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Santos-Lobato BL, Schumacher-Schuh A, Mata IF, Letro GH, Braga-Neto P, Brandão PRP, Godeiro-Junior CO, Coletta MVD, Camargos ST, Borges V, Rieder CRM, Tumas V. Genetics of Parkinson's disease in Brazil: a systematic review of monogenic forms. Arq Neuropsiquiatr 2021; 79:612-623. [PMID: 34468500 DOI: 10.1590/0004-282x-anp-2020-0409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/17/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Increasing numbers of mutations causing monogenic forms of Parkinson's disease (PD) have been described, mostly among patients in Europe and North America. Since genetic architecture varies between different populations, studying the specific genetic profile of Brazilian patients is essential for improving genetic counseling and for selecting patients for clinical trials. OBJECTIVE We conducted a systematic review to identify genetic studies on Brazilian patients and to set a background for future studies on monogenic forms of PD in Brazil. METHODS We searched MEDLINE, EMBASE and Web of Science from inception to December 2019 using terms for "Parkinson's disease", "genetics" and "Brazil". Two independent reviewers extracted the data. For the genes LRRK2 and PRKN, the estimated prevalence was calculated for each study, and a meta-analysis was performed. RESULTS A total of 32 studies were included, comprising 94 Brazilian patients with PD with a causative mutation, identified from among 2,872 screened patients (3.2%). PRKN mutations were causative of PD in 48 patients out of 576 (8.3%). LRRK2 mutations were identified in 40 out of 1,556 patients (2.5%), and p.G2019S was the most common mutation (2.2%). CONCLUSIONS PRKN is the most common autosomal recessive cause of PD, and LRRK2 is the most common autosomal dominant form. We observed that there was a lack of robust epidemiological studies on PD genetics in Brazil and, especially, that the diversity of Brazil's population had not been considered.
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Affiliation(s)
- Bruno L Santos-Lobato
- Universidade Federal do Pará, Laboratório de Neuropatologia Experimental, Belém PA, Brazil.,Hospital Ophir Loyola, Serviço de Neurologia, Belém PA, Brazil
| | - Artur Schumacher-Schuh
- Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Porto Alegre RS, Brazil.,Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Porto Alegre RS, Brazil
| | - Ignacio F Mata
- Lerner Research Institute, Genomic Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Grace H Letro
- Pontifícia Universidade Católica de Campinas, Centro de Ciências da Vida, Campinas SP, Brazil
| | - Pedro Braga-Neto
- Universidade Federal do Ceará, Departamento de Medicina Clínica, Serviço de Neurologia e Neurocirurgia, Fortaleza CE, Brazil
| | - Pedro R P Brandão
- Universidade de Brasília, Laboratório de Neurociências e Comportamento, Brasília DF, Brazil
| | - Clécio O Godeiro-Junior
- Universidade Federal do Rio Grande do Norte, Departamento de Medicina Integrada, Natal RN, Brazil
| | | | - Sarah T Camargos
- Universidade Federal de Minas Gerais, Departamento de Medicina Interna, Belo Horizonte MG, Brazil
| | - Vanderci Borges
- Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Setor de Transtornos de Movimento, São Paulo SP, Brazil
| | - Carlos R M Rieder
- Universidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Neurologia, Porto Alegre RS, Brazil
| | - Vitor Tumas
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil
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Godeiro C, França C, Carra RB, Saba F, Saba R, Maia D, Brandão P, Allam N, Rieder CRM, Freitas FC, Capato T, Spitz M, Faria DDD, Cordellini M, Veiga BAAG, Rocha MSG, Maciel R, Melo LBD, Möller PDS, R R Júnior M, Fornari LHT, Mantese CE, Barbosa ER, Munhoz RP, Coletta MVD, Cury RG. Use of non-invasive stimulation in movement disorders: a critical review. Arq Neuropsiquiatr 2021; 79:630-646. [PMID: 34468499 DOI: 10.1590/0004-282x-anp-2020-0381] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/21/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Noninvasive stimulation has been widely used in the past 30 years to study and treat a large number of neurological diseases, including movement disorders. OBJECTIVE In this critical review, we illustrate the rationale for use of these techniques in movement disorders and summarize the best medical evidence based on the main clinical trials performed to date. METHODS A nationally representative group of experts performed a comprehensive review of the literature in order to analyze the key clinical decision-making factors driving transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in movement disorders. Classes of evidence and recommendations were described for each disease. RESULTS Despite unavoidable heterogeneities and low effect size, TMS is likely to be effective for treating motor symptoms and depression in Parkinson's disease (PD). The efficacy in other movement disorders is unclear. TMS is possibly effective for focal hand dystonia, essential tremor and cerebellar ataxia. Additionally, it is likely to be ineffective in reducing tics in Tourette syndrome. Lastly, tDCS is likely to be effective in improving gait in PD. CONCLUSIONS There is encouraging evidence for the use of noninvasive stimulation on a subset of symptoms in selected movement disorders, although the means to optimize protocols for improving positive outcomes in routine clinical practice remain undetermined. Similarly, the best stimulation paradigms and responder profile need to be investigated in large clinical trials with established therapeutic and assessment paradigms that could also allow genuine long-term benefits to be determined.
