunichGermany
| | - Maik Dahlhoff
- Institute of In Vivo and In Vitro Models, University of Veterinary Medicine ViennaViennaAustria
| | - Clare Rusbridge
- Fitzpatrick Referrals, Halfway LaneSurreyUK
- School of Veterinary Medicine, Faculty of Health & Medical SciencesUniversity of SurreySurreyUK
| | | | | | - Holger A. Volk
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary Medicine Hannover FoundationHannoverGermany
| | - Andrea Fischer
- Section of Neurology, Centre for Clinical Veterinary MedicineLMU MunichMunichGermany
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Huot P. Targeting metabotropic glutamate receptors for the treatment of Parkinson's disease. Neurodegener Dis Manag 2023. [PMID: 37306283 DOI: 10.2217/nmt-2023-0016] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Affiliation(s)
- Philippe Huot
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, H3A 2B4, Canada
- Department of Neurology & Neurosurgery, McGill University, Montreal, QC, H3A 2B4, Canada
- Department of Neuroscience, Movement Disorder Clinic, Division of Neurology, McGill University Health Centre, Montreal, QC, H3A 2B4, Canada
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Grubb S, Joshi A, Hubbell L. Paraneoplastic-Like Syndrome in a Breast Cancer Patient With a Negative Paraneoplastic Panel: A Case Report. Cureus 2023; 15:e40030. [PMID: 37425573 PMCID: PMC10323977 DOI: 10.7759/cureus.40030] [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: 04/24/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Breast cancer is a leading cause of cancer death in the United States, with an increasing incidence in recent years. Paraneoplastic syndromes are uncommon but increasingly recognized complications of many types of cancer, including breast cancer. Here, we describe a case of a patient presenting with confounding symptoms, who was diagnosed with breast cancer and believed to have a paraneoplastic syndrome despite a negative paraneoplastic panel. This case underscores the need for more standardized diagnostic modalities and prompt recognition and treatment of these rare but serious syndromes.
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Affiliation(s)
- Sydney Grubb
- Emergency Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Aarti Joshi
- Obstetrics and Gynecology, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Linette Hubbell
- Internal Medicine, Tallahassee Memorial Healthcare, Tallahassee, USA
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Senevirathne DKL, Mahboob A, Zhai K, Paul P, Kammen A, Lee DJ, Yousef MS, Chaari A. Deep Brain Stimulation beyond the Clinic: Navigating the Future of Parkinson's and Alzheimer's Disease Therapy. Cells 2023; 12:1478. [PMID: 37296599 PMCID: PMC10252401 DOI: 10.3390/cells12111478] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 03/05/2023] [Revised: 04/30/2023] [Accepted: 05/16/2023] [Indexed: 06/12/2023] Open
Abstract
Deep brain stimulation (DBS) is a surgical procedure that uses electrical neuromodulation to target specific regions of the brain, showing potential in the treatment of neurodegenerative disorders such as Parkinson's disease (PD) and Alzheimer's disease (AD). Despite similarities in disease pathology, DBS is currently only approved for use in PD patients, with limited literature on its effectiveness in AD. While DBS has shown promise in ameliorating brain circuits in PD, further research is needed to determine the optimal parameters for DBS and address any potential side effects. This review emphasizes the need for foundational and clinical research on DBS in different brain regions to treat AD and recommends the development of a classification system for adverse effects. Furthermore, this review suggests the use of either a low-frequency system (LFS) or high-frequency system (HFS) depending on the specific symptoms of the patient for both PD and AD.
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Affiliation(s)
| | - Anns Mahboob
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha 24144, Qatar
| | - Kevin Zhai
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha 24144, Qatar
| | - Pradipta Paul
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha 24144, Qatar
| | - Alexandra Kammen
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Darrin Jason Lee
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- USC Neurorestoration Center, University of Southern California, Los Angeles, CA 90033, USA
| | - Mohammad S. Yousef
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha 24144, Qatar
| | - Ali Chaari
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha 24144, Qatar
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Milanowski J, Kozerawski K, Falęcka W, Dudek D, Lisewska B, Lisewski P, Nuszkiewicz J, Wesołowski R, Wojtasik J, Mila-Kierzenkowska C, Szewczyk-Golec K. Changes in the Secretion of Melatonin and Selected Adipokines during the Progression of Parkinson's Disease-Preliminary Studies. Metabolites 2023; 13:metabo13050668. [PMID: 37233709 DOI: 10.3390/metabo13050668] [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] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
Parkinson's disease (PD) is one of the most common neurodegenerative diseases affecting elderly people. Considering the gap in the literature on melatonin and adipokine levels in PD patients at various stages of the disease, we conducted a study to investigate the levels of selected parameters in PD patients at the disease's early (ES) and advanced (AS) stages. Melatonin, leptin, adiponectin, and resistin concentrations were measured in the blood serum of 20 PD patients without dyskinesia (ES), 24 PD patients with dyskinesia (AS), and 20 healthy volunteers as a control group (CG). The data were analyzed using ANOVA. Melatonin was significantly lower in ES (p < 0.05) and higher in AS patients (p < 0.05) compared to CG. The level of leptin was increased both in ES (p < 0.001) and AS (p < 0.001) versus CG, while resistin was increased only in patients with dyskinesia (p < 0.05). Higher melatonin (p < 0.001) and resistin (p < 0.05) and lower leptin (p < 0.05) levels were found in AS versus ES. The main findings of the study include the changes in inflammatory markers' levels during PD and a surprising increase in melatonin level in dyskinesia patients. Further research is necessary, which will be aimed at modulating the secretion of melatonin and adipokines as a treatment target for PD.
