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Angelopoulou E, Bougea A, Hatzimanolis A, Stefanis L, Scarmeas N, Papageorgiou S. Mild Behavioral Impairment in Parkinson's Disease: An Updated Review on the Clinical, Genetic, Neuroanatomical, and Pathophysiological Aspects. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:115. [PMID: 38256375 PMCID: PMC10820007 DOI: 10.3390/medicina60010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024]
Abstract
Neuropsychiatric symptoms (NPS), including depression, anxiety, apathy, visual hallucinations, and impulse control disorders, are very common during the course of Parkinson's disease (PD), occurring even at the prodromal and premotor stages. Mild behavioral impairment (MBI) represents a recently described neurobehavioral syndrome, characterized by the emergence of persistent and impactful NPS in later life, reflecting arisk of dementia. Accumulating evidence suggests that MBI is highly prevalent in non-demented patients with PD, also being associated with an advanced disease stage, more severe motor deficits, as well as global and multiple-domain cognitive impairment. Neuroimaging studies have revealed that MBI in patients with PD may be related todistinct patterns of brain atrophy, altered neuronal connectivity, and distribution of dopamine transporter (DAT) depletion, shedding more light on its pathophysiological background. Genetic studies in PD patients have also shown that specific single-nucleotide polymorphisms (SNPs) may be associated with MBI, paving the way for future research in this field. In this review, we summarize and critically discuss the emerging evidence on the frequency, associated clinical and genetic factors, as well as neuroanatomical and neurophysiological correlates of MBI in PD, aiming to elucidate the underlying pathophysiology and its potential role as an early "marker" of cognitive decline, particularly in this population. In addition, we aim to identify research gaps, and propose novel relative areas of interest that could aid in our better understanding of the relationship of this newly defined diagnostic entity with PD.
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Affiliation(s)
- Efthalia Angelopoulou
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Anastasia Bougea
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Alexandros Hatzimanolis
- Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Leonidas Stefanis
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Nikolaos Scarmeas
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
- Department of Neurology, Columbia University, New York, NY 10032, USA
| | - Sokratis Papageorgiou
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
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Gkotzamanis V, Panagiotakos DB, Yannakoulia M, Maraki M, Kosmidis M, Dardiotis E, Hadjigeorgiou G, Sakka P, Ntanasi E, Mamalaki E, Scarmeas N. Trajectories of healthy aging and their association with prodromal parkinson disease: The HELIAD study. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-8. [PMID: 38048313 DOI: 10.1080/23279095.2023.2289548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
Background: The aim of the present study was to investigate the association of prodromal PD (pPD) with trajectories of healthy aging, according to its latest definition by the WHO.Methods: In a sample of 1,226 older adults (704 women), PD diagnosis was reached through standard clinical research procedures. Probability of pPD was calculated according to the International Parkinson and Movement Disorder Society's research criteria for PD-free participants. A healthy aging metric was introduced using an item response theory approach (IRT) based on information from validated questionnaires assessing functionality. Four trajectories of healthy aging were created based on whether the healthy aging status of participants was above or below the median at baseline and follow up: High-High, High-Low, Low-High and Low-Low.Results: 34.3% belonged to the High-High group, 15.7% to the High-Low, 18.6% to the Low-High and 31.4% to the Low-Low group. Participants with possible/probable pPD were 78% less likely to belong in High-High trajectory of healthy aging as compared to those without pPD (OR = 0.22, 95%CI 0.06-0.79, p-value = 0,02).Conclusion: Our findings suggest an inverse association of pPD probability with healthy aging among older adults; Further research is needed to investigate the clinical implications of this association.
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Affiliation(s)
- Viktor Gkotzamanis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Maria Maraki
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Mary Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, NY, USA
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Li Z, Qian L, Chu J, Liu Y, Maitiniyazi G, Chen Y, Cheng X, He J, Cheng L, Ou M, Wang J, Xia S. Diet Is Associated with Frailty in Lung Cancer: A Possible Role of Gut Microbiota. Nutrients 2023; 15:4298. [PMID: 37836582 PMCID: PMC10574134 DOI: 10.3390/nu15194298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/02/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023] Open
Abstract
This study investigated the associations between diet and frailty in lung cancer patients and the potential role of the gut microbiota involved. We assessed dietary intake and frailty status in 231 lung cancer patients by 3-day, 24-h dietary recalls and Fried frailty criteria, respectively, and collected 50 fecal samples for next-generation sequencing. A total of 75 (32.5%) patients were frail, which might be related to significantly lower intake of energy, protein, carbohydrate, dietary fiber, niacin, leucine, some minerals, and a poorer dietary quality as indicated by the Chinese Healthy Eating Index (p < 0.05). Among these, carbohydrate (OR = 0.98; 95% CI 0.96-0.99; p = 0.010), calcium (OR = 0.99; 95% CI 0.99-1.00; p = 0.025), and selenium (OR = 1.03; 95% CI 1.00-1.06; p = 0.022) were all significantly associated with frailty. A multivariate logistic regression analysis showed that the mean risk of frailty was 0.94 times lower (95% CI 0.90-0.99; p = 0.009) among participants with higher CHEI scores. Additionally, the frail patients demonstrated significantly lower gut microbiota β diversity (p = 0.001) and higher relative abundance of Actinobacteriota (p = 0.033). Frailty in lung cancer patients might be associated with insufficient nutrients intake and a poor dietary quality through gut microbiota regulation.
