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Yoo HS, Kim HK, Lee HS, Yoon SH, Na HK, Kang SW, Lee JH, Ryu YH, Lyoo CH. Predictors associated with the rate of progression of nigrostriatal degeneration in Parkinson's disease. J Neurol 2024:10.1007/s00415-024-12477-z. [PMID: 38839638 DOI: 10.1007/s00415-024-12477-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/20/2024] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Parkinson's disease (PD) manifests as a wide variety of clinical phenotypes and its progression varies greatly. However, the factors associated with different disease progression remain largely unknown. METHODS In this retrospective cohort study, we enrolled 113 patients who underwent 18F-FP-CIT PET scan twice. Given the negative exponential progression pattern of dopamine loss in PD, we applied the natural logarithm to the specific binding ratio (SBR) of two consecutive 18F-FP-CIT PET scans and conducted linear mixed model to calculate individual slope to define the progression rate of nigrostriatal degeneration. We investigated the clinical and dopamine transporter (DAT) availability patterns associated with the progression rate of dopamine depletion in each striatal sub-region. RESULTS More symmetric parkinsonism, the presence of dyslipidemia, lower K-MMSE total score, and lower anteroposterior gradient of the mean putaminal SBR were associated with faster progression rate of dopamine depletion in the caudate nucleus. More symmetric parkinsonism and lower anteroposterior gradient of the mean putaminal SBR were associated with faster depletion of dopamine in the anterior putamen. Older age at onset, more symmetric parkinsonism, the presence of dyslipidemia, and lower anteroposterior gradient of the mean putaminal SBR were associated with faster progression rate of dopamine depletion in the posterior putamen. Lower striatal mean SBR predicted the development of LID, while lower mean SBR in the caudate nuclei predicted the development of dementia. DISCUSSION Our results suggest that the evaluation of baseline clinical features and patterns of DAT availability can predict the progression of PD and its prognosis.
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Affiliation(s)
- Han Soo Yoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, 20 Eonjuro 63-gil, Gangnam-gu, Seoul, South Korea
| | - Han-Kyeol Kim
- Department of Neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - So Hoon Yoon
- Department of Neurology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea
| | - Han Kyu Na
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, 20 Eonjuro 63-gil, Gangnam-gu, Seoul, South Korea
| | - Sung Woo Kang
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, 20 Eonjuro 63-gil, Gangnam-gu, Seoul, South Korea
| | - Jae-Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 20 Eonjuro 63-gil, Gangnam-gu, Seoul, South Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 20 Eonjuro 63-gil, Gangnam-gu, Seoul, South Korea.
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, 20 Eonjuro 63-gil, Gangnam-gu, Seoul, South Korea.
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Hähnel T, Raschka T, Sapienza S, Klucken J, Glaab E, Corvol JC, Falkenburger BH, Fröhlich H. Progression subtypes in Parkinson's disease identified by a data-driven multi cohort analysis. NPJ Parkinsons Dis 2024; 10:95. [PMID: 38698004 PMCID: PMC11066039 DOI: 10.1038/s41531-024-00712-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/16/2024] [Indexed: 05/05/2024] Open
Abstract
The progression of Parkinson's disease (PD) is heterogeneous across patients, affecting counseling and inflating the number of patients needed to test potential neuroprotective treatments. Moreover, disease subtypes might require different therapies. This work uses a data-driven approach to investigate how observed heterogeneity in PD can be explained by the existence of distinct PD progression subtypes. To derive stable PD progression subtypes in an unbiased manner, we analyzed multimodal longitudinal data from three large PD cohorts and performed extensive cross-cohort validation. A latent time joint mixed-effects model (LTJMM) was used to align patients on a common disease timescale. Progression subtypes were identified by variational deep embedding with recurrence (VaDER). In each cohort, we identified a fast-progressing and a slow-progressing subtype, reflected by different patterns of motor and non-motor symptoms progression, survival rates, treatment response, features extracted from DaTSCAN imaging and digital gait assessments, education, and Alzheimer's disease pathology. Progression subtypes could be predicted with ROC-AUC up to 0.79 for individual patients when a one-year observation period was used for model training. Simulations demonstrated that enriching clinical trials with fast-progressing patients based on these predictions can reduce the required cohort size by 43%. Our results show that heterogeneity in PD can be explained by two distinct subtypes of PD progression that are stable across cohorts. These subtypes align with the brain-first vs. body-first concept, which potentially provides a biological explanation for subtype differences. Our predictive models will enable clinical trials with significantly lower sample sizes by enriching fast-progressing patients.
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Affiliation(s)
- Tom Hähnel
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany.
- Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
| | - Tamara Raschka
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, University of Bonn, Bonn, Germany
| | - Stefano Sapienza
- Biomedical Data Science, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Jochen Klucken
- Biomedical Data Science, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg
- Centre Hospitalier de Luxembourg (CHL), Strassen, Luxembourg
| | - Enrico Glaab
- Biomedical Data Science, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Jean-Christophe Corvol
- Sorbonne Université, Paris Brain Institute - ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Neurology, Paris, France
| | - Björn H Falkenburger
- Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Holger Fröhlich
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, University of Bonn, Bonn, Germany
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Xu J. Dopamine D3 Receptor in Parkinson Disease: A Prognosis Biomarker and an Intervention Target. Curr Top Behav Neurosci 2023; 60:89-107. [PMID: 35711029 PMCID: PMC10034716 DOI: 10.1007/7854_2022_373] [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] [Indexed: 01/05/2023]
Abstract
Parkinson disease (PD) dementia, pathologically featured as nigrostriatal dopamine (DA) neuronal loss with motor and non-motor manifestations, leads to substantial disability and economic burden. DA therapy targets the DA D3 receptor (D3R) with high affinity and selectivity. The pathological involvement of D3R is evidenced as an effective biomarker for disease progression and DA agnostic interventions, with compensations of increased DA, decreased aggregates of α-synuclein (α-Syn), enhanced secretion of brain-derived neurotrophic factors (BDNF), attenuation of neuroinflammation and oxidative damage, and promoting neurogenesis in the brain. D3R also interacts with D1R to reduce PD-associated motor symptoms and alleviate the side effects of levodopa (L-DOPA) treatment. We recently found that DA D2 receptor (D2R) density decreases in the late-stage PDs, while high D3R or DA D1 receptor (D1R) + D3R densities in the postmortem PD brains correlate with survival advantages. These new essential findings warrant renewed investigations into the understanding of D3R neuron populations and their cross-sectional and longitudinal regulations in PD progression.