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Affiliation(s)
- Jan Milanowski
- Students Research Club of Medical Biology, Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland
| | - Kamil Kozerawski
- Students Research Club of Medical Biology, Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland
| | - Weronika Falęcka
- Students Research Club of Medical Biology, Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland
| | - Dominik Dudek
- Students Research Club of Medical Biology, Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland
| | | | | | - Jarosław Nuszkiewicz
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland
| | - Roland Wesołowski
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland
| | - Jakub Wojtasik
- Centre for Statistical Analysis, Nicolaus Copernicus University in Toruń, Chopina 12/18 St., 87-100 Toruń, Poland
| | - Celestyna Mila-Kierzenkowska
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland
| | - Karolina Szewczyk-Golec
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland
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Abstract
Levodopa is the most effective agent for treating the symptoms of Parkinson's disease (PD). However, levodopa-induced dyskinesia remains a significant complication that manifests after few years of treatment, for which therapeutic options remain limited. Several agonists of the serotonin type 1A (5-HT1A) receptor with varying levels of efficacy and interaction at other sites, have been tested in the clinic. Clinical trials testing 5-HT1A agonists have yielded inconsistent results in alleviating dyskinesia, especially that the antidyskinetic benefit observed was often accompanied by an adverse effect on motor function. In this article, we summarize and analyze the various clinical trials performed with 5-HT1A agonists in PD patients with dyskinesia and offer perspectives on the future of this class of agents in PD.
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Affiliation(s)
- Jawad Al-Kassmy
- Royal College of Surgeons in Ireland, School of Medicine, Dublin, Ireland
| | - Christine Sun
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, H3A 2B4, Canada
| | - Philippe Huot
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, H3A 2B4, Canada
- Movement Disorder Clinic, Division of Neurology, Department of Neurosciences, McGill University Health Centre, Montreal, QC, H3A 2B4, Canada
- Department of Neurology & Neurosurgery, McGill University, Montreal, QC, H3A 2B4, Canada
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Murakami Y, Nishijima H, Nakamura T, Furukawa T, Kinoshita I, Kon T, Suzuki C, Tomiyama M. Altered Amantadine Effects after Repetitive Treatment for l-dopa-induced Involuntary Movements in a Rat Model of Parkinson's Disease. Neurosci Lett 2023; 806:137248. [PMID: 37061023 DOI: 10.1016/j.neulet.2023.137248] [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: 02/22/2023] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND l-3,4-dihydroxyphenylalanine (l-dopa) is the most effective drug for Parkinson's disease (PD); however, most PD patients develop motor fluctuations including wearing-off and l-dopa-induced dyskinesia (LID). Amantadine is beneficial for improving the motor symptoms, reducing "off" time, and ameliorating LID, although its long-term efficacy remains unknown. OBJECTIVES To investigate the effects of amantadine on PD and LID using a rat model with repetitive drug treatment. METHOD We utilized 6-hydroxydopamine injections to develop a hemiparkinsonian rat model. The rats were assigned to four groups: five rats received l-dopa and benserazide for 31 days, six rats received l-dopa and benserazide plus amantadine for 31 days, five rats received l-dopa and benserazide for 15 days followed by l-dopa and benserazide plus amantadine for 16 days, and five rats received l-dopa and benserazide plus amantadine for 15 days followed by l-dopa and benserazide treatment for 16 days. We evaluated the l-dopa-induced abnormal involuntary movements on treatment days 1, 7, 14, 16, 22, and 29. Subsequently, immunohistochemistry for drebrin was performed. RESULTS l-dopa-induced abnormal movements were reduced on the first day of amantadine treatment, and these effects disappeared with repetitive treatment. In contrast, the extension of l-dopa "on" time was observed after repetitive amantadine treatment. All groups showed enlarged drebrin immunoreactive dots in the dopamine-denervated striatum, indicating that amantadine did not prevent priming effects of repetitive l-dopa treatment. CONCLUSION Anti-LID effect of amantadine diminished after repetitive treatment, and the effect of amantadine on wearing-off emerged after repetitive treatment in a hemiparkinsonian rat model. Fluctuations in amantadine effects should be considered when using it in clinical settings.
