1
|
Heß T, Themann P, Oehlwein C, Milani TL. Does Impaired Plantar Cutaneous Vibration Perception Contribute to Axial Motor Symptoms in Parkinson's Disease? Effects of Medication and Subthalamic Nucleus Deep Brain Stimulation. Brain Sci 2023; 13:1681. [PMID: 38137129 PMCID: PMC10742284 DOI: 10.3390/brainsci13121681] [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: 11/08/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE To investigate whether impaired plantar cutaneous vibration perception contributes to axial motor symptoms in Parkinson's disease (PD) and whether anti-parkinsonian medication and subthalamic nucleus deep brain stimulation (STN-DBS) show different effects. METHODS Three groups were evaluated: PD patients in the medication "on" state (PD-MED), PD patients in the medication "on" state and additionally "on" STN-DBS (PD-MED-DBS), as well as healthy subjects (HS) as reference. Motor performance was analyzed using a pressure distribution platform. Plantar cutaneous vibration perception thresholds (VPT) were investigated using a customized vibration exciter at 30 Hz. RESULTS Motor performance of PD-MED and PD-MED-DBS was characterized by greater postural sway, smaller limits of stability ranges, and slower gait due to shorter strides, fewer steps per minute, and broader stride widths compared to HS. Comparing patient groups, PD-MED-DBS showed better overall motor performance than PD-MED, particularly for the functional limits of stability and gait. VPTs were significantly higher for PD-MED compared to those of HS, which suggests impaired plantar cutaneous vibration perception in PD. However, PD-MED-DBS showed less impaired cutaneous vibration perception than PD-MED. CONCLUSIONS PD patients suffer from poor motor performance compared to healthy subjects. Anti-parkinsonian medication in tandem with STN-DBS seems to be superior for normalizing axial motor symptoms compared to medication alone. Plantar cutaneous vibration perception is impaired in PD patients, whereas anti-parkinsonian medication together with STN-DBS is superior for normalizing tactile cutaneous perception compared to medication alone. Consequently, based on our results and the findings of the literature, impaired plantar cutaneous vibration perception might contribute to axial motor symptoms in PD.
Collapse
Affiliation(s)
- Tobias Heß
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Peter Themann
- Department of Neurology and Parkinson, Clinic at Tharandter Forest, 09633 Halsbruecke, Germany
| | - Christian Oehlwein
- Neurological Outpatient Clinic for Parkinson Disease and Deep Brain Stimulation, 07551 Gera, Germany
| | - Thomas L. Milani
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| |
Collapse
|
2
|
Ozoran H, Srinivasan R. Astrocytes and Alpha-Synuclein: Friend or Foe? JOURNAL OF PARKINSON'S DISEASE 2023; 13:1289-1301. [PMID: 38007674 PMCID: PMC10741342 DOI: 10.3233/jpd-230284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/21/2023] [Indexed: 11/27/2023]
Abstract
Despite its devastating disease burden and alarming prevalence, the etiology of Parkinson's disease (PD) remains to be completely elucidated. PD is characterized by the degeneration of dopaminergic neurons in the substantia nigra pars compacta and this correlates with the accumulation of misfolded α-synuclein. While the aggregation of α-synuclein in the form of Lewy bodies or Lewy neurites is a well-established intraneuronal hallmark of the disease process, our understanding of the glial contribution to aberrant α-synuclein proteostasis is lacking. In this regard, restoring astrocyte function during early PD could offer a promising therapeutic avenue and understanding the involvement of astrocytes in handling/mishandling of α-synuclein is of particular interest. Here, we explore the growing body of scientific literature implicating aberrant astrocytic α-synuclein proteostasis with the seemingly inexorable pathological sequelae typifying PD. We also provide a perspective on how heterogeneity in the morphological relationship between astrocytes and neurons will need to be considered in the context of PD pathogenesis.
