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Wang EW, Brown GL, Lewis MM, Jellen LC, Pu C, Johnson ML, Chen H, Kong L, Du G, Huang X. Susceptibility Magnetic Resonance Imaging Correlates with Glial Density and Tau in the Substantia Nigra Pars Compacta. Mov Disord 2023; 38:464-473. [PMID: 36598274 PMCID: PMC10445152 DOI: 10.1002/mds.29311] [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: 08/28/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Susceptibility magnetic resonance imaging (MRI) is sensitive to iron-related changes in the substantia nigra pars compacta (SNc), the key pathologic locus of parkinsonisms. It is unclear, however, if iron deposition in the SNc is associated with its neurodegeneration. OBJECTIVE The objective of this study was to test whether susceptibility MRI metrics in parkinsonisms are associated with SNc neuropathologic features of dopaminergic neuron loss, gliosis, and α-synuclein and tau burden. METHODS This retrospective study included 27 subjects with both in vivo MRI and postmortem data. Multigradient echo imaging was used to derive the apparent transverse relaxation rate (R2*) and quantitative susceptibility mapping (QSM) in the SNc. Archived midbrain slides that were stained with hematoxylin and eosin, anti-α-synuclein, and anti-tau were digitized to quantify neuromelanin-positive neuron density, glial density, and the percentages of area occupied by positive α-synuclein and tau staining. MRI-histology associations were examined using Pearson correlations and regression. RESULTS Twenty-four subjects had postmortem parkinsonism diagnoses (Lewy body disorder, progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration), two had only Alzheimer's neuropathology, and one exhibited only mild atrophy. Among all subjects, both R2* and QSM were associated with glial density (r ≥ 0.67; P < 0.001) and log-transformed tau burden (r ≥ 0.53; P ≤ 0.007). Multiple linear regression identified glial density and log-transformed tau as determinants for both MRI metrics (R2 ≥ 0.580; P < 0.0001). Neither MRI metric was associated with neuron density or α-synuclein burden. CONCLUSIONS R2* and QSM are associated with both glial density and tau burden, key neuropathologic features in the parkinsonism SNc. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Ernest W. Wang
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Gregory L. Brown
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Mechelle M. Lewis
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Pharmacology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Leslie C. Jellen
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Cunfeng Pu
- Department of Pathology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Melinda L. Johnson
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Hairong Chen
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Lan Kong
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Guangwei Du
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Xuemei Huang
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Pharmacology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Departments of Neurosurgery and Radiology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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Brown GL, Brown MT. Transcranial electrical stimulation in neurological disease. Neural Regen Res 2022; 17:2221-2222. [PMID: 35259838 PMCID: PMC9083147 DOI: 10.4103/1673-5374.335796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/27/2021] [Accepted: 11/05/2021] [Indexed: 11/09/2022] Open
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Han F, Brown GL, Zhu Y, Belkin-Rosen AE, Lewis MM, Du G, Gu Y, Eslinger PJ, Mailman RB, Huang X, Liu X. Decoupling of Global Brain Activity and Cerebrospinal Fluid Flow in Parkinson's Disease Cognitive Decline. Mov Disord 2021; 36:2066-2076. [PMID: 33998068 PMCID: PMC8453044 DOI: 10.1002/mds.28643] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Deposition and spreading of misfolded proteins (α-synuclein and tau) have been linked to Parkinson's disease cognitive dysfunction. The glymphatic system may play an important role in the clearance of these toxic proteins via cerebrospinal fluid (CSF) flow through perivascular and interstitial spaces. Recent studies discovered that sleep-dependent global brain activity is coupled to CSF flow, which may reflect glymphatic function. OBJECTIVE The objective of this current study was to determine if the decoupling of brain activity-CSF flow is linked to Parkinson's disease cognitive dysfunction. METHODS Functional and structural MRI data, clinical motor (Unified Parkinson's Disease Rating Scale), and cognitive (Montreal Cognitive Assessment [MoCA]) scores were collected from 60 Parkinson's disease and 58 control subjects. Parkinson's disease patients were subgrouped into those with mild cognitive impairment (MoCA < 26), n = 31, and those without mild cognitive impairment (MoCA ≥ 26), n = 29. The coupling strength between the resting-state global blood-oxygen-level-dependent signal and associated CSF flow was quantified, compared among groups, and associated with clinical and structural measurements. RESULTS Global blood-oxygen-level-dependent signal-CSF coupling decreased significantly (P < 0.006) in Parkinson's disease patients showing mild cognitive impairment, compared with those without mild cognitive impairment and controls. Reduced global blood-oxygen-level-dependent signal-CSF coupling was associated with decreased MoCA scores present in Parkinson's disease patients (P = 0.005) but not in controls (P = 0.65). Weaker global blood-oxygen-level-dependent signal-CSF coupling in Parkinson's disease patients also was associated with a thinner right entorhinal cortex (Spearman's correlation, -0.36; P = 0.012), an early structural change often seen in Alzheimer's disease. CONCLUSIONS The decoupling between global brain activity and associated CSF flow is related to Parkinson's disease cognitive impairment. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Feng Han
- Department of Biomedical Engineering, The Pennsylvania State University, PA, USA
| | - Gregory L. Brown
- Department of Engineering Science and Mechanics, The Pennsylvania State University, PA, USA
- Department of Neurology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Yalin Zhu
- Department of Biomedical Engineering, The Pennsylvania State University, PA, USA
| | | | - Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Yameng Gu
- Department of Biomedical Engineering, The Pennsylvania State University, PA, USA
| | - Paul J. Eslinger
- Department of Neurology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Radiology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Richard B. Mailman
- Department of Neurology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Radiology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Neurosurgery, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Kinesiology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA
- Institute for Computational and Data Sciences, The Pennsylvania State University, PA, USA
| | - Xiao Liu
- Department of Biomedical Engineering, The Pennsylvania State University, PA, USA
- Institute for Computational and Data Sciences, The Pennsylvania State University, PA, USA
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Wang EW, Trojano ML, Lewis MM, Du G, Chen H, Brown GL, Jellen LC, Song I, Neely E, Kong L, Connor JR, Huang X. HFE H63D Limits Nigral Vulnerability to Paraquat in Agricultural Workers. Toxicol Sci 2021; 181:47-57. [PMID: 33739421 DOI: 10.1093/toxsci/kfab020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Paraquat is an herbicide whose use is associated with Parkinson's disease (PD), a neurodegenerative disorder marked by neuron loss in the substantia nigra pars compacta (SNc). We recently observed that the murine homolog to the human H63D variant of the homeostatic iron regulator (HFE) may decrease paraquat-associated nigral neurotoxicity in mice. The present study examined the potential influence of H63D on paraquat-associated neurotoxicity in humans. Twenty-eight paraquat-exposed workers were identified from exposure histories and compared with 41 unexposed controls. HFE genotypes, and serum iron and transferrin were measured from blood samples. MRI was used to assess the SNc transverse relaxation rate (R2*), a marker for iron, and diffusion tensor imaging scalars of fractional anisotropy (FA) and mean diffusivity, markers of microstructural integrity. Twenty-seven subjects (9 exposed and 18 controls) were H63D heterozygous. After adjusting for age and use of other PD-associated pesticides and solvents, serum iron and transferrin were higher in exposed H63D carriers than in unexposed carriers and HFE wildtypes. SNc R2* was lower in exposed H63D carriers than in unexposed carriers, whereas SNc FA was lower in exposed HFE wildtypes than in either unexposed HFE wildtypes or exposed H63D carriers. Serum iron and SNc FA measures correlated positively among exposed, but not unexposed, subjects. These data suggest that H63D heterozygosity is associated with lower neurotoxicity presumptively linked to paraquat. Future studies with larger cohorts are warranted to replicate these findings and examine potential underlying mechanisms, especially given the high prevalence of the H63D allele in humans.
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Affiliation(s)
- Ernest W Wang
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Max L Trojano
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Mechelle M Lewis
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.,Department of Pharmacology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Guangwei Du
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Hairong Chen
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Gregory L Brown
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Leslie C Jellen
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Insung Song
- Department of Neurosurgery, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Elizabeth Neely
- Department of Neurosurgery, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Lan Kong
- Department of Public Health Sciences, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - James R Connor
- Department of Neurosurgery, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.,Department of Pharmacology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.,Department of Neurosurgery, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.,Department of Radiology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.,Department of Kinesiology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
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Brown GL, Camacci ML, Kim SD, Grillo S, Nguyen JV, Brown DA, Ullah SP, Lewis MM, Du G, Kong L, Sundstrom JM, Huang X, Bowie EM. Choroidal Thickness Correlates with Clinical and Imaging Metrics of Parkinson's Disease: A Pilot Study. J Parkinsons Dis 2021; 11:1857-1868. [PMID: 34275909 PMCID: PMC8530855 DOI: 10.3233/jpd-212676] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is marked clinically by motor symptoms and pathologically by Lewy bodies and dopamine neuron loss in the substantia nigra pars compacta (SNc). Higher iron accumulation, assessed by susceptibility MRI, also is observed as PD progresses. Recently, evidence has suggested that PD affects the retina. OBJECTIVE To better understand retinal alterations in PD and their association to clinical and SNc iron-related imaging metrics. METHODS Ten PD and 12 control participants (2 eyes each) from an ongoing PD imaging biomarker study underwent enhanced depth imaging optical coherence tomography evaluation. Choroidal (vascular) thickness and nerve layers were measured in 4 subregions [superior, temporal, inferior, and nasal] and at 3 foveal distances (1, 1.5, and 3 mm). These metrics were compared between PD and control groups. For significantly different metrics, their associations with clinical [levodopa equivalent daily dosage (LEDD), motor and visuospatial function] and SNc susceptibility MRI metrics [R2* and quantitative susceptibility mapping (QSM)] were explored. RESULTS Compared to control participants, PD participants had a thicker choroid (p = 0.005), but no changes in nerve layers. Higher mean choroidal thickness was associated with lower LEDD (p < 0.01) and better visuospatial function (p < 0.05). Subregion analyses revealed higher choroidal thickness correlated with lower LEDD and better motor and visuospatial measures. Higher mean choroidal thickness also was associated with lower nigral iron MRI (p < 0.05). CONCLUSION A small cohort of PD research participants displayed higher choroidal thickness that was related to better clinical performance and less nigral pathology. These intriguing findings warrant further investigation.