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Affiliation(s)
- Clecio Godeiro
- Universidade Federal do Rio Grande do Norte, Departamento de Medicina Integrada, Natal RN, Brazil
| | - Carina França
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Centro de Distúrbios do Movimento, São Paulo SP, Brazil
| | - Rafael Bernhart Carra
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Centro de Distúrbios do Movimento, São Paulo SP, Brazil
| | - Felipe Saba
- Universidade Estadual de Campinas, São Paulo SP, Brazil
| | - Roberta Saba
- Hospital do Servidor Público Estadual, São Paulo SP, Brazil.,Universidade Federal de São Paulo, São Paulo SP, Brazil
| | - Débora Maia
- Universidade Federal de Minas Gerais, Departamento de Medicina Interna, Unidade de Distúrbios do Movimento, Belo Horizonte MG, Brazil
| | - Pedro Brandão
- Universidade de Brasília, Laboratório de Neurociências e Comportamento, Brasília DF, Brazil
| | - Nasser Allam
- Universidade de Brasília, Laboratório de Neurociências e Comportamento, Brasília DF, Brazil
| | - Carlos R M Rieder
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre RS, Brazil
| | | | - Tamine Capato
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Centro de Distúrbios do Movimento, São Paulo SP, Brazil.,Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Nijmegen, Netherlands
| | - Mariana Spitz
- Universidade do Estado do Rio de Janeiro, Unidade de Distúrbios do Movimento, Rio de Janeiro RJ, Brazil
| | - Danilo Donizete de Faria
- Hospital do Servidor Público Estadual, São Paulo SP, Brazil.,Universidade Federal de São Paulo, São Paulo SP, Brazil
| | | | | | - Maria Sheila G Rocha
- Hospital Santa Marcelina, Departamento de Neurologia e Neurocirurgia Funcional, São Paulo SP, Brazil
| | - Ricardo Maciel
- Universidade Federal de Minas Gerais, Departamento de Medicina Interna, Unidade de Distúrbios do Movimento, Belo Horizonte MG, Brazil
| | - Lucio B De Melo
- Universidade Estadual de Londrina, Serviço de Neurologia, Londrina PR, Brazil
| | - Patricia D S Möller
- Hospital da Criança de Brasília José Alencar, Unidade Pediátrica de Distúrbios do Movimento, Brasília DF, Brazil
| | - Magno R R Júnior
- Universidade Federal do Maranhão, Hospital Universitário, São Luís MA, Brazil
| | - Luís H T Fornari
- Santa Casa de Misericórdia de Porto Alegre, Departamento de Neurologia, Porto Alegre RS, Brazil
| | - Carlos E Mantese
- Hospital Mãe de Deus, Serviço de Neurologia, Porto Alegre RS, Brazil
| | - Egberto Reis Barbosa
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Centro de Distúrbios do Movimento, São Paulo SP, Brazil
| | - Renato P Munhoz
- University of Toronto, Toronto Western Hospital - UHN, Division of Neurology, Morton and Gloria Shulman Movement Disorders Centre and Edmond J. Safra Program in Parkinson's Disease, Toronto ON, Canada.,Krembil Brain Institute, Toronto ON, Canada
| | | | - Rubens Gisbert Cury
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Centro de Distúrbios do Movimento, São Paulo SP, Brazil
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Araujo TG, Schmidt AP, Sanches PRS, Silva Junior DP, Rieder CRM, Ramos JGL. Transcutaneous tibial nerve home stimulation for overactive bladder in women with Parkinson's disease: A randomized clinical trial. Neurourol Urodyn 2020; 40:538-548. [PMID: 33326648 DOI: 10.1002/nau.24595] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/13/2020] [Accepted: 11/28/2020] [Indexed: 01/13/2023]
Abstract