Collapse
Affiliation(s)
- Hakan Ozoran
- Clinical Medical School, University of Oxford, Oxford, UK
- Green Templeton College, University of Oxford, Oxford, UK
| | - Rahul Srinivasan
- Department of Neuroscience & Experimental Therapeutics, Texas A&M University School of Medicine, Bryan, TX, USA
- Texas A&M Institute for Neuroscience (TAMIN), College Station, TX, USA
| |
Collapse
|
3
|
Jellinger KA. Neuropathology and pathogenesis of extrapyramidal movement disorders: a critical update-I. Hypokinetic-rigid movement disorders. J Neural Transm (Vienna) 2019; 126:933-995. [PMID: 31214855 DOI: 10.1007/s00702-019-02028-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/05/2019] [Indexed: 02/06/2023]
Abstract
Extrapyramidal movement disorders include hypokinetic rigid and hyperkinetic or mixed forms, most of them originating from dysfunction of the basal ganglia (BG) and their information circuits. The functional anatomy of the BG, the cortico-BG-thalamocortical, and BG-cerebellar circuit connections are briefly reviewed. Pathophysiologic classification of extrapyramidal movement disorder mechanisms distinguish (1) parkinsonian syndromes, (2) chorea and related syndromes, (3) dystonias, (4) myoclonic syndromes, (5) ballism, (6) tics, and (7) tremor syndromes. Recent genetic and molecular-biologic classifications distinguish (1) synucleinopathies (Parkinson's disease, dementia with Lewy bodies, Parkinson's disease-dementia, and multiple system atrophy); (2) tauopathies (progressive supranuclear palsy, corticobasal degeneration, FTLD-17; Guamian Parkinson-dementia; Pick's disease, and others); (3) polyglutamine disorders (Huntington's disease and related disorders); (4) pantothenate kinase-associated neurodegeneration; (5) Wilson's disease; and (6) other hereditary neurodegenerations without hitherto detected genetic or specific markers. The diversity of phenotypes is related to the deposition of pathologic proteins in distinct cell populations, causing neurodegeneration due to genetic and environmental factors, but there is frequent overlap between various disorders. Their etiopathogenesis is still poorly understood, but is suggested to result from an interaction between genetic and environmental factors. Multiple etiologies and noxious factors (protein mishandling, mitochondrial dysfunction, oxidative stress, excitotoxicity, energy failure, and chronic neuroinflammation) are more likely than a single factor. Current clinical consensus criteria have increased the diagnostic accuracy of most neurodegenerative movement disorders, but for their definite diagnosis, histopathological confirmation is required. We present a timely overview of the neuropathology and pathogenesis of the major extrapyramidal movement disorders in two parts, the first one dedicated to hypokinetic-rigid forms and the second to hyperkinetic disorders.
Collapse
Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
| |
Collapse
|
4
|
Ding H, Xiong Y, Sun J, Chen C, Gao J, Xu H. Asiatic Acid Prevents Oxidative Stress and Apoptosis by Inhibiting the Translocation of α-Synuclein Into Mitochondria. Front Neurosci 2018; 12:431. [PMID: 30002614 PMCID: PMC6031891 DOI: 10.3389/fnins.2018.00431] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/07/2018] [Indexed: 01/08/2023] Open
Abstract
The association of α-synuclein (α-syn) with mitochondria occurs through interaction with mitochondrial complex I. Defects in this protein have been linked to the pathogenesis of Parkinson disease (PD). Overexpression of α-synuclein in cells has been suggested to cause elevations in mitochondrial oxidant radicals and structural and functional abnormalities in mitochondria. Asiatic acid (AA), a triterpenoid, is an antioxidant that is used for depression, and we have shown that pretreatment with AA can prevent PD-like damage, but its therapeutic effects in PD and mechanism remain unknown. In this study, we found that 0.5–2 mg AA/100 g diet significantly improves climbing ability in drosophila and extends their life-span—effects that we attributed to its antioxidant properties. AA also protected mitochondria against oxidative stress and apoptosis in a rotenone-induced cellular model. In an isolated mitochondria model, AA attenuated the decline in mitochondrial membrane potential that was induced by α-syn. Consequently, AA maintained membrane integrity and ATP production. Finally, we demonstrated that AA protects by blocking the translocation of α-syn into mitochondria. Our results suggest that mitochondria are crucial in PD and that AA is an excellent candidate for the prevention and therapy of this disease.