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Affiliation(s)
- Gregory L. Brown
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Mona L. Camacci
- Department of Ophthalmology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Sean D. Kim
- Department of Ophthalmology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Stephanie Grillo
- Department of Ophthalmology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - James V. Nguyen
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Douglas A. Brown
- Department of Ophthalmology, Temple University-Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Sarah P. Ullah
- Department of Ophthalmology, Pittsburgh University School of Medicine, Pittsburgh, PA, USA
| | - Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Lan Kong
- Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Jeffrey M. Sundstrom
- Department of Ophthalmology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Ophthalmology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Kinesiology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Esther M. Bowie
- Department of Ophthalmology, Temple University-Lewis Katz School of Medicine, Philadelphia, PA, USA
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Abstract
Purpose: The reproductive toxicology of mangafodipir trisodium (MnDPDP, Teslascan), a new hepatobiliary MR contrast agent, was evaluated in rats and rabbits. Material and Methods: Male and female fertility and post-natal development were examined in rats after repeated i.v. injections of MnDPDP. The developmental toxicity in rats was investigated after repeated daily i.v. injections during organogenesis with MnDPDP, MnCl2, or DPDP, as well as with MnCl2, administered orally. The developmental toxicity of i.v. injected MnDPDP was also investigated in rabbits. Results: MnDPDP (100 μmol/kg) had no adverse effects on rat fertility. However, both MnDPDP (10–40 μmol/kg) and MnCl2 (30 μmol/kg) caused skeletal abnormalities in the rat, but not in the rabbit given 20 μmol MnDPDP/kg. Maternal treatment of rats with MnDPDP (40 μmol/kg) reduced survival and body weights of neonates, and adversely affected their functional, but not physical development. No skeletal abnormalities were seen in the rat after i.v. administered DPDP (40 μmol/kg) or MnCl2 (6 μmol/kg), or after MnCl2 (400 μmol/kg) given by oral gavage. Maternal toxicity was not seen in rats or rabbits given these doses. Conclusion: MnDPDP caused skeletal abnormalities in foetal rats, but not rabbits, and had no effects on rat fertility. Manganese appears to be the causative agent for inducing bone abnormalities in the rat.
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Affiliation(s)
- D Grant
- Nycomed Imaging AS, Oslo, Norway.
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Frye RE, Casanova MF, Fatemi SH, Folsom TD, Reutiman TJ, Brown GL, Edelson SM, Slattery JC, Adams JB. Neuropathological Mechanisms of Seizures in Autism Spectrum Disorder. Front Neurosci 2016; 10:192. [PMID: 27242398 PMCID: PMC4861974 DOI: 10.3389/fnins.2016.00192] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 04/18/2016] [Indexed: 01/09/2023] Open
Abstract
This manuscript reviews biological abnormalities shared by autism spectrum disorder (ASD) and epilepsy. Two neuropathological findings are shared by ASD and epilepsy: abnormalities in minicolumn architecture and γ-aminobutyric acid (GABA) neurotransmission. The peripheral neuropil, which is the region that contains the inhibition circuits of the minicolumns, has been found to be decreased in the post-mortem ASD brain. ASD and epilepsy are associated with inhibitory GABA neurotransmission abnormalities including reduced GABAA and GABAB subunit expression. These abnormalities can elevate the excitation-to-inhibition balance, resulting in hyperexcitablity of the cortex and, in turn, increase the risk of seizures. Medical abnormalities associated with both epilepsy and ASD are discussed. These include specific genetic syndromes, specific metabolic disorders including disorders of energy metabolism and GABA and glutamate neurotransmission, mineral and vitamin deficiencies, heavy metal exposures and immune dysfunction. Many of these medical abnormalities can result in an elevation of the excitatory-to-inhibitory balance. Fragile X is linked to dysfunction of the mGluR5 receptor and Fragile X, Angelman and Rett syndromes are linked to a reduction in GABAA receptor expression. Defects in energy metabolism can reduce GABA interneuron function. Both pyridoxine dependent seizures and succinic semialdehyde dehydrogenase deficiency cause GABA deficiencies while urea cycle defects and phenylketonuria cause abnormalities in glutamate neurotransmission. Mineral deficiencies can cause glutamate and GABA neurotransmission abnormalities and heavy metals can cause mitochondrial dysfunction which disrupts GABA metabolism. Thus, both ASD and epilepsy are associated with similar abnormalities that may alter the excitatory-to-inhibitory balance of the cortex. These parallels may explain the high prevalence of epilepsy in ASD and the elevated prevalence of ASD features in individuals with epilepsy.
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Affiliation(s)
- Richard E Frye
- Autism Research Program, Arkansas Children's Research InstituteLittle Rock, AR, USA; Department of Pediatrics, University of Arkansas for Medical SciencesLittle Rock, AR, USA
| | - Manuel F Casanova
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville Greenville, SC, USA
| | - S Hossein Fatemi
- Department of Psychiatry, University of Minnesota Medical School Minneapolis, MN, USA
| | - Timothy D Folsom
- Department of Psychiatry, University of Minnesota Medical School Minneapolis, MN, USA
| | - Teri J Reutiman
- Department of Psychiatry, University of Minnesota Medical School Minneapolis, MN, USA
| | | | | | - John C Slattery
- Autism Research Program, Arkansas Children's Research InstituteLittle Rock, AR, USA; Department of Pediatrics, University of Arkansas for Medical SciencesLittle Rock, AR, USA
| | - James B Adams
- School for Engineering of Matter, Transport, and Energy, Arizona State University Tempe, AZ, USA
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Frye RE, Rossignol D, Casanova MF, Brown GL, Martin V, Edelson S, Coben R, Lewine J, Slattery JC, Lau C, Hardy P, Fatemi SH, Folsom TD, MacFabe D, Adams JB. A review of traditional and novel treatments for seizures in autism spectrum disorder: findings from a systematic review and expert panel. Front Public Health 2013; 1:31. [PMID: 24350200 PMCID: PMC3859980 DOI: 10.3389/fpubh.2013.00031] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [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: 04/21/2013] [Accepted: 08/20/2013] [Indexed: 01/20/2023] Open
Abstract
Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD), the effectiveness of treatments for seizures has not been well studied in individuals with ASD. This manuscript reviews both traditional and novel treatments for seizures associated with ASD. Studies were selected by systematically searching major electronic databases and by a panel of experts that treat ASD individuals. Only a few anti-epileptic drugs (AEDs) have undergone carefully controlled trials in ASD, but these trials examined outcomes other than seizures. Several lines of evidence point to valproate, lamotrigine, and levetiracetam as the most effective and tolerable AEDs for individuals with ASD. Limited evidence supports the use of traditional non-AED treatments, such as the ketogenic and modified Atkins diet, multiple subpial transections, immunomodulation, and neurofeedback treatments. Although specific treatments may be more appropriate for specific genetic and metabolic syndromes associated with ASD and seizures, there are few studies which have documented the effectiveness of treatments for seizures for specific syndromes. Limited evidence supports l-carnitine, multivitamins, and N-acetyl-l-cysteine in mitochondrial disease and dysfunction, folinic acid in cerebral folate abnormalities and early treatment with vigabatrin in tuberous sclerosis complex. Finally, there is limited evidence for a number of novel treatments, particularly magnesium with pyridoxine, omega-3 fatty acids, the gluten-free casein-free diet, and low-frequency repetitive transcranial magnetic simulation. Zinc and l-carnosine are potential novel treatments supported by basic research but not clinical studies. This review demonstrates the wide variety of treatments used to treat seizures in individuals with ASD as well as the striking lack of clinical trials performed to support the use of these treatments. Additional studies concerning these treatments for controlling seizures in individuals with ASD are warranted.