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Affiliation(s)
- Ziyuan Li
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Lei Qian
- Department of Rehabilitation, Wuxi Ninth People’s Hospital Affiliated to Soochow University, Wuxi 214063, China;
| | - Jianghui Chu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214125, China;
| | - Yuan Liu
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | | | - Yue Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Xinxin Cheng
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Jianyun He
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Lan Cheng
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Minmin Ou
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Jun Wang
- Department of Rehabilitation, Wuxi Ninth People’s Hospital Affiliated to Soochow University, Wuxi 214063, China;
| | - Shufang Xia
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
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Maraki MI, Yannakoulia M, Xiromerisiou G, Stefanis L, Charisis S, Giagkou N, Kosmidis MH, Dardiotis E, Hadjigeorgiou GM, Sakka P, Scarmeas N, Stamelou M. Mediterranean diet is associated with a lower probability of prodromal Parkinson's disease and risk for Parkinson's disease/dementia with Lewy bodies: A longitudinal study. Eur J Neurol 2023; 30:934-942. [PMID: 36692092 DOI: 10.1111/ene.15698] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE Lifestyle factors have been implicated in the long-lasting neurodegenerative process in prodromal Parkinson's disease (pPD). The aim was to investigate the associations between adherence to a Mediterranean diet (MeDi) and longitudinal changes of pPD probability and the development of Parkinson's disease (PD) or pPD in a Mediterranean older population. METHODS Data from the Hellenic Longitudinal Investigation of Aging and Diet cohort (community-dwelling individuals, aged ≥ 65 years) were used. A detailed food frequency questionnaire was used to evaluate dietary intake and calculate MeDi adherence score, ranging from 0 to 55, with higher scores indicating higher adherence. The probability of pPD was calculated according to the updated Movement Disorder Society research criteria. RESULTS In all, 1047 non-PD/dementia with Lewy bodies (DLB) participants were followed for 3 ± 1 years. MeDi adherence was associated with lower increase in pPD probability over time (b = -0.003, 95% confidence interval -0.006 to -0.001, p = 0.010). Forty-nine participants had incident possible/probable pPD (i.e., pPD probability ≥ 30%). Compared to the participants in the lowest quartile of MeDi adherence, those in the higher quartiles had an approximately 60%-70% lower risk for possible/probable pPD (p for trend 0.003). MeDi-pPD associations were driven by both motor and non-motor pPD markers and not from risk markers. Also, 21 participants were diagnosed with PD/DLB at follow-up. For each unit increase in the MeDi score, there was a 9%-10% lower risk for PD/DLB (hazard ratio 0.906 [95% confidence interval 0.823-0.997], p = 0.044). CONCLUSIONS Mediterranean diet adherence is associated with lower increase in pPD probability over time and lower possible/probable pPD and PD/DLB incidence in older Mediterranean people. More studies are needed to confirm our results in other populations.