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Affiliation(s)
- Yoshiki Murakami
- Department of Neurology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Haruo Nishijima
- Department of Neurology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
| | - Takashi Nakamura
- Department of Neurology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomonori Furukawa
- Department of Neurophysiology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Iku Kinoshita
- Department of Neurology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomoya Kon
- Department of Neurology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chieko Suzuki
- Department of Neurology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masahiko Tomiyama
- Department of Neurology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Bonouvrié LA, Haberfehlner H, Becher JG, Vles JSH, Vermeulen RJ, Buizer AI. Attainment of personal goals in the first year of intrathecal baclofen treatment in dyskinetic cerebral palsy: a prospective cohort study. Disabil Rehabil 2023; 45:1315-1322. [PMID: 35387541 DOI: 10.1080/09638288.2022.2057600] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To assess attainment of individual treatment goals one year after intrathecal baclofen (ITB) pump implantation in individuals with dyskinetic cerebral palsy (CP). MATERIALS AND METHODS A multi-center prospective cohort study was conducted including 34 non-walking individuals with severe dyskinetic CP, classified as Gross Motor Function Classification System (GMFCS) IV/V, aged 4-24 years, 12 months after pump implantation. The main outcome measure was Goal Attainment Scaling (GAS). Predictors of GAS results were analyzed. Complications were registered systematically. RESULTS Seventy-one percent of individuals with dyskinetic CP fully achieved one or more treatment goals. One or more treatment goals were partially achieved in 97% of individuals. Two factors were found to be associated with attainment of goals: Dyskinesia Impairment Scale (DIS) score at baseline and the difference in pain score between baseline and follow-up. These two variables explain 30% of the variance in the outcome. CONCLUSIONS Intrathecal baclofen is effective in achieving individual treatment goals in children and young adults with dyskinetic CP after nine to 12 months of ITB treatment. A positive outcome on treatment goals is, for a small part, associated with higher severity of dystonia at baseline and with improvement of pain during treatment. CLINICAL TRIAL REGISTRATION NUMBER Dutch Trial Register, number NTR3642.Implications for rehabilitationIntrathecal baclofen treatment is effective in attainment of personal treatment goals, one year after pump implantation in patients with dyskinetic cerebral palsy.A positive outcome on treatment goals is, for a small part, related to higher severity of dystonia at the start and on improvement of pain during treatment.
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Affiliation(s)
- Laura A Bonouvrié
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Helga Haberfehlner
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jules G Becher
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Johan S H Vles
- Department Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - R Jeroen Vermeulen
- Department Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Child Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
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Kaga M, Ueda H, Sunagawa C, Oe M, Shima A, Matsukawa N, Ueda T. Belly dancer syndrome improved by withdrawal of droxidopa and amantadine. Clin Case Rep 2023; 11:e7237. [PMID: 37155416 PMCID: PMC10122687 DOI: 10.1002/ccr3.7237] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/11/2023] [Accepted: 04/07/2023] [Indexed: 05/10/2023] Open
Abstract
A man hospitalized for cerebral infarction developed drug-induced belly dancer syndrome, which improved after withdrawal of droxidopa and amantadine. Drugs that modulate dopamine neurotransmission have been reported to be associated with this syndrome. When belly dancer syndrome is suspected, clinicians should consider drug-induced abdominal dyskinesia and medication withdrawal.
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Affiliation(s)
- Mihiro Kaga
- Emergency and General Internal MedicineRakuwakai Marutamachi HospitalKyotoJapan
| | - Hiroyoshi Ueda
- Emergency and General Internal MedicineRakuwakai Marutamachi HospitalKyotoJapan
| | - Chika Sunagawa
- Emergency and General Internal MedicineRakuwakai Marutamachi HospitalKyotoJapan
| | - Masashi Oe
- Emergency and General Internal MedicineRakuwakai Marutamachi HospitalKyotoJapan
| | - Atsushi Shima
- Emergency and General Internal MedicineRakuwakai Marutamachi HospitalKyotoJapan
| | - Nobuyasu Matsukawa
- Emergency and General Internal MedicineRakuwakai Marutamachi HospitalKyotoJapan
| | - Takeshi Ueda
- Emergency and General Internal MedicineRakuwakai Marutamachi HospitalKyotoJapan
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Pisanò CA, Mercatelli D, Mazzocchi M, Brugnoli A, Morella I, Fasano S, Zaveri NT, Brambilla R, O'Keeffe GW, Neubig RR, Morari M. Regulator of G-Protein Signalling 4 (RGS4) negatively modulates nociceptin/orphanin FQ opioid receptor signalling: Implication for l-Dopa-induced dyskinesia. Br J Pharmacol 2023; 180:927-942. [PMID: 34767639 DOI: 10.1111/bph.15730] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 10/11/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Regulator of G-protein signalling 4 (RGS4) is a signal transduction protein that accelerates intrinsic GTPase activity of Gαi/o and Gαq subunits, suppressing GPCR signalling. Here, we investigate whether RGS4 modulates nociceptin/orphanin FQ (N/OFQ) opioid (NOP) receptor signalling and if this modulation has relevance for l-Dopa-induced dyskinesia. EXPERIMENTAL APPROACH HEK293T cells transfected with NOP, NOP/RGS4 or NOP/RGS19 were challenged with N/OFQ and the small-molecule NOP agonist AT-403, using D1-stimulated cAMP levels as a readout. Primary rat striatal neurons and adult mouse striatal slices were challenged with either N/OFQ or AT-403 in the presence of the experimental RGS4 chemical probe, CCG-203920, and D1-stimulated cAMP or phosphorylated extracellular signal regulated kinase 1/2 (pERK) responses were monitored. In vivo, CCG-203920 was co-administered with AT-403 and l-Dopa to 6-hydroxydopamine hemilesioned rats, and dyskinetic movements, striatal biochemical correlates of dyskinesia (pERK and pGluR1 levels) and striatal RGS4 levels were measured. KEY RESULTS RGS4 expression reduced NOFQ and AT-403 potency and efficacy in HEK293T cells. CCG-203920 increased N/OFQ potency in primary rat striatal neurons and potentiated AT-403 response in mouse striatal slices. CCG-203920 enhanced AT-403-mediated inhibition of dyskinesia and its biochemical correlates, without compromising its motor-improving effects. Unilateral dopamine depletion caused bilateral reduction of RGS4 levels, which was reversed by l-Dopa. l-Dopa acutely up-regulated RGS4 in the lesioned striatum. CONCLUSIONS AND IMPLICATIONS RGS4 physiologically inhibits NOP receptor signalling. CCG-203920 enhanced NOP responses and improved the antidyskinetic potential of NOP receptor agonists, mitigating the effects of striatal RGS4 up-regulation occurring during dyskinesia expression. LINKED ARTICLES This article is part of a themed issue on Advances in Opioid Pharmacology at the Time of the Opioid Epidemic. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v180.7/issuetoc.