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Affiliation(s)
- Richard E. Frye
- Arkansas Children’s Hospital Research Institute, Little Rock, AR, USA
| | | | | | - Gregory L. Brown
- Autism Recovery and Comprehensive Health Medical Center, Franklin, WI, USA
| | - Victoria Martin
- Autism Recovery and Comprehensive Health Medical Center, Franklin, WI, USA
| | | | - Robert Coben
- New York University Brain Research Laboratory, New York, NY, USA
| | - Jeffrey Lewine
- MIND Research Network, University of New Mexico, Albuquerque, NM, USA
| | - John C. Slattery
- Arkansas Children’s Hospital Research Institute, Little Rock, AR, USA
| | - Chrystal Lau
- Arkansas Children’s Hospital Research Institute, Little Rock, AR, USA
| | - Paul Hardy
- Hardy Healthcare Associates, Hingham, MA, USA
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Abstract
Immunoglobulin M hemagglutinin and antibody cytophilic for macrophages were produced simultaneously in mice after primary antigenic stimulation with sheep erythrocytes in saline. Antigen emulsified in Freund's complete adjuvant induced formation of cytophilic antibody (CA) in high titer. Purified cytophilic globulin was isolated by permitting it to attach to macrophages in vitro and eluting it at 56 C. The chromatographic elution pattern, molecular weight, and resistance to mercaptoethanol suggested that CA is a member of the immunoglobulin G class of immunoglobulins.
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Affiliation(s)
- G L Brown
- Microbiology Division, U.S. Army Medical Research and Nutrition Laboratory, Fitzsimons General Hospital, Denver, Colorado 80240
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Abstract
Antibody formation in high-altitude-acclimatized and nonacclimatized rabbits was investigated at altitudes of 14,100 (Pikes Peak, Colo.) and 5,330 (Denver, Colo.). Serum pools representing samplings of primary response were titered before and after treatment with 2-mercaptoethanol. Peak titers of 2-mercaptoethanolresistant and -sensitive humoral antibodies were higher in the animals adapted to an altitude of 14,100 ft and in nonadapted animals than in animals maintained at 5,330 ft.
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Affiliation(s)
- G L Brown
- Microbiology and Pathology Divisions, U.S. Army Medical Research and Nutrition Laboratory, Fitzsimons General Hospital, Denver, Colorado 80240
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Brown GL, Goffart M, Dias MV. The effects of adrenaline and of sympathetic stimulation on the demarcation potential of mammalian skeletal muscle. J Physiol 2007; 111:184-94. [PMID: 16991912 PMCID: PMC1392842 DOI: 10.1113/jphysiol.1950.sp004473] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Brown GL, McSwiney BA, Wadge WJ. The sympathetic innervation of the stomach: I. The effect on the stomach of stimulation of the thoracic sympathetic trunk. J Physiol 2007; 70:253-60. [PMID: 16994140 PMCID: PMC1402995 DOI: 10.1113/jphysiol.1930.sp002693] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Bacq ZM, Brown GL. Pharmacological experiments on mammalian voluntary muscle, in relation to the theory of chemical transmission. J Physiol 2007; 89:45-60. [PMID: 16994843 PMCID: PMC1395034 DOI: 10.1113/jphysiol.1937.sp003461] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Ducci F, Newman TK, Funt S, Brown GL, Virkkunen M, Goldman D. A functional polymorphism in the MAOA gene promoter (MAOA-LPR) predicts central dopamine function and body mass index. Mol Psychiatry 2006; 11:858-66. [PMID: 16770335 DOI: 10.1038/sj.mp.4001856] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Variation in brain monoaminergic activity is heritable and modulates risk of alcoholism and other addictions, as well as food intake and energy expenditure. Monoamine oxidase A deaminates the monoamine neurotransmitters serotonin, dopamine (DA), and noradrenaline. The monoamine oxidase A (MAOA) gene (Xp11.5) contains a length polymorphism in its promoter region (MAOA-LPR) that putatively affects transcriptional efficiency. Our goals were to test (1) whether MAOA-LPR contributes to interindividual variation in monoamine activity, assessed using levels of cerebrospinal fluid (CSF) monoamine metabolites; and (2) whether MAOA-LPR genotype influences alcoholism and/or body mass index (BMI). Male, unrelated criminal alcoholics (N=278) and controls (N=227) were collected from a homogeneous Finnish source population. CSF concentration of 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) were available from 208 participants. Single allele, hemizygous genotypes were grouped according to inferred effect of the MAOA alleles on transcriptional activity. MAOA-LPR genotypes had a significant effect on CSF HVA concentration (P=0.01) but explained only 3% of the total variance. There was a detectable but nonsignificant genotype effect on 5-HIAA and no effects on MHPG. Specifically, the genotype conferring high MAOA activity was associated with lower HVA levels in both alcoholics and controls, a finding that persisted after accounting for the potential confounds of alcoholism, BMI, height, and smoking. MAOA-LPR genotype predicted BMI (P<0.005), with the high-activity genotype being associated with lower BMI. MAOA-LPR genotypes were not associated with alcoholism or related psychiatric phenotypes in this data set. Our results suggest that MAOA-LPR allelic variation modulates DA turnover in the CNS, but does so in a manner contrary to our prior expectation that alleles conferring high activity would predict higher HVA levels in CSF. Our results are consistent with an emerging literature that suggests greater complexity in how variation in MAOA expression alters monoaminergic function. Finally, our work suggests that MAOA may be involved in the regulation of BMI. Independent samples are necessary to confirm this preliminary finding.