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Affiliation(s)
- Maria I Maraki
- Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece
- Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Leonidas Stefanis
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
| | - Sokratis Charisis
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Nikolaos Giagkou
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece
| | - Nikolaos Scarmeas
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia University, New York, USA
| | - Maria Stamelou
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
- Parkinson's Disease and Movement Disorders Department HYGEIA Hospital, Athens, Greece
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Zheng Z, Lv Y, Rong S, Sun T, Chen L. Physical Frailty, Genetic Predisposition, and Incident Parkinson Disease. JAMA Neurol 2023; 80:455-461. [PMID: 36912851 PMCID: PMC10012040 DOI: 10.1001/jamaneurol.2023.0183] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Importance Cross-sectional evidence implicates high prevalent frailty in patients with Parkinson disease (PD), whereas the longitudinal association remains unknown. Objectives To examine the longitudinal association of the frailty phenotype with the development of PD and to explore the modification role of genetic risk of PD in such an association. Design, Setting, and Participants This prospective cohort study launched in 2006 to 2010 with a follow-up of 12 years. Data were analyzed from March 2022 to December 2022. The UK Biobank recruited over 500 000 middle-aged and older adults from 22 assessment centers across the United Kingdom. Participants who were younger than 40 years (n = 101), diagnosed with dementia or PD at baseline, and developed dementia, PD, or died within 2 years from baseline were excluded (n = 4050). Participants who had no genetic data or mismatch between genetic sex and reported gender (n = 15 350), were not of self-reported British White descent (n = 27 850), and had no data for frailty assessment (n = 100 450) or any covariates were also excluded (n = 39 706). The final analysis included 314 998 participants. Exposures The physical frailty was assessed by the Fried criteria's frailty phenotype through 5 domains, ie, weight loss, exhaustion, low physical activity, slow walking speed, and low grip strength. The polygenic risk score (PRS) for PD comprised 44 single-nucleotide variants. Main Outcomes and Measures New-onset PD was identified through the hospital admission electronic health records and death register. Results Among 314 998 participants (mean age, 56.1 years; 49.1% male), 1916 new-onset PD cases were documented. Compared with nonfrailty, the hazard ratio (HR) of incident PD in prefrailty and frailty was 1.26 (95% CI, 1.15-1.39) and 1.87 (95% CI, 1.53-2.28), respectively, and the absolute rate difference per 100 000 person-years was 1.6 (95% CI, 1.0-2.3) for prefrailty and 5.1 (95% CI, 2.9-7.3) for frailty. Exhaustion (HR, 1.41; 95% CI, 1.22-1.62), slow gait speed (HR, 1.32; 95% CI, 1.13-1.54), low grip strength (HR, 1.27; 95% CI, 1.13-1.43), and low physical activity (HR, 1.12; 95% CI, 1.00-1.25) were associated with incident PD. A significant interaction between frailty and PRS on PD was found and the highest hazard was observed in participants with frailty and high genetic risk. Conclusions and Relevance Physical prefrailty and frailty were associated with incident PD independent of sociodemographic factors, lifestyles, multiple morbidities, and genetic background. These findings may have implications for the assessment and management of frailty for PD prevention.
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Affiliation(s)
- Zekun Zheng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanling Lv
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuang Rong
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Taoping Sun
- Zhuhai Precision Medicine Center, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai, Guangdong, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Miller-Patterson C, Hsu JY, Willis AW, Hamedani AG. Functional Impairment in Individuals With Prodromal or Unrecognized Parkinson Disease. JAMA Neurol 2023; 80:200-204. [PMID: 36534377 PMCID: PMC9856705 DOI: 10.1001/jamaneurol.2022.4621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/02/2022] [Indexed: 12/23/2022]
Abstract
Importance Daily functioning in individuals with prodromal Parkinson disease requires more detailed description. Objective To evaluate whether functional limitations exist in individuals with Parkinson disease prior to diagnosis compared with the general population. Design, Setting, and Participants This case-control study used Medicare-linked data from the National Health and Aging Trends Study (NHATS), a longitudinal survey in the US, for a random subsample of Medicare beneficiaries aged 65 years or older, with Black and older individuals oversampled by design. Patients with incident Parkinson disease were defined as having 2 or more Medicare diagnoses from January 2011 to December 2017, with Medicare eligibility 2 or more consecutive years prior to the first diagnosis. Controls were defined as individuals with Medicare eligibility at a baseline year and 2 or more years prior, with no Parkinson disease diagnosis. Analyses were conducted from November 2021 to June 2022. Exposures Responses to survey questions addressing dexterity, eating, mobility, mood, pain, sleep, speech, strength, and vision. Main Outcome and Measures Associations between survey responses and Parkinson disease diagnosis in the first year of diagnosis (baseline) and up to 3 years prior to diagnosis (ie, during the prodromal phase) were examined using logistic regression. Results A total of 6674 participants were included. The participant numbers and case prevalence each year varied from 3492 to 5049 and from 700 to 1180 per 100 000 population, respectively. The median age groups were 75 to 79 years and 80 to 84 years, and the percentage of females varied from 48.21% (27 of 56 cases) to 59.98% (2079 of 3466 controls) across all years, with similar proportions among cases and controls. Individuals with prodromal Parkinson disease were less likely to report being able to walk 6 blocks (odds ratio [OR], 0.34; 95% CI, 0.15-0.82), stand independently from a kneeling position (OR, 0.30; 95% CI, 0.11-0.85), or lift a heavy object above one's head (OR, 0.36; 95% CI, 0.15-0.87) and were more likely to report imbalance (OR, 2.77; 95% CI, 1.24-6.20) 3 years prior to diagnosis. Conclusions and Relevance The findings suggest that individuals with prodromal or unrecognized Parkinson disease may have greater impairment in activities involving mobility and strength up to 3 years prior to diagnosis compared with the general population. Identification of prodromal disease may facilitate earlier intervention to improve function.