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Affiliation(s)
- Clarissa A Pisanò
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Daniela Mercatelli
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Martina Mazzocchi
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Alberto Brugnoli
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Ilaria Morella
- Neuroscience and Mental Health Research Institute, Division of Neuroscience, School of Biosciences, Cardiff University, Cardiff, UK
| | - Stefania Fasano
- Neuroscience and Mental Health Research Institute, Division of Neuroscience, School of Biosciences, Cardiff University, Cardiff, UK
| | - Nurulain T Zaveri
- Astraea Therapeutics, Medicinal Chemistry Division, Mountain View, California, USA
| | - Riccardo Brambilla
- Neuroscience and Mental Health Research Institute, Division of Neuroscience, School of Biosciences, Cardiff University, Cardiff, UK
- Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, Pavia, Italy
| | - Gerard W O'Keeffe
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Richard R Neubig
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan, USA
| | - Michele Morari
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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Lin S, Wang D, Sang H, Xiao H, Yan K, Wang D, Zhang Y, Yi L, Shao G, Shao Z, Yang A, Zhang L, Sun J. Predicting poststroke dyskinesia with resting-state functional connectivity in the motor network. Neurophotonics 2023; 10:025001. [PMID: 37025568 PMCID: PMC10072005 DOI: 10.1117/1.nph.10.2.025001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
SIGNIFICANCE Motor function evaluation is essential for poststroke dyskinesia rehabilitation. Neuroimaging techniques combined with machine learning help decode a patient's functional status. However, more research is needed to investigate how individual brain function information predicts the dyskinesia degree of stroke patients. AIM We investigated stroke patients' motor network reorganization and proposed a machine learning-based method to predict the patients' motor dysfunction. APPROACH Near-infrared spectroscopy (NIRS) was used to measure hemodynamic signals of the motor cortex in the resting state (RS) from 11 healthy subjects and 31 stroke patients, 15 with mild dyskinesia (Mild), and 16 with moderate-to-severe dyskinesia (MtS). The graph theory was used to analyze the motor network characteristics. RESULTS The small-world properties of the motor network were significantly different between groups: (1) clustering coefficient, local efficiency, and transitivity: MtS > Mild > Healthy and (2) global efficiency: MtS < Mild < Healthy. These four properties linearly correlated with patients' Fugl-Meyer Assessment scores. Using the small-world properties as features, we constructed support vector machine (SVM) models that classified the three groups of subjects with an accuracy of 85.7%. CONCLUSIONS Our results show that NIRS, RS functional connectivity, and SVM together constitute an effective method for assessing the poststroke dyskinesia degree at the individual level.