AIMS This study aims to investigate the efficacy of transcutaneous tibial nerve home stimulation for overactive bladder (OAB) in women with Parkinson's disease (PD). METHODS The current study is a prospective, randomized, double-blind, sham-controlled trial. Home intervention was carried out and assessments were conducted at a tertiary hospital in South Brazil. Women with PD and OAB symptoms were included in the study. Patients were randomly divided into two groups: (1) stimulation and (2) sham. Both groups underwent intervention at home for 12 weeks. Patients were evaluated at baseline and at 12 weeks (end of intervention), 30- and 90-day follow-up. The primary outcome was the mean reduction in the number of urgency incontinence episodes, and secondary outcomes included daytime and nighttime urinary frequency, urinary urgency episodes, use of pad (reported in a 24-h bladder diary), OAB-V8 and King's Health Questionnaire scores, and maintenance of symptom relief after discontinuation of the intervention. RESULTS In total, 30 consecutive patients completed the study (15/group). The stimulation group showed a reduction in nighttime urinary frequency (0.9 ± 0.6), urinary urgency (1.0 ± 1.2), urgency incontinence episodes (0.5 ± 0.6), use of pads (1.3 ± 1.2), and OAB-V8 (1.3 ± 1.2) and King's Health Questionnaire scores. In a 30-day and 90-day follow-up, 8 (53.3%) and 5 (33.3%) stimulation patients, respectively, reported full maintenance of symptom relief after discontinuation of the intervention. Stimulation patients presented a statistically significant improvement of symptoms as compared with sham patients (p = .001). CONCLUSIONS Transcutaneous tibial nerve home stimulation can be used in clinical practice as an effective nonpharmacological resource for the reduction of OAB symptoms in women with PD, and the resulting relief seems to persist in the follow-up (30 and 90 days).
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Affiliation(s)
- Tatiane G Araujo
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Adriana P Schmidt
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo R S Sanches
- Biomedical Engineering Department, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Danton P Silva Junior
- Biomedical Engineering Department, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Carlos R M Rieder
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.,Neurology Department, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - José G L Ramos
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.,Urogynecology Department, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Passos-Monteiro E, B. Schuch F, T. Franzoni L, R. Carvalho A, A. Gomeñuka N, Becker M, Rieder CRM, Andrade A, G. Martinez F, S. Pagnussat A, A. Peyré-Tartaruga L. Nordic Walking and Free Walking Improve the Quality of Life, Cognitive Function, and Depressive Symptoms in Individuals with Parkinson's Disease: A Randomized Clinical Trial. J Funct Morphol Kinesiol 2020; 5:jfmk5040082. [PMID: 33467297 PMCID: PMC7739412 DOI: 10.3390/jfmk5040082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/23/2020] [Accepted: 10/09/2020] [Indexed: 12/18/2022] Open
Abstract
Nordic walking's (NW) degree of effectiveness regarding health-related parameters in people with Parkinson's Disease (PD) is a subject of debate. While NW seems to improve functionality, a clear non-motor benefit has not been demonstrated. The aim of this randomized controlled trial was to compare the effects of 9-week NW and free walking (FW) training programs on quality of life, cognitive function, and depressive symptoms in individuals with PD. Thirty-three people with PD, (Hoehn and Yahr 1-4) were randomized into two groups: NW (n = 16) and FW (n = 17). We analyzed quality of life, cognitive function, depressive symptoms, and motor symptoms. Significant improvements were found in the overall, physical, psychological, social participation, and intimacy domains of quality of life, as well as in cognitive function and depressive symptoms for both groups. Only the NW group showed improvement in the autonomy domain. Individuals with PD had a similar enhancement of non-motor symptoms after walking training, with or without poles. However, the NW group showed a more significant improvement in the autonomy domain, strengthening the applied and clinical potential of NW in people with PD. Future studies are needed to determine the efficacy of walking training without poles in subjects with PD.