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Affiliation(s)
- Cameron Miller-Patterson
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Jesse Y. Hsu
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
| | - Allison W. Willis
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
| | - Ali G. Hamedani
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
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Toth D, Reglodi D, Schwieters L, Tamas A. Role of endocrine PACAP in age-related diseases. Front Endocrinol (Lausanne) 2023; 14:1118927. [PMID: 36967746 PMCID: PMC10033946 DOI: 10.3389/fendo.2023.1118927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
Pituitary adenylate cyclase activating polypeptide (PACAP) is a conserved neuropeptide, which confers diverse anti-aging endocrine and paracrine/autocrine effects, including anti-apoptotic, anti-inflammatory and antioxidant action. The results of the in vivo and in vitro experiments show that increasing emphasis is being placed on the diagnostic/prognostic biomarker potential of this neuropeptide in a wide array of age-related diseases. After the initial findings regarding the presence and alteration of PACAP in different body fluids in physiological processes, an increasing number of studies have focused on the changes of its levels in various pathological conditions associated with advanced aging. Until 2016 - when the results of previous human studies were reviewed - a vast majority of the studies had dealt with age-related neurological diseases, like cerebrovascular and neurodegenerative diseases, multiple sclerosis, as well as some other common diseases in elderly such as migraine, traumatic brain injury and post-traumatic stress disorder, chronic hepatitis and nephrotic syndrome. The aim of this review is to summarize the old and the new results and highlight those 'classical' and emerging clinical fields in which PACAP may become subject to further investigation as a diagnostic and/or prognostic biomarker in age-related diseases.
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Affiliation(s)
- Denes Toth
- Department of Forensic Medicine, University of Pécs Medical School, Pécs, Hungary
| | - Dora Reglodi
- Department of Anatomy, ELKH-PTE PACAP Research Team, Centre for Neuroscience, University of Pécs Medical School, Pécs, Hungary
| | - Lili Schwieters
- Department of Anatomy, ELKH-PTE PACAP Research Team, Centre for Neuroscience, University of Pécs Medical School, Pécs, Hungary
| | - Andrea Tamas
- Department of Anatomy, ELKH-PTE PACAP Research Team, Centre for Neuroscience, University of Pécs Medical School, Pécs, Hungary
- *Correspondence: Andrea Tamas,
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Lammers-Lietz F, Zacharias N, Mörgeli R, Spies CD, Winterer G. Functional Connectivity of the Supplementary and Presupplementary Motor Areas in Postoperative Transition Between Stages of Frailty. J Gerontol A Biol Sci Med Sci 2022; 77:2464-2473. [PMID: 35040961 DOI: 10.1093/gerona/glac012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Frailty is a multietiological geriatric syndrome of run-down physical reserves with high vulnerability to stressors. Transitions between physical robustness and frailty often occur in the context of medical interventions. Studies suggest that neurological disorders contribute to faster progression of frailty. In a previous cross-sectional study we found altered functional connectivity of supplementary motor area (SMA) in (pre)frail compared to robust patients. We analyzed functional connectivity of the SMA and presupplementary motor area (pre-SMA) in patients with postoperative transitions between physical robustness and stages of frailty. METHODS We investigated 120 cognitively healthy patients (49.2% robust, 47.5% prefrail, 3.3% frail, 37.5% female, median age 71 [65-87] years) undergoing elective surgery from the BioCog project, a multicentric prospective cohort study on postoperative delirium and cognitive dysfunction. Assessments took place 14 days before and 3 months after surgery, comprising assessments of a modified frailty phenotype according to Fried and resting-state functional magnetic resonance imaging at 3 T. The associations between functional connectivity of the SMA and pre-SMA networks, preoperative frailty stages, and postoperative transitions were examined using mixed linear effects models. RESULTS Nineteen patients showed physical improvement after surgery, 24 patients progressed to (pre)frailty and in 77 patients no transition was observed. At follow-up, 57 (47.5%) patients were robust, 52 (43.3%) prefrail, and 11 (9.2%) frail. Lower functional connectivity in the pre-SMA network was associated with more unfavorable postoperative transition types. An exploratory analysis suggested that the association was restricted to patients who were prefrail at baseline. There was no association of transition type with SMA functional connectivity in the primary analysis. In an exploratory analysis, transition from prefrailty to robustness was associated with higher functional connectivity and progression in robust patients was associated with higher SMA network segregation. CONCLUSIONS Our findings implicate that dysfunctions of cortical networks involved in higher cognitive control of motion are associated with postoperative transitions between frailty stages. The pre-SMA may be a target for neurofeedback or brain stimulation in approaches to prevent frailty. Clinical Trials Registration Number: NCT02265263.