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Affiliation(s)
- Jinbin Xu
- Division of Radiological Sciences, Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
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4
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Kim HK, Lee MJ, Yoo HS, Lee JH, Ryu YH, Lyoo CH. Temporal trajectory model for dopaminergic input to the striatal subregions in Parkinson's disease. Parkinsonism Relat Disord 2022; 103:42-49. [PMID: 36037782 DOI: 10.1016/j.parkreldis.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/21/2022] [Accepted: 08/07/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Almost half of the nigral neurons are already lost during the preclinical period of Parkinson's disease (PD), and then the speed of neuronal loss is slowly attenuated during the subsequent progression. We sought to establish long-term temporal trajectory models for the dopaminergic input to the striatal subregions and a 4D-temporal trajectory model for the dopamine transporter positron emission tomography (PET). METHODS We selected 83 patients in PD spectrum who underwent dopamine transporter PET scan twice and 71 age-matched healthy controls. We created temporal trajectories of specific binding ratios of the striatal subregions by integrating function between baseline values and their annual change rates and also created 4D-temporal trajectory model by applying the same method for each striatal voxel. Using the PET data of additional 100 PD patients, we estimated an individual time point in the 4D-temporal trajectory model for the validation. RESULTS Degenerative loss of striatal dopaminergic input first appeared in the posterior dorsal putamen in the more affected side at 14.4 years before the clinical onset, and subsequently in the posterior ventral and anterior putamen, and finally in the caudate. The time delay between the initiation of dopaminergic loss in the more and less affected posterior dorsal putamen was 6.1 years. The estimated individual time points within the entire disease course were correlated with the motor severity. CONCLUSION Our temporal trajectory model demonstrated a sequential loss of dopaminergic input in the striatal subregions in PD and may be beneficial for the evaluation of individual status of disease progression.
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Affiliation(s)
- Han-Kyeol Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Jun Lee
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Republic of Korea
| | - Han Soo Yoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Furukawa K, Shima A, Kambe D, Nishida A, Wada I, Sakamaki H, Yoshimura K, Terada Y, Sakato Y, Mitsuhashi M, Sawamura M, Nakanishi E, Taruno Y, Yamakado H, Fushimi Y, Okada T, Nakamoto Y, Takahashi R, Sawamoto N. Motor progression and nigrostriatal neurodegeneration in Parkinson’s disease. Ann Neurol 2022; 92:110-121. [DOI: 10.1002/ana.26373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Koji Furukawa
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Atsushi Shima
- Human Brain Research Center Kyoto University Graduate School of Medicine Kyoto Japan
| | - Daisuke Kambe
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Akira Nishida
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Ikko Wada
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Haruhi Sakamaki
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Kenji Yoshimura
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yuta Terada
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yusuke Sakato
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Masahiro Mitsuhashi
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Masanori Sawamura
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Etsuro Nakanishi
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yosuke Taruno
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Hodaka Yamakado
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine Kyoto University Graduate School of Medicine Kyoto Japan
| | - Tomohisa Okada
- Human Brain Research Center Kyoto University Graduate School of Medicine Kyoto Japan
- Department of Diagnostic Imaging and Nuclear Medicine Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine Kyoto University Graduate School of Medicine Kyoto Japan
| | - Ryosuke Takahashi
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Nobukatsu Sawamoto
- Department of Human Health Sciences Kyoto University Graduate School of Medicine Kyoto Japan
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Prange S, Metereau E, Maillet A, Klinger H, Schmitt E, Lhommée E, Bichon A, Lancelot S, Meoni S, Broussolle E, Castrioto A, Tremblay L, Krack P, Thobois S. Limbic Serotonergic Plasticity Contributes to the Compensation of Apathy in Early Parkinson's Disease. Mov Disord 2022; 37:1211-1221. [PMID: 35238430 DOI: 10.1002/mds.28971] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND De novo Parkinson's disease (PD) patients with apathy exhibit prominent limbic serotonergic dysfunction and microstructural disarray. Whether this distinctive lesion profile at diagnosis entails different prognosis remains unknown. OBJECTIVES To investigate the progression of dopaminergic and serotonergic dysfunction and their relation to motor and nonmotor impairment in PD patients with or without apathy at diagnosis. METHODS Thirteen de novo apathetic and 13 nonapathetic PD patients were recruited in a longitudinal double-tracer positron emission tomography cohort study. We quantified the progression of presynaptic dopaminergic and serotonergic pathology using [11 C]PE2I for dopamine transporter and [11 C]DASB for serotonin transporter at baseline and 3 to 5 years later, using linear mixed-effect models and mediation analysis to compare the longitudinal evolution between groups for clinical impairment and region-of-interest-based analysis. RESULTS After the initiation of dopamine replacement therapy, apathy, depression, and anxiety improved at follow-up in patients with apathy at diagnosis (n = 10) to the level of patients without apathy (n = 11). Patients had similar progression of motor impairment, whereas mild impulsive behaviors developed in both groups. Striato-pallidal and mesocorticolimbic presynaptic dopaminergic loss progressed similarly in both groups, as did serotonergic pathology in the putamen, caudate nucleus, and pallidum. Contrastingly, serotonergic innervation selectively increased in the ventral striatum and anterior cingulate cortex in apathetic patients, contributing to the reversal of apathy besides dopamine replacement therapy. CONCLUSION Patients suffering from apathy at diagnosis exhibit compensatory changes in limbic serotonergic innervation within 5 years of diagnosis, with promising evidence that serotonergic plasticity contributes to the reversal of apathy. The relationship between serotonergic plasticity and dopaminergic treatments warrants further longitudinal investigations. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Stéphane Prange
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France.,Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN Network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Elise Metereau
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France.,Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN Network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Audrey Maillet
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France
| | - Hélène Klinger
- Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN Network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Emmanuelle Schmitt
- Inserm, U1216, CHU Grenoble Alpes, Unité Troubles du Mouvement, Grenoble Institut Neurosciences, Univ. Grenoble Alpes, Grenoble, France
| | - Eugénie Lhommée
- Inserm, U1216, CHU Grenoble Alpes, Unité Troubles du Mouvement, Grenoble Institut Neurosciences, Univ. Grenoble Alpes, Grenoble, France
| | - Amélie Bichon
- Inserm, U1216, CHU Grenoble Alpes, Unité Troubles du Mouvement, Grenoble Institut Neurosciences, Univ. Grenoble Alpes, Grenoble, France
| | - Sophie Lancelot
- CNRS UMR5292, INSERM U1028, Univ. Lyon 1, Lyon Neuroscience Research Center, Université de Lyon, Lyon, France.,Hospices Civils de Lyon, Lyon, France.,CERMEP-Imaging Platform, Groupement Hospitalier Est, Bron, France
| | - Sara Meoni
- Inserm, U1216, CHU Grenoble Alpes, Unité Troubles du Mouvement, Grenoble Institut Neurosciences, Univ. Grenoble Alpes, Grenoble, France
| | - Emmanuel Broussolle
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France.,Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN Network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France.,Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon 1, Oullins, France
| | - Anna Castrioto
- Inserm, U1216, CHU Grenoble Alpes, Unité Troubles du Mouvement, Grenoble Institut Neurosciences, Univ. Grenoble Alpes, Grenoble, France
| | - Léon Tremblay
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France
| | - Paul Krack
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Stéphane Thobois
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France.,Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN Network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France.,Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon 1, Oullins, France
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7
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Motor and non-motor circuit disturbances in early Parkinson disease: which happens first? Nat Rev Neurosci 2022; 23:115-128. [PMID: 34907352 DOI: 10.1038/s41583-021-00542-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 12/15/2022]
Abstract
For the last two decades, pathogenic concepts in Parkinson disease (PD) have revolved around the toxicity and spread of α-synuclein. Thus, α-synuclein would follow caudo-rostral propagation from the periphery to the central nervous system, first producing non-motor manifestations (such as constipation, sleep disorders and hyposmia), and subsequently impinging upon the mesencephalon to account for the cardinal motor features before reaching the neocortex as the disease evolves towards dementia. This model is the prevailing theory of the principal neurobiological mechanism of disease. Here, we scrutinize the temporal evolution of motor and non-motor manifestations in PD and suggest that, even though the postulated bottom-up mechanisms are likely to be involved, early involvement of the nigrostriatal system is a key and prominent pathophysiological mechanism. Upcoming studies of detailed clinical manifestations with newer neuroimaging techniques will allow us to more closely define, in vivo, the role of α-synuclein aggregates with respect to neuronal loss during the onset and progression of PD.