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Affiliation(s)
- F Ducci
- Laboratory of Neurogenetics, NIAAA, NIH, Rockville, MD 20852, USA.
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Kavanagh JJ, Gershenson DM, Choi H, Lewis L, Patel K, Brown GL, Garcia A, Spriggs DR. Multi-institutional phase 2 study of TLK286 (TELCYTA, a glutathione S-transferase P1-1 activated glutathione analog prodrug) in patients with platinum and paclitaxel refractory or resistant ovarian cancer. Int J Gynecol Cancer 2005; 15:593-600. [PMID: 16014111 DOI: 10.1111/j.1525-1438.2005.00114.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The purpose of this study was to determine the safety and efficacy of TLK286 (TELCYTA(TM)), a glutathione analog prodrug, in patients with platinum and paclitaxel refractory or resistant ovarian carcinoma. Thirty-six patients with measurable disease were enrolled. TLK286 was administered at 1000 mg/m2 intravenously every 3 weeks. The endpoints were objective response rate assessed by Response Evaluation Criteria in Solid Tumors (RECIST) and survival. Adverse events were graded using the National Cancer Institute Common Toxicity Criteria. Thirty-four platinum refractory or resistant patients (94%) were evaluable for objective tumor response. Five patients (15%) had objective tumor responses, including one durable complete response (CR) of greater than 3 years and continuing. The disease stabilization rate was 50%, including one CR (3%), four partial responses (12%), and 12 durable disease stabilizations (35%). Responses were accompanied by improvement in clinical symptoms and Eastern Cooperative Oncology Group Performance Status (ECOG PS) and decline in CA125 levels. Median survival was 423 days with survival of 60% at 1 year and 40% at 18 months. TLK286 was well tolerated in this population. TLK286 is an active agent in chemotherapy-resistant ovarian cancer. Further studies of TLK286 in platinum and paclitaxel refractory or resistant ovarian cancer are in progress.
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Affiliation(s)
- J J Kavanagh
- The M.D. Anderson Cancer Center, University of Texas, Houston, Texas, USA
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Affiliation(s)
- M E Ernst
- Division of Clinical and Administrative Pharmacy, College of Pharmacy, University of Iowa (UI), S411 PHAR, Iowa City, IA 52242, USA.
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Abstract
It is common in catastrophic food-contamination events that consumers fail to adjust instantaneously to a normal consumption level. One explanation is that consumers only gradually accept new positive information as being trustworthy. The gradual establishment of the trustworthiness of the released information depends on both positive and negative media coverage over time. We examine the individual "trust" effects by extending the prospective reference theory (Viscusi, 1989) to include a dynamic adjustment process of risk perception. Conditions that allow aggregation of changes in risk perceptions across individuals are described. The proposed model describes a general updating process of risk perceptions to media coverage and can be applied to explain the temporal impact of media coverage on consumption of a broad range of goods (food or nonfood). A case study of milk contamination is conducted to demonstrate consumer demand adjustment process to a temporarily unfavorable shock. The results suggest that effects of positive and negative information to adjustment of consumption and risk perception are asymmetric over time.
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Affiliation(s)
- S Liu
- Department of Economics, University of New Hampshire
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Lappalainen J, Long JC, Eggert M, Ozaki N, Robin RW, Brown GL, Naukkarinen H, Virkkunen M, Linnoila M, Goldman D. Linkage of antisocial alcoholism to the serotonin 5-HT1B receptor gene in 2 populations. Arch Gen Psychiatry 1998; 55:989-94. [PMID: 9819067 DOI: 10.1001/archpsyc.55.11.989] [Citation(s) in RCA: 226] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND In mice, quantitative trait locus studies and behavioral evaluation of animals deleted for 5-HT1B have implicated this serotonin autoreceptor in alcohol consumption and aggressive behavior. We therefore investigated whether the 5-HT1B gene (HTR1B) is linked to alcoholism with aggressive and impulsive behavior in the human, as represented by 2 psychiatric diagnoses: antisocial personality disorder and intermittent explosive disorder comorbid with alcoholism. METHODS Linkage was first tested in 640 Finnish subjects, including 166 alcoholic criminal offenders, 261 relatives, and 213 healthy controls. This was followed by a study in a large multigenerational family derived from a Southwestern American Indian tribe (n=418) with a high rate of alcoholism. All subjects were psychiatrically interviewed, blind-rated for psychiatric diagnoses, and typed for a HTR1B G861C polymorphism and for a closely linked short-tandem repeat locus, D6S284. Linkage was evaluated in sib pairs, and by using an association approach in which pedigree randomization corrects for nonindependence of observations on related subjects. RESULTS In Finnish sib pairs, antisocial alcoholism showed significant evidence of linkage to HTR1B G861C (P=.04) and weak evidence with D6S284 (P=.06). By association analysis, the 183 Finnish antisocial alcoholics had a significantly higher HTR1B-861C allele frequency than the other 457 Finns we studied (P=.005). In the Southwestern American Indian tribe, significant sib pair linkage of antisocial alcoholism to HTR1B G861C (P=.01) was again observed, and there was also significant linkage to D6S284 (P=.01). CONCLUSION These results suggest that a locus predisposing to antisocial alcoholism may be linked to HTR1B at 6q13-15.