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Affiliation(s)
- Florian Lammers-Lietz
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Norman Zacharias
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Pharmaimage Biomarker Solutions GmbH, Berlin, Germany
| | - Rudolf Mörgeli
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia D Spies
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Georg Winterer
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Pharmaimage Biomarker Solutions GmbH, Berlin, Germany
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Gonçalves RSDSA, Maciel ÁCC, Rolland Y, Vellas B, de Souto Barreto P. Frailty biomarkers under the perspective of geroscience: A narrative review. Ageing Res Rev 2022; 81:101737. [PMID: 36162706 DOI: 10.1016/j.arr.2022.101737] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 01/31/2023]
Abstract
Cellular and molecular aging biomarkers might contribute to identify at-risk individuals for frailty before overt clinical manifestations appear. Although studies on the associations of aging biomarkers and frailty exist, no investigation has gathered this information using a structured framework for identifying aging biomarkers; as a result, the evidence on frailty and aging biomarkers is diffuse and incomplete. Therefore, this narrative review aimed to gather information on the associations of the hallmarks of aging and frailty under the perspective of geroscience. The literature on human studies on this topic is sparse and mainly composed of cross-sectional investigations performed in small study samples. The main putative aging biomarkers associated to frailty were: mitochondrial DNA copy number (genomic instability and mitochondrial dysfunction), telomere length (telomere attrition), global DNA methylation (epigenetic alterations), Hsp70 and Hsp72 (loss of proteostasis), IGF-1 and SIRT1 (deregulated nutrient-sensing), GDF-15 (mitochondrial dysfunction, cellular senescence and altered intercellular communication), CD4 + and CD8 + cell percentages (cellular senescence), circulating osteogenic progenitor (COP) cells (stem cell exhaustion), and IL-6, CRP and TNF-alpha (altered intercellular communication). IGF-1, SIRT1, GDF-15, IL-6, CRP and TNF-alpha presented more evidence among these biomarkers, highlighting the importance of inflammation and nutrient sensing on frailty. Further longitudinal studies investigating biomarkers across the hallmarks of aging would provide valuable information on this topic.
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Affiliation(s)
| | | | - Yves Rolland
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France; CERPOP, Inserm 1295, Université de Toulouse, UPS, Toulouse, France.
| | - Bruno Vellas
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France; CERPOP, Inserm 1295, Université de Toulouse, UPS, Toulouse, France.
| | - Philipe de Souto Barreto
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France; CERPOP, Inserm 1295, Université de Toulouse, UPS, Toulouse, France.
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10
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Sousa-Fraguas MC, Rodríguez-Fuentes G, Conejo NM. Frailty and cognitive impairment in Parkinson’s disease: a systematic review. Neurol Sci 2022; 43:6693-6706. [PMID: 36056182 DOI: 10.1007/s10072-022-06347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/12/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Frailty can lead to increased vulnerability in older people and patients with Parkinson's disease (pwPD) and worsen their health conditions. These patients can also develop cognitive function impairment. The objective is to analyze whether there is a relationship between frailty and cognitive impairment in pwPD, and to find out which instruments to use for its evaluation. METHODS Publications were searched in PubMed, Medline, Web of Science, Cinalh, Cochrane Library, Embase, Phycinfo, and Scopus. The results were measured with the instruments that are used to assess frailty and cognitive impairment, and analyze their relationship. RESULTS Two hundred seventy-one articles were identified, of which 12 met the inclusion criteria. All studies assessed frailty and cognitive function in pwPD. Five studies analyzed the relationship between frailty and cognitive impairment. The most used instruments were the Fried scale followed by the Clinical Frailty Scale (CFS) for frailty. Cognitive impairment was mostly evaluated with the Mini-Mental State Examination and the Montreal Cognitive Assessment. The prevalence data ranged from 20.2 to 51.5% with the Fried scale and from 35.6 to 83.9% with the CFS. Cognitive impairment was present in 15 to 45.2% of the pwPD. CONCLUSION Analysis of the included studies shows a relationship between frailty and cognitive impairment in pwPD. There was significant variability in the application of the scales used, which influences the prevalence data. More observational and experimental studies are needed to provide more evidence on this association and to determine which is the optimal tool to identify frailty in pwPD using multidimensional scales.