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Roussakis AA, Zeng Z, Lao-Kaim NP, Martin-Bastida A, Piccini P. Parkinson's disease laterality: a 11C-PE2I PET imaging study. J Neurol 2021; 268:582-589. [PMID: 32880071 PMCID: PMC7880931 DOI: 10.1007/s00415-020-10204-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 11/27/2022]
Abstract
Asymmetry of striatal dopaminergic deficits and motor symptoms is a typical characteristic of idiopathic Parkinson's disease (PD). This study aims to characterise the trend of asymmetry in moderate-stage PD. We performed a 19-month longitudinal study in 27 patients with PET-CT imaging and appropriate clinical assessments. 11C-PE2I non-displaceable binding potential (BPND) was calculated bilaterally for the striatum at baseline and follow-up to estimate the in vivo density of striatal dopamine transporters (DAT). Changes in striatal 11C-PE2I BPND over time were more prominent in the ipsilateral as compared to contralateral side. Changes in MDS-UPDRS-III (motor component of the Movement Disorders Society Unified PD Rating Scale) were not different between the clinically most and least affected body sides. Our data support that the asymmetry in striatal dopaminergic degeneration becomes less prominent in moderate-stage PD. In contrast, during the above period, the asymmetry of motor symptoms was maintained between the clinically most and least affected body sides.
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Affiliation(s)
- Andreas-Antonios Roussakis
- Division of Neurology, Neurology Imaging Unit, Hammersmith Hospital, Imperial College London, Du Cane Road, London, W12 0NN, UK
| | - Zhou Zeng
- Division of Neurology, Neurology Imaging Unit, Hammersmith Hospital, Imperial College London, Du Cane Road, London, W12 0NN, UK
- Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Nicholas P Lao-Kaim
- Division of Neurology, Neurology Imaging Unit, Hammersmith Hospital, Imperial College London, Du Cane Road, London, W12 0NN, UK
| | - Antonio Martin-Bastida
- Division of Neurology, Neurology Imaging Unit, Hammersmith Hospital, Imperial College London, Du Cane Road, London, W12 0NN, UK
- Department of Neurology and Neurosciences, Clinica Universidad de Navarra, Pamplona, Madrid, Spain
| | - Paola Piccini
- Division of Neurology, Neurology Imaging Unit, Hammersmith Hospital, Imperial College London, Du Cane Road, London, W12 0NN, UK.
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Curcumin-Activated Mesenchymal Stem Cells Derived from Human Umbilical Cord and Their Effects on MPTP-Mouse Model of Parkinson's Disease: A New Biological Therapy for Parkinson's Disease. Stem Cells Int 2020; 2020:4636397. [PMID: 32148518 PMCID: PMC7048946 DOI: 10.1155/2020/4636397] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 01/23/2020] [Indexed: 02/07/2023] Open
Abstract
Background The aim of this study was to investigate the effects of human umbilical cord mesenchymal stem cell activated by curcumin (hUC-MSCs-CUR) on Parkinson's disease (PD). hUC-MSCs can differentiate into many types of adult tissue cells including dopaminergic (DA) neurons. CUR could protect DA neurons from apoptosis induced by 6-hydroxydopamine (6-OHDA). Therefore, we used the hUC-MSCs activated by CUR for the treatment of PD in an animal model. Methods The hUC-MSCs-CUR was transplanted into the MPTP-induced PD mouse models via the tail vein. We found that hUC-MSCs-CUR significantly improved the motor ability, increased the tyrosine hydroxylase (TH), dopamine (DA), and Bcl-2 levels, and reduced nitric oxide synthase, Bax, and cleaved caspase 3 expression in PD mice. The supernatant of hUC-MSCs-CUR (CM-CUR) was used to stimulate the SH-SY5Y cellular model of PD; cell proliferation, differentiation, TH, and neuronal-specific marker microtubular-associated protein 2 (MAP2) expressions were examined. Results Our data showed that CM-CUR significantly promoted cell proliferation and gradually increased TH and MAP2 expression in SH-SY5Y PD cells. The beneficial effects could be associated with significant increase of rough endoplasmic reticulum in the hUC-MSCs-CUR, which secretes many cytokines and growth factors beneficial for PD treatment. Conclusions Transplantation of hUC-MSCs-CUR could show promise for improving the motor recovery of PD.
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Yang P, Perlmutter JS, Benzinger TLS, Morris JC, Xu J. Dopamine D3 receptor: A neglected participant in Parkinson Disease pathogenesis and treatment? Ageing Res Rev 2020; 57:100994. [PMID: 31765822 PMCID: PMC6939386 DOI: 10.1016/j.arr.2019.100994] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/13/2019] [Accepted: 11/20/2019] [Indexed: 12/20/2022]
Abstract
Parkinson disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms which relentlessly and progressively lead to substantial disability and economic burden. Pathologically, these symptoms follow the loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc) associated with abnormal α-synuclein (α-Syn) deposition as cytoplasmic inclusions called Lewy bodies in pigmented brainstem nuclei, and in dystrophic neurons in striatal and cortical regions (Lewy neurites). Pharmacotherapy for PD focuses on improving quality of life and primarily targets dopaminergic pathways. Dopamine acts through two families of receptors, dopamine D1-like and dopamine D2-like; dopamine D3 receptors (D3R) belong to dopamine D2 receptor (D2R) family. Although D3R's precise role in the pathophysiology and treatment of PD has not been determined, we present evidence suggesting an important role for D3R in the early development and occurrence of PD. Agonist activation of D3R increases dopamine concentration, decreases α-Syn accumulation, enhances secretion of brain derived neurotrophic factors (BDNF), ameliorates neuroinflammation, alleviates oxidative stress, promotes neurogenesis in the nigrostriatal pathway, interacts with D1R to reduce PD associated motor symptoms and ameliorates side effects of levodopa (L-DOPA) treatment. Furthermore, D3R mutations can predict PD age of onset and prognosis of PD treatment. The role of D3R in PD merits further research. This review elucidates the potential role of D3R in PD pathogenesis and therapy.