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Affiliation(s)
- J Lappalainen
- Section of Population Genetics and Linkage, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20852, USA
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Nielsen DA, Virkkunen M, Lappalainen J, Eggert M, Brown GL, Long JC, Goldman D, Linnoila M. A tryptophan hydroxylase gene marker for suicidality and alcoholism. Arch Gen Psychiatry 1998; 55:593-602. [PMID: 9672049 DOI: 10.1001/archpsyc.55.7.593] [Citation(s) in RCA: 183] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Tryptophan hydroxylase (TPH) is the rate-limiting enzyme in the synthesis of serotonin. Low turnover rate of this monoamine neurotransmitter is associated with impaired impulse control. We previously reported that, in Finns, TPH genotype was associated with suicidality, a pathophysiological mechanism that may involve impaired impulse control. METHODS Association and sib-pair linkage analyses of a polymorphism in intron 7 of the TPH gene with suicidality, alcoholism, and the Karolinska Scales of Personality were conducted in 804 Finnish alcoholic offenders, controls, and their relatives, in a sample that included 369 sib pairs. RESULTS The association of the TPH 17 779C (L) allele to suicidality in impulsive offenders reported previously was replicated in a new group of Finnish offenders (P=.001, n=122). The intron 7 variant in the TPH gene showed significant evidence for linkage to suicidality (P=.006 in unaffected sib pairs), severe suicide attempts (P=.006 in unaffected sib pairs; regression: P=.01), alcoholism (P=.003 in unaffected sib-pairs; regression: P=.02), and Karolinska Scales of Personality socialization score (regression: P=.002). CONCLUSIONS The status of the TPH A779C allele as a marker for suicidality was replicated and linkage with alcoholism and Karolinska Scales of Personality socialization score was also observed. A functional variant(s) in or close to the TPH gene may predispose individuals to suicidality and other behaviors thought to be influenced by serotonin.
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Affiliation(s)
- D A Nielsen
- Section of Molecular Genetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
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Bayliss C, Bent E, Culham DE, MacLellan S, Clarke AJ, Brown GL, Wood JM. Bacterial genetic loci implicated in the Pseudomonas putida GR12-2R3--canola mutualism: identification of an exudate-inducible sugar transporter. Can J Microbiol 1997; 43:809-18. [PMID: 9336944 DOI: 10.1139/m97-118] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Pseudomonas putida GR12-2R3 promotes the emergence and growth of diverse plant species. Analyses of TnphoA insertion mutations are revealing bacterial characteristics pertinent to the plant-microbe interaction. Pseudomonas putida PG269 is a TnphoA insertion derivative of GR12-2R3 that expresses canola seed exudate-inducible alkaline phosphatase (PhoA) activity. It promoted the growth of canola roots, as well as strain GR12-2R3, and outgrew its parent when they were cocultured in the presence of canola roots or in liquid seed exudate medium. (In contrast, mutant PG126 failed to promote canola root growth and was outgrown by its parent strain.) The PhoA activity of strain PG269 was induced by glucosamine and other sugars; glucosamine inhibited the growth of strain GR12-2R3 and stimulated the growth of strain PG269. Strain PG269 contained two TnphoA insertions: seiA1::TnphoA and seiB1::TnphoA. Strain PG312, which contained only insertion seiA1::TnphoA, shared all aspects of the PG269 phenotype, except the ability to outcompete strain GR12-2R3 during coculture. Insertion seiA1::TnphoA interrupted an open reading frame related in sequence to members of the MalF family of sugar transporter subunits. The PhoA-inducing fraction of canola seed exudate was hydrophilic, low in molecular weight, and heat stable. It cochromatographed with basic amino acids and amino sugars, and was inactivated by strains GR12-2R3 and PG269. Gene seiA may encode a subunit of an ABC transporter with broad specificity for glucose and related sugars whose expression can be induced by exudate sugars.
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Affiliation(s)
- C Bayliss
- Department of Microbiology, University of Guelph, ON, Canada
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Blazak WF, Brown GL, Gray TJ, Treinen KA, Denny KH. Developmental toxicity study of mangafodipir trisodium injection (MnDPDP) in New Zealand white rabbits. Fundam Appl Toxicol 1996; 33:11-5. [PMID: 8812204 DOI: 10.1006/faat.1996.0137] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Mangafodipir trisodium injection (MnDPDP) is an intravenously administered manganese chelate undergoing clinical evaluation for magnetic resonance imaging contrast enhancement of the hepatobiliary system. The anticipated single clinical dose for adults is 5 micromol/kg body wt. MnDPDP, as well as the inorganic salt, MnCl2, was previously shown to induce a specific syndrome of skeletal abnormalities in rats. The syndrome malformations included angulated or irregularly shaped clavicle, femur, fibula, humerus, ilium, radius, scapula, tibia, and/or ulna. The objective of the present study was to assess the developmental toxicity of MnDPDP in a second mammalian species, the New Zealand White rabbit. MnDPDP was intravenously administered daily to groups of rabbits (22 per group) on Days 6 through 18 of pregnancy at doses of 0 (saline), 5, 20, 40, and 60 micromol/kg MnDPDP. Fetuses were examined on Day 29 of pregnancy for external, visceral, and skeletal abnormalities. Treatment with MnDPDP did not result in overt symptoms of maternal toxicity, and there were no significant effects on maternal body weight gains or feed consumption. The maternal no-observed-adverse-effect level (NOAEL), therefore, was 60 micromol/kg MnDPDP. Treatment with MnDPDP resulted in a significant increase in postimplantation loss at 60 micromol/kg, but there was no significant increase in external, visceral, or skeletal abnormalities at any dose. The developmental NOAEL for MnDPDP, therefore, was 40 micromol/kg. These results indicate that the developmental toxicity profile of MnDPDP differs considerably in the rat and rabbit. In the rat, this compound induces specific skeletal abnormalities, whereas in the rabbit, embryo/fetal toxicity is the most sensitive developmental endpoint with no evidence for the induction of specific skeletal abnormalities.