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11
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Ebina J, Ebihara S, Kano O. Similarities, differences and overlaps between frailty and Parkinson's disease. Geriatr Gerontol Int 2022; 22:259-270. [PMID: 35243739 DOI: 10.1111/ggi.14362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/07/2021] [Accepted: 01/27/2022] [Indexed: 12/12/2022]
Abstract
Parkinson's disease is a neurodegenerative disorder clinically characterized by bradykinesia, rest tremor, rigidity, and postural and gait disturbances, which are frequently observed in older people. It also shows non-motor symptoms, such as depression, anxiety, cognitive impairment and dementia. The number of patients is gradually increasing worldwide. Aging is a risk factor for the onset of Parkinson's disease, and various physiological effects of aging influence its progression. Frailty is a geriatric syndrome in which the reversible and vulnerable status between robustness and disability is affected by various physiological stressors with aging. Frailty consists of physical, psychological and social aspects. Furthermore, sarcopenia, a syndrome characterized by the loss of muscle mass, strength and function, is also significantly associated with frailty. To maintain the quality of life of older people, frailty, including sarcopenia, should be quickly and appropriately managed. Polypharmacy is an important factor causing the progression of frailty in geriatric syndrome. Although Parkinson's disease and frailty have similar symptoms, and are considered to affect each other, the clinical features and mechanisms of both largely remain unclear. Nevertheless, little literature on the relationship between frailty and Parkinson's disease is currently available. This narrative review aims to clarify the relationships between Parkinson's disease and frailty, not only on the physical, but also on the mental, cognitive, and social aspects and issues regarding polypharmacy in Parkinson's disease explored by previous studies. Geriatr Gerontol Int 2022; 22: 259-270.
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Affiliation(s)
- Junya Ebina
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Satoru Ebihara
- Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Osamu Kano
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
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12
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Balomenos V, Bounou L, Charisis S, Stamelou M, Ntanasi E, Georgiadi K, Mourtzinos I, Tzima K, Anastasiou CA, Xiromerisiou G, Maraki M, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Sakka P, Stefanis L, Scarmeas N. Dietary Inflammatory Index score and prodromal Parkinson's disease incidence: The HELIAD study. J Nutr Biochem 2022; 105:108994. [PMID: 35341916 DOI: 10.1016/j.jnutbio.2022.108994] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/21/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to investigate the association of the inflammatory potential of diet with prodromal Parkinson's disease (pPD) probability and incidence among community-dwelling older individuals without clinical features of parkinsonism at baseline. METHODS The sample consisted of 1,030 participants 65 years old or older, drawn from a population-based cohort study of older adults in Greece (Hellenic Longitudinal Investigation of Aging and Diet - HELIAD). We calculated pPD probability, according to International Parkinson and Movement Disorder Society research criteria. Dietary Inflammatory Index (DII) was used to measure the dietary inflammatory potential, with higher index score reflecting a more pro-inflammatory diet. Associations of baseline DII with pPD probability cross-sectionally, and with possible/probable pPD incidence (pPD probability ≥30%) during the follow-up period, were examined via general linear models and generalized estimating equations, respectively. RESULTS Cross-sectionally, one unit increase of DII score[DII (min, max) = -5.83, 6.01]was associated with 4.9% increased pPD probability [β=0.049, 95%CI (0.025-0.090), p<0.001]. Prospectively, 62 participants developed pPD during 3.1±0.9 (mean±SD) years of follow-up. One unit increase in DII was associated with 20.3% increased risk for developing pPD [RR=1.203, 95%CI (1.070-1.351), p=0.002]. Participants in the highest tertile of DII score were 2.6 times more likely to develop pPD [β=2.594, 95%CI (1.332-5.050), p=0.005], compared to those in the lowest tertile. CONCLUSION More pro-inflammatory diet was related with higher pPD probability and pPD incidence (pPD probability ≥30%) in a community-dwelling older adult population. Further studies are needed to confirm these findings.
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Affiliation(s)
- Vassilis Balomenos
- School of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, GR-68100, Greece
| | - Lamprini Bounou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece
| | - Socratis Charisis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece; Department of Neurology, Health Science Center at San Antonio, University of Texas, 7703 Floyd Curl Drive, San Antonio, Texas, TX 78229, USA
| | - Maria Stamelou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece; Parkinson's Disease and Movement Disorders Department, Hygeia Hospital, 4, Erythrou Stavrou Str. & Kifisias Av., Marousi, Athens, GR-151 23, Greece; Medical School, University of Cyprus, 93 Ayiou Nikolaou Str., Egkomi Nicosia, CY-2408, Cyprus
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece
| | - Kyriaki Georgiadi
- School of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, GR-68100, Greece
| | - Ioannis Mourtzinos
- Department of Food Science and Technology, Faculty of Agriculture, Aristotle University of Thessaloniki, P.O. Box 256, Thessaloniki, GR-54124, Greece
| | - Katerina Tzima
- Department of Food Biosciences, Teagasc Food Research Centre, Ashtown, D15 DY05, Dublin, Ireland
| | - Costas A Anastasiou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Str., Kallithea, Athens, GR-176 76, Greece
| | - Georgia Xiromerisiou
- School of Medicine, University of Thessaly, 22 Papakiriazi Str., Larissa, GR-41222, Greece
| | - Maria Maraki
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Str., Kallithea, Athens, GR-176 76, Greece; Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 41 Ethnikis Antistasis Str., Dafni, Athens, GR-17237, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Str., Kallithea, Athens, GR-176 76, Greece.