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Affiliation(s)
- Pengfei Yang
- Department of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110, USA
| | - Joel S Perlmutter
- Department of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110, USA; Department of Neurology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110, USA; Department of Neuroscience, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110, USA; Department of Physical Therapy, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110, USA; Department of Occupational Therapy, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110, USA
| | - Jinbin Xu
- Department of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110, USA.
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Huang X, Lewis MM, Van Scoy LJ, De Jesus S, Eslinger PJ, Arnold AC, Miller AJ, Fernandez-Mendoza J, Snyder B, Harrington W, Kong L, Wang X, Sun D, Delnomdedieu M, Duvvuri S, Mahoney SE, Gray D, Mailman R. The D1/D5 Dopamine Partial Agonist PF-06412562 in Advanced-Stage Parkinson's Disease: A Feasibility Study. JOURNAL OF PARKINSON'S DISEASE 2020; 10:1515-1527. [PMID: 32986682 PMCID: PMC8640973 DOI: 10.3233/jpd-202188] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Current drug treatments have little efficacy in advanced-to-end-stage Parkinson's disease (advPD), yet there are no reports of interventional trials in advPD. D1 dopamine agonists have the potential to provide benefit. OBJECTIVE To determine the feasibility and safety of the selective D1/D5 dopamine partial agonist PF 06412562 in advPD. METHODS A two-week, randomized, double blind, crossover phase Ib study in advPD patients compared standard-of-care (SoC) carbidopa/levodopa with PF 06412562. Each week, there was a Day 1 baseline evaluation with overnight levodopa washout, then treatment on Days 2 and 3 with either SoC or PF-06412562 (split dose 25 + 20 mg), followed by discharge on Day 4. Primary endpoints were safety and tolerability. Secondary endpoints were global clinical impression of change (GCI-C) rated by clinicians and caregivers. RESULTS Eight advPD patients and their caregivers consented to participate and six were randomized (average disease duration: 22 y). None withdrew voluntarily. One participant with baseline Day 1 dehydration, pre-renal kidney injury, and autonomic dysfunction experienced symptomatic and serious hypotension after receiving PF-06412562 in Week 1 and was discontinued from the study. All other adverse events were rated mild (PF-06412562: n = 1, SoC: n = 0), moderate (PF-06412562: n = 1, SoC: n = 1), or severe but non-serious (PF-06412562: n = 3, SoC: n = 2). No clinically meaningful laboratory changes were observed. Among the five participants who completed the study, GCI-C favored PF-06412562 in two per clinicians' and four participants per caregivers' rating. CONCLUSION PF-06412562 was tolerated in advPD patients. This study provides the feasibility for future safety and efficacy studies in this population with unmet needs.
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Affiliation(s)
- Xuemei Huang
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Pharmacology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Kinesiology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Translational Brain Research Center, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Mechelle M. Lewis
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Pharmacology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Translational Brain Research Center, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Lauren Jodi Van Scoy
- Department of Medicine, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Humanities, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Psychiatry, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Sol De Jesus
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Translational Brain Research Center, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Paul J. Eslinger
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Medicine, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Neural and Behavioral Sciences, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Public Health Sciences, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Translational Brain Research Center, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Amy C. Arnold
- Department of Neural and Behavioral Sciences, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Amanda J. Miller
- Department of Neural and Behavioral Sciences, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Julio Fernandez-Mendoza
- Department of Neural and Behavioral Sciences, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Bethany Snyder
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - William Harrington
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Lan Kong
- Department of Public Health Sciences, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Xi Wang
- Department of Public Health Sciences, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | - Dongxiao Sun
- Department of Pharmacology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
| | | | | | | | - David Gray
- Cerevel Neurosciences LLC., Boston, MA, 02116 USA
| | - Richard Mailman
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Department of Pharmacology, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
- Translational Brain Research Center, Penn State Hershey Medical Center, Hershey, PA, USA Penn State College of Medicine, Hershey, PA 17033 USA
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12
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Perlmutter JS, Stoessl AJ. Striatal DAT SPECT: Caveat Emptor! Mov Disord 2019; 34:1430-1432. [PMID: 31769089 DOI: 10.1002/mds.27811] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/08/2019] [Accepted: 07/14/2019] [Indexed: 12/17/2022] Open
Affiliation(s)
- Joel S Perlmutter
- Departments of Neurology, Radiology, Neuroscience and Programs in Physical Therapy and Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - A Jon Stoessl
- Division of Neurology & Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
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13
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Bakshi S, Chelliah V, Chen C, van der Graaf PH. Mathematical Biology Models of Parkinson's Disease. CPT Pharmacometrics Syst Pharmacol 2019; 8:77-86. [PMID: 30358157 PMCID: PMC6389348 DOI: 10.1002/psp4.12362] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 09/19/2018] [Indexed: 12/27/2022] Open
Abstract
Parkinsons disease (PD) is a progressive neurodegenerative disease with substantial and growing socio-economic burden. In this multifactorial disease, aging, environmental, and genetic factors contribute to neurodegeneration and dopamine (DA) deficiency in the brain. Treatments aimed at DA restoration provide symptomatic relief, however, no disease modifying treatments are available, and PD remains incurable to date. Mathematical modeling can help understand such complex multifactorial neurological diseases. We review mathematical modeling efforts in PD with a focus on mechanistic models of pathogenic processes. We consider models of α-synuclein (Asyn) aggregation, feedbacks among Asyn, DA, and mitochondria and proteolytic systems, as well as pathology propagation through the brain. We hope that critical understanding of existing literature will pave the way to the development of quantitative systems pharmacology models to aid PD drug discovery and development.
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Affiliation(s)
- Suruchi Bakshi
- Certara QSPBredaThe Netherlands
- Systems Biomedicine and PharmacologyLeiden Academic Centre for Drug Research (LACDR)Leiden UniversityLeidenThe Netherlands
| | | | - Chao Chen
- Clinical Pharmacology Modelling & SimulationGlaxoSmithKlineUxbridgeUK
| | - Piet H. van der Graaf
- Systems Biomedicine and PharmacologyLeiden Academic Centre for Drug Research (LACDR)Leiden UniversityLeidenThe Netherlands
- Certara QSPCanterbury
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14
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Duarte Folle A, Paul KC, Bronstein JM, Keener AM, Ritz B. Clinical progression in Parkinson's disease with features of REM sleep behavior disorder: A population-based longitudinal study. Parkinsonism Relat Disord 2019; 62:105-111. [PMID: 30833231 DOI: 10.1016/j.parkreldis.2019.01.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Rapid Eye Movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment and is associated with incidence of neurodegenerative disorders, especially Parkinson's disease (PD). Whether PD with RBD constitutes a distinct subtype with unique progression is unknown. Here, we investigated motor and cognitive symptom progression in patients with self-reported RBD features in adult life. METHODS We screened for RBD in a cohort of 776 PD patients whom we ascertained using a population-based strategy. Among participants with at least one follow-up (60%), we compared those with and without probable RBD (pRBD) estimating hazard rate ratios for progression events UPDRS-III≥ 35 and MMSE≤ 24. RESULTS Prevalence of pRBD at baseline was 21%. In adjusted Cox regression models among patients with a Postural Instability and Gait Dysfunction (PIGD) phenotype, those with pRBD progressed faster to a UPDRS-III≥ 35 (HR = 1.92, 95% CI = 1.12; 3.27). Also, all patients with pRBD progressed twice as fast to a MMSE score≤ 24 (HR = 2.04, 95% CI = 1.13; 3.69). In sensitivity analyses, using alternative definition of pRBD and accounting for bias due to loss to follow-up results remained similar. DISCUSSION Employing data from one of the largest population-based studies of PD, in which movement disorder specialists assessed patients, we confirm evidence that pRBD features are a clinical marker for faster cognitive decline and possibly also motor progression in PD patients, the latter for patients with a PIGD subtype early in disease.