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Affiliation(s)
- Shuoshu Lin
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Dan Wang
- Beijing Rehabilitation Hospital of Capital Medical University, Department of Traditional Chinese Medicine, Beijing, China
| | - Haojun Sang
- Chinese Institute for Brain Research, Beijing, China
| | - Hongjun Xiao
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Kecheng Yan
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Dongyang Wang
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Yizheng Zhang
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Li Yi
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Guangjian Shao
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Zhiyong Shao
- Foshan University, School of Mechatronic Engineering and Automation, Foshan, China
| | - Aoran Yang
- Beijing Rehabilitation Hospital of Capital Medical University, Department of Traditional Chinese Medicine, Beijing, China
| | - Lei Zhang
- Chinese Institute for Brain Research, Beijing, China
- Capital Medical University, School of Biomedical Engineering, Beijing, China
| | - Jinyan Sun
- Foshan University, School of Medicine, Foshan, China
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Hacker ML, Meystedt JC, Turchan M, Cannard KR, Harper K, Fan R, Ye F, Davis TL, Konrad PE, Charles D. Eleven-Year Outcomes of Deep Brain Stimulation in Early-Stage Parkinson Disease. Neuromodulation 2023; 26:451-458. [PMID: 36567243 PMCID: PMC10198566 DOI: 10.1016/j.neurom.2022.10.051] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/16/2022] [Accepted: 10/04/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The deep brain stimulation (DBS) in early-stage Parkinson's disease (PD) pilot clinical trial randomized 30 patients (Hoehn & Yahr II off; medication duration 0.5-4 years; without dyskinesia/motor fluctuations) to optimal drug therapy (ODT) (early ODT) or bilateral subthalamic nucleus (STN) DBS plus ODT (early DBS+ODT). This study aims to report the 11-year outcomes of patients who completed the DBS in early-stage PD pilot clinical trial. MATERIALS AND METHODS Attempts were made to contact all 29 subjects who completed the two-year trial to participate in an 11-year follow-up study. Mixed-effects models compared overall trend in outcomes for randomization groups (fixed-effects: assigned treatment, year, their interaction; random-effect: subject) to account for repeated measures. RESULTS Twelve subjects participated in this 11-year follow-up study (n = 8 early ODT, n = 4 early DBS+ODT). Participating subjects were 70.0 ± 4.8 years old with a PD medication duration of 13.7 ± 1.7 years (early DBS duration 11.5 ± 1.3 years, n = 4). Three early ODT subjects received STN-DBS as standard of care (DBS duration 6.5 ± 2.0 years). Early ODT subjects had worse motor complications (Unified Parkinson's Disease Rating Scale [UPDRS]-IV) than early DBS+ODT subjects over the 11-year follow-up period (between-group difference = 3.5 points; pinteraction = 0.03). Early DBS+ODT was well-tolerated after 11 years and showed comparable outcomes to early ODT for other UPDRS domains, Parkinson Disease Questionnaire-39 (PDQ-39), and levodopa equivalent daily dose (LEDD). CONCLUSIONS Eleven years after randomization, early DBS+ODT subjects had fewer motor complications than early ODT subjects. These results should be interpreted with caution because only 40% of pilot trial subjects participated in this 11-year follow-up study. The Food and Drug Administration has approved the conduct of a pivotal clinical trial evaluating DBS in early-stage PD (IDEG050016). CLINICAL TRIAL REGISTRATION The Clinicaltrials.gov registration number for the study is NCT00282152.
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Affiliation(s)
- Mallory L Hacker
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | | | - Maxim Turchan
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kevin R Cannard
- Department of Neurology, Walter Reed National Military Center, Bethesda, MD, USA
| | - Kelly Harper
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Run Fan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fei Ye
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Thomas L Davis
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Peter E Konrad
- Department of Neurosurgery, West Virginia University, Morgantown, WV, USA
| | - David Charles
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
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Marcelis W, Vandamme S, Goethals M, De Weweire M, Vanhauwaert D, Cortier J, Maenhoudt W, Van Damme O. Adapting STN-DBS Stimulation Pattern for the Treatment of "Choreo Dystonic Lower Limb Dyskinesia" in Parkinson's Disease. Mov Disord Clin Pract 2023; 10:323-325. [PMID: 36825065 PMCID: PMC9941931 DOI: 10.1002/mdc3.13607] [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] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- William Marcelis
- Department of NeurosurgeryAZ Delta, Roeselare‐Menen‐TorhoutRoeselareBelgium
| | - Stijn Vandamme
- Department of NeurosurgeryAZ Delta, Roeselare‐Menen‐TorhoutRoeselareBelgium
| | - Maarten Goethals
- Department of NeurosurgeryAZ Delta, Roeselare‐Menen‐TorhoutRoeselareBelgium
- Department of NeurologyAZ Delta, Roeselare‐Menen‐TorhoutRoeselareBelgium
| | - Mieke De Weweire
- Department of NeurosurgeryAZ Delta, Roeselare‐Menen‐TorhoutRoeselareBelgium
- Department of NeurologyAZ Delta, Roeselare‐Menen‐TorhoutRoeselareBelgium
| | | | - Jeroen Cortier
- Department of NeurosurgeryAZ Delta, Roeselare‐Menen‐TorhoutRoeselareBelgium
| | - Wim Maenhoudt
- Department of NeurosurgeryAZ Delta, Roeselare‐Menen‐TorhoutRoeselareBelgium
| | - Olivier Van Damme
- Department of NeurosurgeryAZ Delta, Roeselare‐Menen‐TorhoutRoeselareBelgium
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44
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Kaasinen V, Luo S, Martinez-Martin P, Goetz CG, Stebbins GT. Cross-Cultural Differences in Patient Perceptions of Dyskinesia in Parkinson's Disease. Mov Disord 2023; 38:688-692. [PMID: 36670051 DOI: 10.1002/mds.29335] [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] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The prevalence of levodopa-induced dyskinesia (LID) in Parkinson's disease (PD) varies among geographical regions. Cultural differences in patient-based perceptions of LID have not been studied. OBJECTIVE We compared patient and clinician evaluations of LID severity across multiple cultures in patients with PD. METHODS The data set included the Unified Dyskinesia Rating (UDysRS) scores from 16 language translation programs (3566 patients). We defined the Perception Severity Index (PSI) as the ratio between normalized patient-based subjective ratings (UDysRS Part 1B) and normalized clinician examination (Parts 3 and 4) scores (Part 1B/Parts 3 + 4) and compared the PSI across languages. RESULTS The mean PSI for the Chinese language (2.16) was higher than those of all other languages, whereas the ratio for the Korean language (0.73) was lower than those for Japanese, German, Turkish, Greek, Polish, and Finnish languages (corrected P values <0.05). CONCLUSIONS Culture, as represented by language, affects the subjective perception of LID and needs to be considered in multinational clinical PD trials on dyskinesia. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Valtteri Kaasinen