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Affiliation(s)
- W F Blazak
- Nycomed Inc., Wayne, Pennsylvania, 19087, USA
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Kelemen GH, Brown GL, Kormanec J, Potúcková L, Chater KF, Buttner MJ. The positions of the sigma-factor genes, whiG and sigF, in the hierarchy controlling the development of spore chains in the aerial hyphae of Streptomyces coelicolor A3(2). Mol Microbiol 1996; 21:593-603. [PMID: 8866481 DOI: 10.1111/j.1365-2958.1996.tb02567.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
whiG and sigF encode RNA polymerase sigma factors required for sporulation in the aerial hyphae of Streptomyces coelicolor. Their expression was analysed during colony development in wild-type and sporulation-defective whi mutant strains. Each gene was transcribed from a single promoter. Unexpectedly, whiG mRNA was present at all time points, including those taken prior to aerial mycelium formation; this suggests that whiG may be regulated post-transcriptionally. Transcription of whiG did not depend upon any of the six known 'early' whi genes required for sporulation septum formation (whiA, B, G, H, I and J), placing it at the top of the hierarchy of whi loci. sigF expression appeared to be regulated at the level of transcription; sigF transcripts were detected transiently when sporulation septa were observed in the aerial hyphae. Transcription of sigF depended upon all six of the early whi genes, including whiG. The sigF promoter does not resemble the consensus sequence established for sigma WhiG-dependent promoters and E sigma WhiG did not transcribe from the sigF promoter in vitro. Consequently, the genetic dependence of sigF upon whiG is very likely to be indirect. These results show that there is a hierarchical relationship between sigma factors required for Streptomyces sporulation and also that at least five other genes are involved in this transcriptional network.
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Affiliation(s)
- G H Kelemen
- Department of Genetics, John Innes Centre, Colney, Norwich, UK.
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Fils-Aime ML, Eckardt MJ, George DT, Brown GL, Mefford I, Linnoila M. Early-onset alcoholics have lower cerebrospinal fluid 5-hydroxyindoleacetic acid levels than late-onset alcoholics. Arch Gen Psychiatry 1996; 53:211-6. [PMID: 8611057 DOI: 10.1001/archpsyc.1996.01830030029006] [Citation(s) in RCA: 131] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND We investigated the interrelationships of age at onset of excessive alcohol consumption, family history of alcoholism, psychiatric comorbidity, and cerebrospinal fluid monoamine metabolite concentrations in abstinent, treatment-seeking alcoholics. METHODS We studied 131 recently abstinent alcoholics. Supervised abstinence was maintained on a research ward at the National Institutes of Health Clinical Center for a minimum of 3 weeks. All alcoholics received a low-monoamine diet for a minimum of 3 days before lumbar puncture. Lumbar punctures were performed in the morning after an overnight fast. Monamine metabolites and tryptophan in cerebrospinal fluid were quantified with liquid chromatography by means of electrochemical detection. Psychiatric diagnoses were established from blind-rated Schedule for Affective Disorders and Schizophrenia-Lifetime version interviews administered by a research social worker. Severity and age at onset of excessive alcohol consumption were documented with a structured lifetime drinking history questionnaire and with selected alcoholism screening questionnaires (CAGE and Michigan Alcoholism Screening Test). Family history of alcoholism was obtained from the probands. RESULTS A majority of the treatment-seeking, primarily white male alcoholics had a lifetime history of psychiatric disorders other than alcoholism. None fulfilled criteria for antisocial personality disorder. Early-onset alcoholics (onset of excessive consumption before 25 years of age) had a more severe course of alcoholism and lower mean cerebrospinal fluid 5-hydroxyindoleacetic acid concentration than late-onset alcoholics. Patients who reported both parents to be alcoholics had particularly low mean cerebrospinal fluid 5-hydroxyindoleacetic acid, homovanillic acid, and tryptophan concentrations. CONCLUSION Among treatment-seeking alcoholics, early age at onset is generally associated with a more severe course of alcoholism and lower cerebrospinal fluid 5-hydroxyindoleacetic acid concentration.
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Affiliation(s)
- M L Fils-Aime
- Laboratory of Clinical Studies, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Md. USA
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Osborne BG, Ibe F, Brown GL, Petagine F, Scudamore KA, Banks JN, Hetmanski MT, Leonard CT. The effects of milling and processing on wheat contaminated with ochratoxin A. Food Addit Contam 1996; 13:141-53. [PMID: 9064239 DOI: 10.1080/02652039609374392] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Samples of sound home-grown wheat (one hard and one soft milling) were obtained, cleaned, and gamma-irradiation used to reduce numbers of viable naturally-occurring fungi. Each sample was inoculated with a toxigenic strain of Penicillium verrucosum and monitored for ochratoxin A formation. When ochratoxin A had reached a level of 60 micrograms/kg, the samples were milled into ten fractions which were analysed for ochratoxin A by an HPLC method with immunoaffinity column clean-up. Each straight-run white flour was baked into bread which was analysed in the same way. Relationships between ochratoxin A levels in naturally-contaminated wheat and the products of milling and baking were established. The recovery of ochratoxin A in wholemeal compared with the cleaned wheat was essentially complete and no significant loss occurred on baking white or wholemeal flour into bread. Recoveries in the straight-run white flours, however, were only approximately one-third for the hard wheat and two-thirds for the soft wheat of the ochratoxin A in the uncleaned wheat. The reason for this was that a much higher proportion of the ochratoxin A was found in the bran and offal fractions from hard wheat than from soft. Conversely, a much higher proportion of the ochratoxin A was found in the reduction flour from soft wheat than from hard. Scouring was examined as a possible method of decontamination of wheat prior to milling. This process removes a proportion of the pericarp (bran coat) prior to milling. The results of the study confirmed that scouring reduced the ochratoxin A level in white and wholemeal flour three-fold for both the hard and soft wheat.