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Affiliation(s)
- Aline Duarte Folle
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Kimberly C Paul
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Jeff M Bronstein
- Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA; Department of Neurology, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Adrienne M Keener
- Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
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15
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Kuter KZ, Olech Ł, Dencher NA. Increased energetic demand supported by mitochondrial electron transfer chain and astrocyte assistance is essential to maintain the compensatory ability of the dopaminergic neurons in an animal model of early Parkinson's disease. Mitochondrion 2018; 47:227-237. [PMID: 30578987 DOI: 10.1016/j.mito.2018.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 10/03/2018] [Accepted: 12/11/2018] [Indexed: 01/03/2023]
Abstract
Partial degeneration of dopaminergic neurons in the substantia nigra (SN), induces locomotor disability in animals but with time it is spontaneously compensated for by neurons surviving in the tissue by increasing their functional efficiency. Such compensation probably increases energy requirements and astrocyte support could be essential for this ability. We studied the effect of degeneration of dopaminergic neurons induced by the selective toxin 6-hydroxydopamine and/or death of 30% of astrocytes induced by chronic infusion of the glial toxin fluorocitrate on functioning of the mitochondrial electron transfer chain (ETC) complexes (Cxs) I, II, IV and their higher assembled forms, supercomplexes in the rat SN. Astrocyte death decreased Cx I and IV performance, while significantly increased the amount of Cx II protein SDHA, indicating system adaptation. After death of 50% of dopaminergic neurons in the SN, we observed increased mitochondrial Cxs performing, especially Cx I and IV in the remaining cells. It corresponded with reduction of behavioural deficits. Those results support the hypothesis that the compensatory ability of surviving neurons requires meeting their higher energetic demand by ETC. When astrocytes were defective, the neurons remaining after partial lesion were not able to enhance their functioning anymore and compensate for deficits. It proves in vivo that astrocytic support is important for compensatory potential of neurons in the SN. Neuro-glia cooperation is fundamental for compensation for early deficits in the nigrostriatal system.
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Affiliation(s)
- Katarzyna Z Kuter
- Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland; Department of Chemistry, Physical Biochemistry, Technische Universität Darmstadt, Darmstadt, Germany.
| | - Łukasz Olech
- Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Norbert A Dencher
- Department of Chemistry, Physical Biochemistry, Technische Universität Darmstadt, Darmstadt, Germany; Research Center for Molecular Mechanisms of Ageing and Age-related Neurodegenerative Diseases, Moscow Institute of Physics and Technology MIPT, Dolgoprudny/Moscow, Russia
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16
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Prange S, Danaila T, Laurencin C, Caire C, Metereau E, Merle H, Broussolle E, Maucort-Boulch D, Thobois S. Age and time course of long-term motor and nonmotor complications in Parkinson disease. Neurology 2018; 92:e148-e160. [DOI: 10.1212/wnl.0000000000006737] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 09/11/2018] [Indexed: 01/12/2023] Open
Abstract
ObjectiveTo determine the time course of hazard for motor and nonmotor milestones of Parkinson disease (PD) in the long term and to investigate whether risk scales nonlinearly with time is instrumental in identifying changes in pathological processes and evaluating disease-modifying therapies in PD.MethodsOutpatients with PD at the Lyon University Movement Disorders Center were evaluated for 7 clinical milestones in this retrospective cohort study, encompassing 4 domains of PD progression: (1) motor (motor fluctuations, dyskinesias); (2) axial (postural instability and falls, freezing of gait); (3) neuropsychiatric (impulse control disorders, hallucinations); and (4) cognitive (dementia) complications. For each complication, we estimated the outcome-specific hazard using parsimonious smooth parametric Poisson regression models allowing for nonlinear scaling over disease duration, age at diagnosis, current age, and their interaction.ResultsA total of 1,232 patients with PD experienced 1,527 disease-related complications in up to 12 years of follow-up. Specific to each complication, hazard rates increased dramatically starting from diagnosis and were highest for motor fluctuations and lowest for dementia up to 6 years after diagnosis in patients aged 65 years at diagnosis. Nonlinear patterns indicated dramatic changes in the course of PD after 5 years and predicted more severe axial prognosis after 70 years and for motor fluctuations, dyskinesias, and impulse control disorders before 60 years at diagnosis.ConclusionTime course of motor and nonmotor milestones in PD is determined by disease duration and age at diagnosis in nonlinear patterns and their interaction. This indicates disease- and age-specific thresholds across the multiple neurodegenerative processes accumulating in PD at different paces.
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17
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Abstract
Positron emission tomography (PET) has revealed key insights into the pathophysiology of movement disorders. This paper will focus on how PET investigations of pathophysiology are particularly relevant to Parkinson disease, a neurodegenerative condition usually starting later in life marked by a varying combination of motor and nonmotor deficits. Various molecular imaging modalities help to determine what changes in brain herald the onset of pathology; can these changes be used to identify presymptomatic individuals who may be appropriate for to-be-developed treatments that may forestall onset of symptoms or slow disease progression; can PET act as a biomarker of disease progression; can molecular imaging help enrich homogenous cohorts for clinical studies; and what other pathophysiologic mechanisms relate to nonmotor manifestations. PET methods include measurements of regional cerebral glucose metabolism and blood flow, selected receptors, specific neurotransmitter systems, postsynaptic signal transducers, and abnormal protein deposition. We will review each of these methodologies and how they are relevant to important clinical issues pertaining to Parkinson disease.