- Department of Clinical Neurosciences, Faculty of Medicine, University of Turku, Turku, Finland.,Neurocenter, Turku University Hospital, Turku, Finland
| | - Sheng Luo
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases, Carlos III Institute of Health, Madrid, Spain
| | - Christopher G Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
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45
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Öztürk Z, Aydın O, Bodur İ, Yaradılmış RM, Çelik HA, Tuygun N. Dyskinesia due to mexiletine overdose: a rare presentation. Turk J Pediatr 2023; 65:704-706. [PMID: 37661688 DOI: 10.24953/turkjped.2023.84] [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] [Indexed: 09/05/2023]
Abstract
BACKGROUND Mexiletine, a class IB antiarrhythmic, is a structural analog of lidocaine. Our knowledge of mexiletine overdose is based on lidocaine overdose reports. Only a few cases of mexiletine overdose have been reported, including fatal overdoses. Mexiletine toxicity primarily affects the central nervous, cardiovascular, and gastrointestinal systems. CASE A 16-year-old female was brought to our hospital by ambulance after taking an unknown dose of mexiletine in a suicide attempt. Ventricular fibrillation developed while in the ambulance; cardiopulmonary resuscitation was started and spontaneous circulation returned within 1 min. The patient had been taking oral mexiletine for 1 month to treat primary erythromelalgia. Her vital signs were normal, but she was unconscious. Following gastric lavage she was transferred to the pediatric intensive care unit. Midazolam and levetiracetam were required due to uncontrolled seizures. During the first hour of hospitalization, severe dyskinesia characterized by abnormal involuntary large hyperkinetic movements in all 4 extremities was observed and successfully treated with 2 doses of intravenous biperiden. The patient was discharged on day 6 of hospitalization. CONCLUSIONS Mexiletine overdose can be life-threatening. In addition to rapid and effective resuscitation, rapid identification and management of cardiovascular and central nervous system manifestations are key to preventing morbidity and mortality. The presented case had severe dyskinesia that was successfully treated with repeated doses of biperiden. Biperiden did not cause arrhythmia. Based on the presented case, we think biperiden should be considered for the treatment of movement disorders in cases of mexiletine overdose.
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Affiliation(s)
- Zeynelabidin Öztürk
- Department of Pediatric Intensive Care, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology, Pediatric Health and Disease Training and Research Hospital, Ankara
| | - Orkun Aydın
- Department of Pediatric Emergency Medicine, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology, Pediatric Health and Disease Training and Research Hospital, Ankara
| | - İlknur Bodur
- Department of Pediatric Emergency Medicine, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology, Pediatric Health and Disease Training and Research Hospital, Ankara
| | - Raziye Merve Yaradılmış
- Department of Pediatric Emergency Medicine, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology, Pediatric Health and Disease Training and Research Hospital, Ankara
| | - Hale Atalay Çelik
- Department of Pediatric Neurology, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology, Pediatric Health and Disease Training and Research Hospital, Ankara, Türkiye
| | - Nilden Tuygun
- Department of Pediatric Emergency Medicine, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology, Pediatric Health and Disease Training and Research Hospital, Ankara
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46
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Chaudhuri KR, Kovács N, Pontieri FE, Aldred J, Bourgeois P, Davis TL, Cubo E, Anca-Herschkovitsch M, Iansek R, Siddiqui MS, Simu M, Bergmann L, Ballina M, Kukreja P, Ladhani O, Jia J, Standaert DG. Levodopa Carbidopa Intestinal Gel in Advanced Parkinson's Disease: DUOGLOBE Final 3-Year Results. J Parkinsons Dis 2023; 13:769-783. [PMID: 37302039 PMCID: PMC10473130 DOI: 10.3233/jpd-225105] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Levodopa-carbidopa intestinal gel (LCIG) improves motor and non-motor symptoms in patients with advanced Parkinson's disease (aPD). OBJECTIVE To present the final 36-month efficacy and safety results from DUOGLOBE (DUOdopa/Duopa in Patients with Advanced Parkinson's Disease - a GLobal OBservational Study Evaluating Long-Term Effectiveness; NCT02611713). METHODS DUOGLOBE was an international, prospective, long-term, real-world, observational study of patients with aPD initiating LCIG in routine clinical care. The primary endpoint was change in patient-reported "Off" time to Month 36. Safety was assessed by monitoring serious adverse events (SAEs). RESULTS Significant improvements in "Off" time were maintained over 3 years (mean [SD]: -3.3 hours [3.7]; p < 0.001). There were significant improvements to Month 36 in total scores of the Unified Dyskinesia Rating Scale (-5.9 [23.7]; p = 0.044), Non-Motor Symptoms Scale (-14.3 [40.5]; p = 0.002), Parkinson's Disease Sleep Scale-2 (-5.8 [12.9]; p < 0.001), and Epworth Sleepiness Scale (-1.8 [6.0]; p = 0.008). Health-related quality of life and caregiver burden significantly improved through Months 24 and 30, respectively (Month 24, 8-item Parkinson's Disease Questionnaire Summary Index, -6.0 [22.5]; p = 0.006; Month 30, Modified Caregiver Strain Index, -2.3 [7.6]; p = 0.026). Safety was consistent with the well-established LCIG profile (SAEs: 54.9% of patients; discontinuations: 54.4%; discontinuations due to an adverse event: 27.2%). Of 106 study discontinuations, 32 patients (30.2%) continued LCIG outside the study. CONCLUSION DUOGLOBE demonstrates real-world, long-term, reductions in motor and non-motor symptoms in patients with aPD treated with LCIG.