Collapse
Affiliation(s)
- Hongqun Ding
- Department of Clinical Laboratory Diagnostics, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Yuyun Xiong
- Department of Clinical Laboratory, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Jing Sun
- Department of Medicinal Pharmacy, School of Pharmacy, Jiangsu University, Zhenjiang, China
| | - Chen Chen
- Department of Medicinal Pharmacy, School of Pharmacy, Jiangsu University, Zhenjiang, China
| | - Jing Gao
- Department of Medicinal Pharmacy, School of Pharmacy, Jiangsu University, Zhenjiang, China
| | - Huaxi Xu
- Department of Clinical Laboratory Diagnostics, School of Medicine, Jiangsu University, Zhenjiang, China
| |
Collapse
|
5
|
Jellinger KA. Neuropathobiology of non-motor symptoms in Parkinson disease. J Neural Transm (Vienna) 2015; 122:1429-40. [PMID: 25976432 DOI: 10.1007/s00702-015-1405-5] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/30/2015] [Indexed: 01/23/2023]
Abstract
Parkinson disease (PD) is a multisystem disorder associated with α-synuclein aggregates throughout the central, autonomic, and peripheral nervous system, clinically characterized by motor and non-motor (NM) symptoms. The NMS in PD, many of which antedating motor dysfunction and representing a preclinical phase spanning 20 or more years, are linked to widespread distribution of α-synuclein pathology not restricted to the dopaminergic nigrostriatal system that is responsible for core motor features of PD. The pathologic substrate of NM manifestations such as olfactory, autonomic (gastrointestinal, urogenital, cardia, respiratory), sensory, skin, sleep, visual, neuropsychiatric dysfunctions (cognitive, mood, dementia), and others are critically reviewed. In addition to non-nigral brainstem nuclei, α-synuclein pathology involves sympathetic and parasympathetic, enteric, cardiac and pelvic plexuses, and many other organs indicating a topographical and chronological spread, particularly in the prodromal stages of the disease. Few animal models recapitulate NMS in PD. The relationship between regional α-synuclein/Lewy pathology, neurodegeneration and the corresponding clinical deficits awaits further elucidation. Controlled clinicopathologic studies will refine the correlations between presymptomatic and late-developing NM features of PD and neuropathology, and new premotor biomarkers will facilitate early diagnosis of PD as a basis for more effective preventive and therapeutic options of this devastating disease.
Collapse
Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Kenyongasse 18, 1070, Vienna, Austria.
| |
Collapse
|
6
|
Krismer F, Jellinger KA, Scholz SW, Seppi K, Stefanova N, Antonini A, Poewe W, Wenning GK. Multiple system atrophy as emerging template for accelerated drug discovery in α-synucleinopathies. Parkinsonism Relat Disord 2014; 20:793-9. [PMID: 24894118 PMCID: PMC4141743 DOI: 10.1016/j.parkreldis.2014.05.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 04/27/2014] [Accepted: 05/07/2014] [Indexed: 12/21/2022]
Abstract
There is evidence that the α-synucleinopathies Parkinson's disease (PD) and the Parkinson variant of multiple system atrophy (MSA-P) overlap at multiple levels. Both disorders are characterized by deposition of abnormally phosphorylated fibrillar α-synuclein within the central nervous system suggesting shared pathophysiological mechanisms. Despite the considerable clinical overlap in the early disease stages, MSA-P, in contrast to PD, is fatal and rapidly progressive. Moreover recent clinical studies have shown that surrogate markers of disease progression can be quantified easily and may reliably depict the rapid course of MSA. We therefore posit that, MSA-P may be exploited as a filter barrier in the development of disease-modifying therapeutic strategies targeting common pathophysiological mechanisms of α-synucleinopathies. This approach might reduce the number of negative phase III clinical trials, and, in turn, shift the available resources to earlier development stages, thereby increasing the number of candidate compounds validated. α-synucleinopathies overlap at multiple levels. α-synucleinopathies are characterized by an abnormal deposition of α-synuclein. Validated surrogate markers in MSA reliably monitor disease progression. MSA may serve as a template disease for other α-synucleinopathies.