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Affiliation(s)
- Baijayanta Maiti
- Department of Neurology, Washington University in St. Louis, St Louis, MO.
| | - Joel S Perlmutter
- Department of Neurology, Washington University in St. Louis, St Louis, MO; Department of Radiology, Washington University in St. Louis, St Louis, MO; Department of Neuroscience, Washington University in St. Louis, St Louis, MO; Department of Physical Therapy, Washington University in St. Louis, St Louis, MO; Department of Occupational Therapy, Washington University in St. Louis, St Louis, MO
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18
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Shimony JS, Rutlin J, Karimi M, Tian L, Snyder AZ, Loftin SK, Norris SA, Perlmutter JS. Validation of diffusion tensor imaging measures of nigrostriatal neurons in macaques. PLoS One 2018; 13:e0202201. [PMID: 30183721 PMCID: PMC6124722 DOI: 10.1371/journal.pone.0202201] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 07/30/2018] [Indexed: 11/19/2022] Open
Abstract
Objective Interpretation of diffusion MRI in the living brain requires validation against gold standard histological measures. We compared diffusion values of the nigrostriatal tract to PET and histological results in non-human primates (NHPs) with varying degrees of unilateral nigrostriatal injury induced by MPTP, a toxin selective for dopaminergic neurons. Methods Sixteen NHPs had MRI and PET scans of three different presynaptic radioligands and blinded video-based motor ratings before and after unilateral carotid artery infusion of variable doses of MPTP. Diffusion measures of connections between midbrain and striatum were calculated. Then animals were euthanized to quantify striatal dopamine concentration, stereologic measures of striatal tyrosine hydroxylase (TH) immunostained fiber density and unbiased stereologic counts of TH stained nigral cells. Results Diffusion measures correlated with MPTP dose, nigral TH-positive cell bodies and striatal TH-positive fiber density but did not correlate with in vitro nigrostriatal terminal field measures or in vivo PET measures of striatal uptake of presynaptic markers. Once nigral TH cell count loss exceeded 50% the stereologic terminal field measures reached a near zero floor effect but the diffusion measures continued to correlate with nigral cell counts. Conclusion Diffusion measures in the nigrostriatal tract correlate with nigral dopamine neurons and striatal fiber density, but have the same relationship to terminal field measures as a previous report of striatal PET measures of presynaptic neurons. These diffusion measures have the potential to act as non-invasive index of the severity of nigrostriatal injury. Diffusion imaging of the nigrostriatal tract could potentially have diagnostic value in humans with Parkinson disease or related disorders.
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Affiliation(s)
- Joshua S. Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Neuroscience, Washington University School of Medicine, St. Louis, Missouri, United States of America
- * E-mail:
| | - Jerrel Rutlin
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Morvarid Karimi
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Linlin Tian
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Abraham Z. Snyder
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Susan K. Loftin
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Scott A. Norris
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Joel S. Perlmutter
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Neuroscience, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, United States of America
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19
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Kaasinen V, Vahlberg T. Striatal dopamine in
P
arkinson disease: A meta‐analysis of imaging studies. Ann Neurol 2017; 82:873-882. [DOI: 10.1002/ana.25103] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/20/2017] [Accepted: 11/20/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Valtteri Kaasinen
- Division of Clinical NeurosciencesTurku University Hospital
- Department of NeurologyUniversity of Turku
- Turku PET Centre, University of Turku
| | - Tero Vahlberg
- Departments of Clinical Medicine
- BiostatisticsUniversity of TurkuTurku Finland
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20
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Kuter K, Olech Ł, Głowacka U. Prolonged Dysfunction of Astrocytes and Activation of Microglia Accelerate Degeneration of Dopaminergic Neurons in the Rat Substantia Nigra and Block Compensation of Early Motor Dysfunction Induced by 6-OHDA. Mol Neurobiol 2017; 55:3049-3066. [PMID: 28466266 PMCID: PMC5842510 DOI: 10.1007/s12035-017-0529-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/06/2017] [Indexed: 01/01/2023]
Abstract
Progressive degeneration of dopaminergic neurons in the substantia nigra (SN) is the underlying cause of Parkinson’s disease (PD). The disease in early stages is difficult to diagnose, because behavioral deficits are masked by compensatory processes. Astrocytic and microglial pathology precedes motor symptoms. Besides supportive functions of astrocytes in the brain, their role in PD is unrecognized. Prolonged dysfunction of astrocytes could increase the vulnerability of dopaminergic neurons and advance their degeneration during aging. The aim of our studies was to find out whether prolonged dysfunction of astrocytes in the SN is deleterious for neuronal functioning and if it influences their survival after toxic insult or changes the compensatory potential of the remaining neurons. In Wistar rat model, we induced activation, prolonged dysfunction, and death of astrocytes by chronic infusion of fluorocitrate (FC) into the SN, without causing dopaminergic neuron degeneration. Strongly enhanced dopamine turnover in the SN after 7 days of FC infusion was induced probably by microglia activated in response to astrocyte stress. The FC effect was reversible, and astrocyte pool was replenished 3 weeks after the end of infusion. Importantly, the prolonged astrocyte dysfunction and microglia activation accelerated degeneration of dopaminergic neurons induced by 6-hydroxydopamine and blocked the behavioral compensation normally observed after moderate neurodegeneration. Impaired astrocyte functioning, activation of microglia, diminishing compensatory capability of the dopaminergic system, and increasing neuronal vulnerability to external insults could be the underlying causes of PD. This animal model of prolonged astrocyte dysfunction can be useful for in vivo studies of glia–microglia–neuron interaction.
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Affiliation(s)
- Katarzyna Kuter
- Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna St., 31-343, Krakow, Poland.
| | - Łukasz Olech
- Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna St., 31-343, Krakow, Poland
| | - Urszula Głowacka
- Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna St., 31-343, Krakow, Poland
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Takeda A, Perlmutter JS. Striatal molecular imaging of presynaptic markers: Ready, fire, aim. Neurology 2017; 88:1388-1389. [PMID: 28283591 DOI: 10.1212/wnl.0000000000003827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Atsushi Takeda
- From the Department of Neurology (A.T.), National Hospital Organization, Sendai-Nishitaga Hospital, Sendai, Miyagi, Japan; and Departments of Neurology, Radiology, and Neuroscience and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO.
| | - Joel S Perlmutter
- From the Department of Neurology (A.T.), National Hospital Organization, Sendai-Nishitaga Hospital, Sendai, Miyagi, Japan; and Departments of Neurology, Radiology, and Neuroscience and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO.