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, Thessaloniki, GR- 54124, Greece
| | - Efthimios Dardiotis
- School of Medicine, University of Thessaly, 22 Papakiriazi Str., Larissa, GR-41222, Greece
| | - Georgios Hadjigeorgiou
- Medical School, University of Cyprus, 93 Ayiou Nikolaou Str., Egkomi Nicosia, CY-2408, Cyprus
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, 8 Zinonos Eleatou Str., Marousi, GR-151 23, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece; Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephessiou Str., Athens, GR-115 27, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, 630 West 168th Str., New York, NY 10032, USA
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13
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Maraki MI, Hatzimanolis A, Mourtzi N, Stefanis L, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou GM, Sakka P, Ramirez A, Grenier-Boley B, Lambert JC, Heilmann-Heimbach S, Stamelou M, Scarmeas N, Xiromerisiou G. Association of the Polygenic Risk Score With the Probability of Prodromal Parkinson's Disease in Older Adults. Front Mol Neurosci 2022; 14:739571. [PMID: 34992521 PMCID: PMC8724535 DOI: 10.3389/fnmol.2021.739571] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 11/29/2021] [Indexed: 12/19/2022] Open
Abstract
Several studies have investigated the association of the Parkinson’s disease (PD) polygenic risk score (PRS) with several aspects of well-established PD. We sought to evaluate the association of PRS with the prodromal stage of PD. We calculated PRS in a longitudinal sample (n = 1120) of community dwelling individuals ≥ 65 years from the HELIAD (The Hellenic Longitudinal Investigation of Aging and Diet) study in order to evaluate the association of this score with the probability of prodromal PD or any of the established risk and prodromal markers in MDS research criteria, using regression multi-adjusted models. Increases in PRS estimated from GWAS summary statistics’ ninety top SNPS with p < 5 × 10–8 was associated with increased odds of having probable/possible prodromal PD (i.e., ≥ 30% probability, OR = 1.033, 95%CI: 1.009–1.057 p = 0.006). From the prodromal PD risk markers, significant association was found between PRS and global cognitive deficit exclusively (p = 0.003). To our knowledge, our study is the first population based study investigating the association between PRS scores and prodromal markers of Parkinson’s disease. Our results suggest a strong relationship between the accumulation of many common genetic variants, as measured by PRS, and cognitive deficits.
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Affiliation(s)
- Maria I Maraki
- Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.,Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece
| | - Alexandros Hatzimanolis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece.,Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens, Greece
| | - Niki Mourtzi
- First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Leonidas Stefanis
- First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Georgios M Hadjigeorgiou
- School of Medicine, University of Thessaly, Larissa, Greece.,Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE Bonn), Bonn, Germany.,Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, United States.,Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, United States
| | - Benjamin Grenier-Boley
- INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE Facteurs de Risque et Determinants Moléculaires des Maladies Liées au Vieillissement, University of Lille, Lille, France
| | - Jean-Charles Lambert
- INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE Facteurs de Risque et Determinants Moléculaires des Maladies Liées au Vieillissement, University of Lille, Lille, France
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, School of Medicine and University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Maria Stamelou
- First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece
| | - Nikolaos Scarmeas
- First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, United States
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14
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Belvisi D, Canevelli M, Costanzo M, Giangrosso M, Fabbrini A, Borraccino A, Bruno G, Berardelli A, Fabbrini G. The role of frailty in Parkinson's disease: a cross-sectional study. J Neurol 2021; 269:3006-3014. [PMID: 34791518 DOI: 10.1007/s00415-021-10873-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Frailty is an age-related state of increased risk for health-related adverse outcomes that reflects multisystem physiological changes and likely influences the clinical expression and disease progression of neurodegenerative disorders. The aim of the present study was to assess the potential relationship between frailty, as assessed by a frailty index (FI), and motor symptom severity, motor subtypes, and non-motor domains in Parkinson's disease (PD). METHODS We consecutively enrolled 150 PD patients. We administered an FI specifically designed for PD that included 50 age-related multidimensional biological deficits. Patients underwent a clinical assessment that evaluated motor and non-motor manifestations of PD. Using the FI score, we classified PD patients as relatively fit (FI ≤ 0.10), less fit (0.10 < FI ≤ 0.21), or frail (FI > 0.21). A linear regression model was designed to explore possible associations between frailty level and PD motor and non-motor manifestations. RESULTS Frail patients showed greater motor symptom severity and motor complications than fitter patients. A trend towards a higher prevalence of the postural instability/gait disorder subtype was also observed in frail versus relatively fit and less fit patients. The global burden of non-motor symptoms was higher in frail patients. Increased frailty was associated with more severe motor and non-motor symptoms, as well as with more pronounced cognitive deficits. These associations remained significant even when "traditional" predictors of PD severity (age, disease duration, and levodopa equivalent daily dose) were considered. CONCLUSIONS The present findings indicate that the FI is associated with both motor and non-motor features of PD.