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Affiliation(s)
- K. Ray Chaudhuri
- Parkinson’s Foundation International Centre of Excellence, King’s College Hospital, and King’s College Institute of Psychiatry, Biomedical Research Centre, Psychology & Neuroscience, London, United Kingdom
| | - Norbert Kovács
- Department of Neurology, University of Pécs, Pécs, Hungary
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
- Santa Lucia Foundation, IRCCS, Rome, Italy
| | | | | | - Thomas L. Davis
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Esther Cubo
- Neurology Department, Hospital Universitario Burgos, Burgos, Spain
| | | | - Robert Iansek
- Kingston Centre, Monash Health, Melbourne, Victoria, Australia
| | - Mustafa S. Siddiqui
- Department of Neurology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Mihaela Simu
- Department of Neurology, Victor Babes Universityof Medicine and Pharmacy, Timisoara, Romania
| | | | | | | | | | - Jia Jia
- AbbVie Inc., North Chicago, IL, USA
| | - David G. Standaert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
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47
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Steel D, Vezyroglou A, Barwick K, Smith M, Vogt J, Gibbon FM, Cross JH, Kurian MA. Both Heterozygous and Homozygous Loss-of-Function JPH3 Variants Are Associated with a Paroxysmal Movement Disorder. Mov Disord 2023; 38:155-157. [PMID: 36273396 PMCID: PMC10092631 DOI: 10.1002/mds.29250] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/09/2022] [Accepted: 08/29/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- Dora Steel
- Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.,Department of Neurology, Great Ormond Street Hospital, London, United Kingdom
| | - Aikaterini Vezyroglou
- Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.,Department of Neurology, Great Ormond Street Hospital, London, United Kingdom
| | - Katy Barwick
- Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Martin Smith
- Department of Paediatric Neurology, Oxford University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Julie Vogt
- West Midlands Regional Genetics Service, Birmingham Women and Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom
| | - Frances M Gibbon
- Noah's Ark Children's Hospital for Wales, Cardiff and Vale University Health Board, Cardiff, Wales, United Kingdom
| | - J Helen Cross
- Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.,Department of Neurology, Great Ormond Street Hospital, London, United Kingdom
| | - Manju A Kurian
- Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.,Department of Neurology, Great Ormond Street Hospital, London, United Kingdom
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48
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Funatsu A, Yamamoto Y, Araki M, Aga F, Mine H. Orofacial Dyskinesia and Intractable Hiccups in a Patient with Varicella-zoster Virus Encephalomyelitis. Intern Med 2023; 62:119-122. [PMID: 35676037 PMCID: PMC9876721 DOI: 10.2169/internalmedicine.9334-22] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
A 73-year-old Japanese man with diabetic complications presented with involuntary lip movements and long-lasting hiccups after developing zoster rash. Magnetic resonance imaging revealed lesions involving the medial temporal lobe and C1 level of the spinal cord. Varicella-zoster virus (VZV) encephalomyelitis was diagnosed. We considered attributing the orofacial dyskinesia, a very rare symptom of VZV central nervous system (CNS) complications, to the temporal lobe lesion. Although the culprit lesion for the hiccups was unclear, further examinations may have clarified this issue. As immunocompromised patients with herpes zoster may develop CNS complications with a wide variety of symptoms, special care is needed.