Collapse
Affiliation(s)
- Florian Krismer
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
| | | | - Sonja W Scholz
- Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD 21287, USA.
| | - Klaus Seppi
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
| | - Nadia Stefanova
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
| | - Angelo Antonini
- Department of Parkinson's Disease and Movement Disorders, IRCCS San Camillo, Venice, Italy.
| | - Werner Poewe
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
| | - Gregor K Wenning
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
| |
Collapse
|
7
|
Kuzdas-Wood D, Stefanova N, Jellinger KA, Seppi K, Schlossmacher MG, Poewe W, Wenning GK. Towards translational therapies for multiple system atrophy. Prog Neurobiol 2014; 118:19-35. [PMID: 24598411 PMCID: PMC4068324 DOI: 10.1016/j.pneurobio.2014.02.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 02/07/2014] [Accepted: 02/21/2014] [Indexed: 12/28/2022]
Abstract
Multiple system atrophy (MSA) is a fatal adult-onset neurodegenerative disorder of uncertain etiopathogenesis manifesting with autonomic failure, parkinsonism, and ataxia in any combination. The underlying neuropathology affects central autonomic, striatonigral and olivopontocerebellar pathways and it is associated with distinctive glial cytoplasmic inclusions (GCIs, Papp-Lantos bodies) that contain aggregates of α-synuclein. Current treatment options are very limited and mainly focused on symptomatic relief, whereas disease modifying options are lacking. Despite extensive testing, no neuroprotective drug treatment has been identified up to now; however, a neurorestorative approach utilizing autologous mesenchymal stem cells has shown remarkable beneficial effects in the cerebellar variant of MSA. Here, we review the progress made over the last decade in defining pathogenic targets in MSA and summarize insights gained from candidate disease-modifying interventions that have utilized a variety of well-established preclinical MSA models. We also discuss the current limitations that our field faces and suggest solutions for possible approaches in cause-directed therapies of MSA.
Collapse
Affiliation(s)
- Daniela Kuzdas-Wood
- Department of Neurology, Innsbruck Medical University, Anichstraße 35, Innsbruck 6020, Austria
| | - Nadia Stefanova
- Department of Neurology, Innsbruck Medical University, Anichstraße 35, Innsbruck 6020, Austria
| | | | - Klaus Seppi
- Department of Neurology, Innsbruck Medical University, Anichstraße 35, Innsbruck 6020, Austria
| | - Michael G Schlossmacher
- Divisions of Neuroscience and Neurology, The Ottawa Hospital Research Institute, University of Ottawa, 451 Smyth Road, RGH #1412, Ottawa, ON, K1H 8M5, Canada
| | - Werner Poewe
- Department of Neurology, Innsbruck Medical University, Anichstraße 35, Innsbruck 6020, Austria
| | - Gregor K Wenning
- Department of Neurology, Innsbruck Medical University, Anichstraße 35, Innsbruck 6020, Austria.
| |
Collapse
|
8
|
|
9
|
Müller SK, Bender A, Laub C, Högen T, Schlaudraff F, Liss B, Klopstock T, Elstner M. Lewy body pathology is associated with mitochondrial DNA damage in Parkinson's disease. Neurobiol Aging 2013; 34:2231-3. [DOI: 10.1016/j.neurobiolaging.2013.03.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 02/24/2013] [Accepted: 03/11/2013] [Indexed: 12/24/2022]
|
10
|
Dunning CJR, George S, Brundin P. What's to like about the prion-like hypothesis for the spreading of aggregated α-synuclein in Parkinson disease? Prion 2013; 7:92-7. [PMID: 23360753 PMCID: PMC3609056 DOI: 10.4161/pri.23806] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
α-Synuclein is a key protein in Parkinson disease. Not only is it the major protein component of Lewy bodies, but it is implicated in several cellular processes that are disrupted in Parkinson disease. Misfolded α-synuclein has also been shown to spread from cell-to-cell and, in a prion-like fashion, trigger aggregation of α-synuclein in the recipient cell. In this mini-review we explore the evidence that misfolded α-synuclein underlies the spread of pathology in Parkinson disease and discuss why it should be considered a prion-like protein.
Collapse
|
11
|
Jellinger KA. Neurobiology of cognitive impairment in Parkinson’s disease. Expert Rev Neurother 2012; 12:1451-1466. [DOI: 10.1586/ern.12.131] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
|
12
|
Jellinger KA. Potential role of α-synuclein in neurodegeneration: studies in a rat animal model. J Neurochem 2012; 122:659-60. [PMID: 22671859 DOI: 10.1111/j.1471-4159.2012.07821.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|