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Affiliation(s)
- Daniele Belvisi
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
- IRCCS Neuromed, via Atinense 18, 86077, Pozzilli, IS, Italy
| | - Marco Canevelli
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Matteo Costanzo
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Margherita Giangrosso
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Andrea Fabbrini
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Andrea Borraccino
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Giuseppe Bruno
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Alfredo Berardelli
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
- IRCCS Neuromed, via Atinense 18, 86077, Pozzilli, IS, Italy
| | - Giovanni Fabbrini
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
- IRCCS Neuromed, via Atinense 18, 86077, Pozzilli, IS, Italy.
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15
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Charisis S, Ntanasi E, Stamelou M, Xiromerisiou G, Maraki M, Veskoukis AS, Yannakoulia M, Kosmidis MH, Anastasiou CA, Giagkou N, Dardiotis E, Hadjigeorgiou G, Sakka P, Kouretas D, Stefanis L, Scarmeas N. Plasma Glutathione and Prodromal Parkinson's Disease Probability. Mov Disord 2021; 37:200-205. [PMID: 34695238 DOI: 10.1002/mds.28826] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/08/2021] [Accepted: 09/30/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND A decrease in glutathione (GSH) levels is considered one of the earliest biochemical changes in Parkinson's disease (PD). OBJECTIVE The authors explored the potential role of plasma GSH as a risk/susceptibility biomarker for prodromal PD (pPD) by examining its longitudinal associations with pPD probability trajectories. METHODS A total of 405 community-dwelling participants (median age [interquartile range] = 73.2 [7.41] years) without clinical features of parkinsonism were followed for a mean (standard deviation) of 3.0 (0.9) years. RESULTS A 1 μmol/L increase in plasma GSH was associated with 0.4% (95% confidence interval [CI], 0.1%-0.7%; P = 0.017) less increase in pPD probability for 1 year of follow-up. Compared with participants in the lowest GSH tertile, participants in the highest GSH tertile had a 12.9% (95% CI, 22.4%-2.2%; P = 0.020) slower rate of increase of pPD probability for 1 year of follow-up. CONCLUSION Plasma GSH was associated with pPD probability trajectories; therefore, it might assist in the identification of individuals who are likely to reach the threshold for pPD diagnosis more rapidly. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sokratis Charisis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Maria Stamelou
- Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece.,Department of Neurology, Philipps University, Marburg, Germany
| | | | - Maria Maraki
- Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.,Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece
| | | | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Nikolaos Giagkou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Demetrios Kouretas
- Department of Biochemistry-Biotechnology, University of Thessaly, Larisa, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, USA
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16
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Narasimhan M, Schwartz R, Halliday G. Parkinsonism and cerebrovascular disease. J Neurol Sci 2021; 433:120011. [PMID: 34686356 DOI: 10.1016/j.jns.2021.120011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/01/2021] [Accepted: 09/29/2021] [Indexed: 11/27/2022]
Abstract
The relationship between cerebrovascular disease and parkinsonism is commonly seen in everyday clinical practice but remains ill-defined and under-recognised with little guidance for the practising neurologist. We attempt to define this association and to illustrate key clinical, radiological and pathological features of the syndrome of Vascular Parkinsonism (VaP). VaP is a major cause of morbidity in the elderly associated with falls, hip fractures and cognitive impairment. Although acute parkinsonism is reported in the context of an acute cerebrovascular event, the vast majority of VaP presents as an insidious syndrome usually in the context of vascular risk factors and radiological evidence of small vessel disease. There may be an anatomic impact on basal ganglia neuronal networks, however the effect of small vessel disease (SVD) on these pathways is not clear. There are now established reporting standards for radiological features of SVD on MRI. White matter hyperintensities and lacunes have been thought to be the representative radiological features of SVD but other features such as the perivascular space are gaining more importance, especially in context of the glymphatic system. It is important to consider VaP in the differential diagnosis of Parkinson disease (PD) and in these situations, neuroimaging may offer diagnostic benefit especially in those patients with atypical presentations or refractoriness to levodopa. Proactive management of vascular risk factors, monitoring of bone density and an exercise program may offer easily attainable therapeutic targets in PD and VaP. Levodopa therapy should be considered in patients with VaP, however the dose and effect may be different from use in PD. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.
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Affiliation(s)
- Manisha Narasimhan
- Brain and Mind Centre and Faculty of Health and Medical Sciences, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia.
| | - Raymond Schwartz
- Brain and Mind Centre and Faculty of Health and Medical Sciences, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Glenda Halliday
- Brain and Mind Centre and Faculty of Health and Medical Sciences, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
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