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22
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Strafella AP, Bohnen NI, Perlmutter JS, Eidelberg D, Pavese N, Van Eimeren T, Piccini P, Politis M, Thobois S, Ceravolo R, Higuchi M, Kaasinen V, Masellis M, Peralta MC, Obeso I, Pineda-Pardo JÁ, Cilia R, Ballanger B, Niethammer M, Stoessl JA. Molecular imaging to track Parkinson's disease and atypical parkinsonisms: New imaging frontiers. Mov Disord 2017; 32:181-192. [DOI: 10.1002/mds.26907] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/21/2016] [Accepted: 11/27/2016] [Indexed: 12/23/2022] Open
Affiliation(s)
- Antonio P. Strafella
- Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Parkinson Disease Program, Neurology Div/Dept. Medicine, Toronto Western Hospital, UHN; Krembil Research Institute, UHN; Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH; University of Toronto; Ontario Canada
| | - Nicolaas I. Bohnen
- University of Michigan & Veterans Administration Medical Center; Ann Arbor Michigan USA
| | - Joel S. Perlmutter
- Neurology, Radiology, Neuroscience, Physical Therapy & Occupational Therapy; Washington University in St. Louis; St. Louis Missouri USA
| | - David Eidelberg
- Center for Neurosciences; The Feinstein Institute for Medical Research; Manhasset New York USA
| | - Nicola Pavese
- Newcastle Magnetic Resonance Centre & Positron Emission Tomography Centre; Newcastle University; Campus for Ageing & Vitality Newcastle upon Tyne United Kingdom
| | - Thilo Van Eimeren
- Multimodal Neuroimaging Group-Department of Nuclear Medicine Department of Neurology-University of Cologne; Institute of Neuroscience and Medicine, Jülich Research Center, German Center for Neurodegenerative Diseases (DZNE); Germany
| | - Paola Piccini
- Neurology Imaging Unit, Centre of Neuroinflammation and Neurodegeneration, Division of Brain Sciences, Hammersmith Campus; Imperial College London; United Kingdom
| | - Marios Politis
- Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry; Psychology and Neuroscience, King's College London; London United Kingdom
| | - Stephane Thobois
- Hospices Civils de Lyon, Hopital Neurologique Pierre Wertheimer; Université Lyon 1; CNRS, Centre de Neurosciences Cognitives; UMR 5229 Lyon France
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, Movement Disorders and Parkinson Center; University of Pisa; Italy
| | - Makoto Higuchi
- National Institute of Radiological Sciences; National Institutes for Quantum and Radiological Science and Technology; Chiba Japan
| | - Valtteri Kaasinen
- Division of Clinical Neurosciences, Turku University Hospital; Department of Neurology; University of Turku; Turku PET Centre, University of Turku; Turku Finland
| | - Mario Masellis
- Cognitive & Movement Disorders Clinic, Sunnybrook Health Sciences Centre; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute; University of Toronto; Toronto Ontario Canada
| | - M. Cecilia Peralta
- Movement Disorder and Parkinson's Disease Program; CEMIC University Hospital; Buenos Aires Argentina
| | - Ignacio Obeso
- Centro Integral de Neurociencias (CINAC), Hospitales Madrid Puerta del Sur & Centro de Investigación Biomédica en Red; Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
| | - Jose Ángel Pineda-Pardo
- Centro Integral de Neurociencias (CINAC), Hospitales Madrid Puerta del Sur & Centro de Investigación Biomédica en Red; Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
| | - Roberto Cilia
- Parkinson Institute; ASST Gaetano Pini-CTO; Milan Italy
| | - Benedicte Ballanger
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Neuroplasticity & Neuropathology of Olfactory Perception Team; University Lyon; France
| | - Martin Niethammer
- Center for Neurosciences; The Feinstein Institute for Medical Research; Manhasset New York USA
| | - Jon A. Stoessl
- Pacific Parkinson's Research Centre & National Parkinson Foundation Centre of Excellence; University of British Columbia & Vancouver Coastal Health; Vancouver British Columbia Canada
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Xiang Y, Gong T, Wu J, Li J, Chen Y, Wang Y, Li S, Cong L, Lin Y, Han Y, Yin L, Wang G, Du Y. Subtypes evaluation of motor dysfunction in Parkinson’s disease using neuromelanin-sensitive magnetic resonance imaging. Neurosci Lett 2017; 638:145-150. [DOI: 10.1016/j.neulet.2016.12.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 11/16/2016] [Accepted: 12/15/2016] [Indexed: 10/20/2022]
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Venuto CS, Potter NB, Dorsey ER, Kieburtz K. A review of disease progression models of Parkinson's disease and applications in clinical trials. Mov Disord 2016; 31:947-956. [PMID: 27226141 PMCID: PMC4931998 DOI: 10.1002/mds.26644] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/19/2016] [Accepted: 03/04/2016] [Indexed: 12/31/2022] Open
Abstract
Quantitative disease progression models for neurodegenerative disorders are gaining recognition as important tools for drug development and evaluation. In Parkinson's disease (PD), several models have described longitudinal changes in the Unified Parkinson's Disease Rating Scale (UPDRS), one of the most utilized outcome measures for PD trials assessing disease progression. We conducted a literature review to examine the methods and applications of quantitative disease progression modeling for PD using a combination of key words including "Parkinson disease," "progression," and "model." For this review, we focused on models of PD progression quantifying changes in the total UPDRS scores against time. Four different models reporting equations and parameters have been published using linear and nonlinear functions. The reasons for constructing disease progression models of PD thus far have been to quantify disease trajectories of PD patients in active and inactive treatment arms of clinical trials, to quantify and discern symptomatic and disease-modifying treatment effects, and to demonstrate how model-based methods may be used to design clinical trials. The historical lack of efficiency of PD clinical trials begs for model-based simulations in planning for studies that result in more informative conclusions, particularly around disease modification. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Charles S. Venuto
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, NY, USA
- Department of Neurology, University of Rochester, Rochester NY USA
| | - Nicholas B. Potter
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, NY, USA
| | - E. Ray Dorsey
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, NY, USA
- Department of Neurology, University of Rochester, Rochester NY USA
| | - Karl Kieburtz
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, NY, USA
- Department of Neurology, University of Rochester, Rochester NY USA
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Therapeutic Effects of CUR-Activated Human Umbilical Cord Mesenchymal Stem Cells on 1-Methyl-4-phenylpyridine-Induced Parkinson's Disease Cell Model. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9140541. [PMID: 27340670 PMCID: PMC4906196 DOI: 10.1155/2016/9140541] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/02/2016] [Accepted: 03/27/2016] [Indexed: 12/16/2022]
Abstract
The purpose of this study is to evaluate the therapeutic effects of human umbilical cord-derived mesenchymal stem cells (hUC-MSC) activated by curcumin (CUR) on PC12 cells induced by 1-methyl-4-phenylpyridinium ion (MPP+), a cell model of Parkinson's disease (PD). The supernatant of hUC-MSC and hUC-MSC activated by 5 µmol/L CUR (hUC-MSC-CUR) were collected in accordance with the same concentration. The cell proliferation and differentiation potential to dopaminergic neuronal cells and antioxidation were observed in PC12 cells after being treated with the above two supernatants and 5 µmol/L CUR. The results showed that the hUC-MSC-CUR could more obviously promote the proliferation and the expression of tyrosine hydroxylase (TH) and microtubule associated protein-2 (MAP2) and significantly decreased the expression of nitric oxide (NO) and inducible nitric oxide synthase (iNOS) in PC12 cells. Furtherly, cytokines detection gave a clue that the expression of IL-6, IL-10, and NGF was significantly higher in the group treated with the hUC-MSC-CUR compared to those of other two groups. Therefore, the hUC-MSC-CUR may be a potential strategy to promote the proliferation and differentiation of PD cell model, therefore providing new insights into a novel therapeutic approach in PD.