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Affiliation(s)
- Akito Funatsu
- Center for Clinical Education and Training, Takamatsu Red Cross Hospital, Japan
| | - Yohei Yamamoto
- Department of Neurology, Takamatsu Red Cross Hospital, Japan
| | - Midori Araki
- Department of Neurology, Takamatsu Red Cross Hospital, Japan
| | - Fumitoshi Aga
- Department of Radiology, Takamatsu Red Cross Hospital, Japan
| | - Hideki Mine
- Department of Neurology, Takamatsu Red Cross Hospital, Japan
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49
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Ralph E, Carroll K, Danks M, Harvey A. Development of a Clinical Framework for the Assessment of Dyskinesia and Function in the Upper Limb in Children with Cerebral Palsy. Phys Occup Ther Pediatr 2023; 43:1-13. [PMID: 36097697 DOI: 10.1080/01942638.2022.2104149] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Dyskinesia in cerebral palsy (CP) is a complex movement disorder that can significantly impact upper limb function. Despite a range of available tools, there is no consensus on best practice assessment of upper limb function in children with CP and dyskinesia. This study aimed to develop a clinical framework for the assessment of the impact of dyskinesia on upper limb function in children with CP. DESIGN Modified Delphi study using expert consensus. METHODS An expert panel of six highly experienced Australian therapists ranked assessment tools sourced from existing evidence-based literature using a five-point Likert scale. Tools rated as important for use "most" or "all" of the time, by 80% of respondents were accepted into the framework following two survey rounds and a third stage discussion. RESULTS Of 21 tools, 12 were included in the framework under five categories: (i) screening for dyskinesia; (ii) measuring the severity of dyskinesia; (iii) Classifying upper limb functional ability; (iv) measuring upper limb functional ability; and (v) measuring upper limb movement. CONCLUSIONS The framework for assessing the impact of dyskinesia on upper limb function in CP aims to guide clinicians to improve assessment consistency and facilitate individualized goal-directed management. Further studies with a larger number of expert clinicians and researchers will further strengthen the utility of the framework.
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Affiliation(s)
- Edward Ralph
- Allied Health, Hummingbird House, Chermside, Australia
| | - Kate Carroll
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University, Brisbane, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Parkville, Australia
| | - Marcella Danks
- Faculty of Health Sciences, School of Allied Health, Australian Catholic University, Virginia, Australia
| | - Adrienne Harvey
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia
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50
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Wu SH, Shi YJ, An YF, Zhao DD, Li HB, Li GL. [Neuroprotective effect of cinnamaldehyde in MPTP-induced mouse model of subacute Parkinson's disease]. Zhongguo Zhong Yao Za Zhi 2022; 47:6485-6493. [PMID: 36604895 DOI: 10.19540/j.cnki.cjcmm.20220721.702] [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] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This paper aims to explore the neuroprotective effect of cinnamaldehyde(CA) in mice with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-induced subacute Parkinson's disease(PD) and the mechanism. To be specific, male C57 BL/6 mice(n=72, SPF) were randomized into control group, model group, positive control(madopar 0.1 mg·g~(-1)) group, and low-dose, me-dium-dose, and high-dose CA groups(0.15, 0.30, 0.60 mg·g~(-1)). MPTP(intraperitoneal injection, 0.03 mg·g~(-1), once a day for 5 days) was used to induce subacute PD in mice except for the control group. The administration began from the day of modeling and lasted 19 days. On the 0 th, 12 th, and 19 th day, the open field test, pole test, and rotarod test were carried out. After the tests, the mice were killed and brains were separated. In addition, the organ index was measured. The number of cells in substantia nigra(SN) in the midbrain of MPTP-induced PD model mice was detected based on hematoxylin and eosin(HE) staining. The levels of tyrosine hydroxylase(TH)-and α-synuclein(α-Syn)-positive cells in SN were determined by immunohistochemical staining, and the protein levels of TH and α-Syn in SN by Western blot. The results showed that the MPTP-stimulated mice had abnormal behaviors such as erect hair, arched back, rigidity of the tail, slow movement, and tremor, decreased number of crossings and rearing, increased frequency of urination and defecation, longer time of pole climbing, and shorter time of staying on the rotating rod. In addition, the mice showed obvious damage of neurons in the SN and reduced neuron cells in irregular arrangement with some shrinking. In addition, the average optical density of TH in SN decreased and that of α-Syn increased. All these suggested the successful modeling. CA displayed obvious therapeutic effect on the PD mice, as manifested by the increased number of crossings and rearing, decreased frequency of urination and defecation, shorter time of climbing pole, longer time of staying on the rotating rod, and more neuron cells in the SN with a few pykno-tic cells. Moreover, CA significantly alleviated the decrease of TH and the overexpression of α-Syn in SN. As a result, the MPTP-induced injury of dopaminergic neurons was alleviated. The performance of 0.3 mg·g~(-1) CA was the best. This study is expected to lay a scientific basis for the development of CA products.
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Affiliation(s)
- Su-Hui Wu
- Henan University of Chinese Medicine, Henan Zhong-jing Recipe Health and Aging Industry Engineering Research Center Zhengzhou 450046, China
| | - Ya-Jin Shi
- Henan University of Chinese Medicine, Henan Zhong-jing Recipe Health and Aging Industry Engineering Research Center Zhengzhou 450046, China
| | - Ying-Feng An
- Henan University of Chinese Medicine, Henan Zhong-jing Recipe Health and Aging Industry Engineering Research Center Zhengzhou 450046, China
| | - Dan-Dan Zhao
- Henan University of Chinese Medicine, Henan Zhong-jing Recipe Health and Aging Industry Engineering Research Center Zhengzhou 450046, China
| | - Han-Bing Li
- Henan University of Chinese Medicine, Henan Zhong-jing Recipe Health and Aging Industry Engineering Research Center Zhengzhou 450046, China
| | - Gen-Lin Li
- Henan University of Chinese Medicine, Henan Zhong-jing Recipe Health and Aging Industry Engineering Research Center Zhengzhou 450046, China
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