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Neumann PG, Brown GL. State legislative approaches to regulating the use of genetic information. Health Care Law Newsl 1995; 10:5-7. [PMID: 10152639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
As genetic testing becomes more prevalent and the uses for genetic information multiply, we are likely to witness more demand for comprehensive state legislation on the order of the Oregon law regulating the procedures for obtaining and using genetic information. In addition, the United States Senate has expressed an interest in the subject. The Senate Labor and Human Resources Committee reportedly agreed on August 2, 1995 to include in a health insurance reform bill (S. 1028) language prohibiting health plans from using genetic information when determining eligibility, continuation, enrollment, or contribution requirements. 4 BNA's Health Law Rep. at 1218 (Aug. 10, 1995). Insurance companies continue to maintain that genetic test results are simply another factor that should rightfully be used during underwriting, much as age, medical history, and physical examinations are routinely used today. Right to privacy advocates argue that genetic testing provides employers and insurance companies with too much information and offers a great potential for discrimination. As more states wrestle with this issue, these competing interests are likely to be debated in public forums throughout the country.
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Enoch MA, Rohrbaugh JW, Davis EZ, Harris CR, Ellingson RJ, Andreason P, Moore V, Varner JL, Brown GL, Eckardt MJ. Relationship of genetically transmitted alpha EEG traits to anxiety disorders and alcoholism. Am J Med Genet 1995; 60:400-8. [PMID: 8546153 DOI: 10.1002/ajmg.1320600510] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We tested the hypothesis that a heritable EEG trait, the low voltage alpha (LV), is associated with psychiatric disorders. Modest to moderate evidence for genetic linkage of both panic disorder and the low voltage alpha trait to the same region of chromosome 20q has recently been reported, raising the issue of whether there is a phenotypic correlation between these traits. A total of 124 subjects including 50 unrelated index subjects and 74 relatives were studied. Alpha EEG power was measured and EEG phenotypes were impressionistically classified. Subjects were psychiatrically interviewed using the SADS-L and blind-rated by RDC criteria. Alcoholics were four times more likely to be LV (including so-called borderline low voltage alpha) than were nonalcoholic, nonanxious subjects. Alcoholics with anxiety disorder are 10 times more likely to be LV. However, alcoholics without anxiety disorder were similar to nonalcoholics in alpha power. An anxiety disorder (panic disorder, phobia, or generalized anxiety) was found in 14/17 LV subjects as compared to 34/101 of the rest of the sample (P < 0.01). Support for these observations was found in the unrelated index subjects in whom no traits would be shared by familial clustering. Lower alpha power in anxiety disorders was not state-dependent, as indicated by the Spielberger Anxiety Scale. Familial covariance of alpha power was 0.25 (P < 0.01). These findings indicate there may be a shared factor underlying the transmissible low voltage alpha EEG variant and vulnerability to anxiety disorders with associated alcoholism. This factor is apparently not rare, because LV was found in approximately 10% of unrelated index subjects and 5% of subjects free of alcoholism and anxiety disorders.
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Affiliation(s)
- M A Enoch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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Brown GL. Mandatory national health service. JAMA 1993; 270:2805; author reply 2808. [PMID: 8133606 DOI: 10.1001/jama.270.23.2805c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Goldman D, Brown GL, Albaugh B, Robin R, Goodson S, Trunzo M, Akhtar L, Lucas-Derse S, Long J, Linnoila M. DRD2 dopamine receptor genotype, linkage disequilibrium, and alcoholism in American Indians and other populations. Alcohol Clin Exp Res 1993; 17:199-204. [PMID: 8488955 DOI: 10.1111/j.1530-0277.1993.tb00749.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We defined interpopulation differences in the frequency of the dopamine D2 receptor DRD2/Taq1 A1 allele, which has previously been associated with alcoholism. Frequencies of the A1 allele in unrelated subjects were 0.18 to 0.20 (se = 0.02 to 0.03) in several Caucasian populations previously assessed, 0.38 (+/- 0.05) in American Blacks (n = 44), 0.63 (+/- 0.07) in Jemez Pueblo Indians (n = 23), and 0.80 (+/- 0.04) in Cheyenne Indians (n = 52). The existence of large interpopulation differences in the frequency of the Taq1 alleles suggests that associations to disease status could readily be generated or masked if disease and control groups were uneven in ethnic composition. To address the possibility that the 4-fold higher frequency of the A1 allele in Cheyenne Indians was related to an increased vulnerability to alcoholism in that population, 47 Cheyenne Indians were psychiatrically interviewed and blind-rated. However, there was no significant difference between interviewed controls (0.73 +/- 0.06, n = 24), subjects with alcoholism and/or drug abuse (0.74 +/- 0.06, n = 23) and noninterviewed population controls (0.87 +/- 0.05, n = 20). Legitimate association of the DRD2/Taq1 allele to alcoholism would presumably require it to be in linkage disequilibrium (nonrandom association) with a functional mutation at DRD2 or elsewhere. The level of disequilibrium would vary between populations and could place an upper bound on the strength of an association.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- D Goldman
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892
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