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The Effect of MSCs Derived from the Human Umbilical Cord Transduced by Fibroblast Growth Factor-20 on Parkinson's Disease. Stem Cells Int 2016; 2016:5016768. [PMID: 27274736 PMCID: PMC4871973 DOI: 10.1155/2016/5016768] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 02/05/2016] [Accepted: 02/16/2016] [Indexed: 12/16/2022] Open
Abstract
Cell therapy is a potential therapeutic approach for Parkinson's disease (PD). Mesenchymal stem cells derived from the human umbilical cord (hUC-MSCs) give priority to PD patients because of multiple advantages. The appropriate gene transduction of hUC-MSC before transplantation is a promising procedure for cell therapy. Fibroblast growth factor-20 (FGF-20) has been shown to protect dopaminergic neurons against a range of toxic insults in vitro. In this study, the hUC-MSCs were gene transduced with FGF-20, and then we transplanted them into the PD mice model. The results showed that MSC-FGF-20 treatment obviously improved the behavior of PD, accompanied by the increase of tyrosine carboxylase- (TH-) positive cell and dopamine (DA). Furtherly, immunohistochemistry disclosed that MSC-FGF-20 obviously promoted the degradation of nuclear factor-κB (NF-κB), a transcription factor that controls genes encoding proinflammatory cytokines, highly expressed in the nigrostriatal dopaminergic regions in PD patients. Therefore, MSC-FGF-20 has a potential for improving PD, closely related to the degradation of NF-κB.
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Change in Motor and Nonmotor Symptoms Severity in a "Real-Life" Cohort of Subjects with Parkinson's Disease. NEUROSCIENCE JOURNAL 2015; 2015:368989. [PMID: 26366406 PMCID: PMC4558456 DOI: 10.1155/2015/368989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 08/16/2015] [Indexed: 11/18/2022]
Abstract
Background. Parkinson's disease (PD) is a chronic and progressive disorder. Rates of change in motor symptoms have been more studied compared to nonmotor symptoms. The objective was to describe these changes in a real-life cohort of subjects with PD. Methods. A cohort study was carried out from 2011 to 2013. Consecutive patients with PD were recruited from a movement disorders clinic. MDS-UPDRS, PDQ-8, and NMSS were applied to all subjects at an initial evaluation and a subsequent visit (21 ± 3 months). Disease severity was categorized using a recent classification of MDS-UPDRS severity. Results. The MDS-UPDRS Part III showed a significant decrease of 7.2 ± 2.31 points (p = 0.001) between evaluations. A mean increase of 0.9 ± 0.6 points (p = 0.015) in the MDS-UPDRS Part IV was observed. An increase of 14.3 ± 11.4 points (p = 0.043) in the NMSS total score was found; when assessed individually, the difference was statistically significant only for the perceptual problems/hallucinations item. Quality of life remained unchanged. Conclusion. Motor improvement was observed accompanied by an increase in motor complications possibly as a result of treatment optimization. Nonmotor symptoms worsened as a whole. The overall effect in the quality of life was negligible.
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Castellanos G, Fernández-Seara MA, Lorenzo-Betancor O, Ortega-Cubero S, Puigvert M, Uranga J, Vidorreta M, Irigoyen J, Lorenzo E, Muñoz-Barrutia A, Ortiz-de-Solorzano C, Pastor P, Pastor MA. Automated neuromelanin imaging as a diagnostic biomarker for Parkinson's disease. Mov Disord 2015; 30:945-52. [PMID: 25772492 DOI: 10.1002/mds.26201] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 01/20/2015] [Accepted: 02/09/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We aimed to analyze the diagnostic accuracy of an automated segmentation and quantification method of the SNc and locus coeruleus (LC) volumes based on neuromelanin (NM)-sensitive MRI (NM-MRI) in patients with idiopathic (iPD) and monogenic (iPD) Parkinson's disease (PD). METHODS Thirty-six patients (23 idiopathic and 13 monogenic PARKIN or LRRK2 mutations) and 37 age-matched healthy controls underwent 3T-NM-MRI. SNc and LC volumetry were performed using fully automated multi-image atlas segmentation. The diagnostic performance to differentiate PD from controls was measured using the area under the curve (AUC) and likelihood ratios based on receiver operating characteristic (ROC) analyses. RESULTS We found a significant reduction of SNc and LC volumes in patients, when compared to controls. ROC analysis showed better diagnostic accuracy when using SNc volume than LC volume. Significant differences between ipsilateral and contralateral SNc volumes, in relation to the more clinically affected side, were found in patients with iPD (P = 0.007). Contralateral atrophy in the SNc showed the highest power to discriminate PD subjects from controls (AUC, 0.93-0.94; sensitivity, 91%-92%; specificity, 89%; positive likelihood ratio: 8.4-8.5; negative likelihood ratio: 0.09-0.1 at a single cut-off point). Interval likelihood ratios for contralateral SNc volume improved the diagnostic accuracy of volumetric measurements. CONCLUSION SNc and LC volumetry based on NM-MRI resulting from the automated segmentation and quantification technique can yield high diagnostic accuracy for differentiating PD from health and might be an unbiased disease biomarker. © 2015 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Gabriel Castellanos
- Neuroimaging Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - María A Fernández-Seara
- Neuroimaging Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Oswaldo Lorenzo-Betancor
- Neurogenetics Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Sara Ortega-Cubero
- Neurogenetics Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Marc Puigvert
- Pulmonary Department, Clínica Universidad de Navarra, University of Navarra School of Medicine, Pamplona, Spain
| | - Javier Uranga
- Cancer Imaging Laboratory, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain
| | - Marta Vidorreta
- Neuroimaging Laboratory, University of Navarra, Pamplona, Spain
| | - Jaione Irigoyen
- Neuroimaging Laboratory, University of Navarra, Pamplona, Spain.,Neurogenetics Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain.,Department of Neurology, Clínica Universidad de Navarra, University of Navarra School of Medicine, Pamplona, Spain
| | - Elena Lorenzo
- Neurogenetics Laboratory, University of Navarra, Pamplona, Spain
| | - Arrate Muñoz-Barrutia
- Cancer Imaging Laboratory, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain.,Bioengineering and Aerospace Engineering Department, University Carlos III of Madrid and Gregorio Marañon Health Research Institute, Madrid, Spain
| | - Carlos Ortiz-de-Solorzano
- Cancer Imaging Laboratory, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain
| | - Pau Pastor
- Neurogenetics Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain.,Department of Neurology, Clínica Universidad de Navarra, University of Navarra School of Medicine, Pamplona, Spain.,Department of Neurology, Hospital Universitari Mutua de Terrassa, University of Barcelona, Barcelona, Spain
| | - María A Pastor
- Neuroimaging Laboratory, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain.,Department of Neurology, Clínica Universidad de Navarra, University of Navarra School of Medicine, Pamplona, Spain
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Marinus J, van der Heeden JF, van Hilten JJ. Calculating clinical progression rates in Parkinson's disease: Methods matter. Parkinsonism Relat Disord 2014; 20:1263-7. [DOI: 10.1016/j.parkreldis.2014.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/28/2014] [Accepted: 08/12/2014] [Indexed: 11/16/2022]
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