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Affiliation(s)
- Elren Passos-Monteiro
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, RS, Brazil; (E.P.-M.); (A.R.C.); (N.A.G.); (M.B.); (F.G.M.); (L.A.P.-T.)
- Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90040-060, RS, Brazil;
- Human Movement Sciences Graduate Program, School of Physical Education, Universidade Federal do Pará (UFPA), Castanhal 66075-110, PA, Brazil
| | - Felipe B. Schuch
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, RS, Brazil; (E.P.-M.); (A.R.C.); (N.A.G.); (M.B.); (F.G.M.); (L.A.P.-T.)
- Department of Sports Methods and Techniques, Universidade Federal de Santa Maria (UFSM), Santa Maria 97105-900, RN, Brazil
- Correspondence: ; Tel.: +55-55-32207788
| | - Leandro T. Franzoni
- Postgraduate Program in Medical Science, Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, RS, Brazil;
| | - Alberito R. Carvalho
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, RS, Brazil; (E.P.-M.); (A.R.C.); (N.A.G.); (M.B.); (F.G.M.); (L.A.P.-T.)
- Physical Therapy College, Universidade Estadual do Oeste do Paraná (UNIOESTE), Cascavel 85819-170, PA, Brazil
| | - Natalia A. Gomeñuka
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, RS, Brazil; (E.P.-M.); (A.R.C.); (N.A.G.); (M.B.); (F.G.M.); (L.A.P.-T.)
- Departamento de Investigación de la Facultad de Ciencias de la Salud, Universidad Católica de las Misiones, Posadas (UCAMI), Misiones N3300, Argentina
| | - Marindia Becker
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, RS, Brazil; (E.P.-M.); (A.R.C.); (N.A.G.); (M.B.); (F.G.M.); (L.A.P.-T.)
| | - Carlos R. M. Rieder
- Movement Disorders Clinics, Division of Neurology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil;
| | - Alexandro Andrade
- Laboratory of Psychology of Sport and Exercise, Department of Physical Education, Center of Health Sciences and Sports, Santa Catarina State University (UDESC), Florianópolis 89223-100, SC, Brazil;
| | - Flávia G. Martinez
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, RS, Brazil; (E.P.-M.); (A.R.C.); (N.A.G.); (M.B.); (F.G.M.); (L.A.P.-T.)
| | - Aline S. Pagnussat
- Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90040-060, RS, Brazil;
- Rehabilitation Sciences Graduate Program, Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFSCPA), Porto Alegre 90050-170, RS, Brazil
| | - Leonardo A. Peyré-Tartaruga
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, RS, Brazil; (E.P.-M.); (A.R.C.); (N.A.G.); (M.B.); (F.G.M.); (L.A.P.-T.)
- Human Movement Sciences Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre 90040-060, RS, Brazil
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Pagnussat AS, Salazar AP, Pinto C, Redivo Marchese R, Rieder CRM, Alves Filho JO, Franco AR, Kleiner AFR. Plantar stimulation alters brain connectivity in idiopathic Parkinson's disease. Acta Neurol Scand 2020; 142:229-238. [PMID: 32299120 DOI: 10.1111/ane.13253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/25/2020] [Accepted: 04/11/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Individuals with Parkinson's disease (PD) and freezing of gait (FOG) present peripheral and central sensitivity disturbances that impair motor performance. This study aimed to investigate long-term effects of plantar sensory stimulation on brain activity, brain connectivity, and gait velocity of individuals with PD and FOG. METHODS Twenty-five participants were enrolled in this clinical trial (NCT02594540). Plantar sensory stimulation was delivered using the Automated Mechanical Peripheral Stimulation therapy (AMPS). Volunteers were randomly assigned to real or placebo AMPS groups and received eight sessions of treatment. The primary outcome was brain activity (task-based fMRI-active ankle dorsi-plantar flexion). Secondary outcomes were brain connectivity (resting state-RS fMRI) and gait velocity. fMRI was investigated on the left, right, and mid-sensory motor regions, left and right basal ganglia. RESULTS No changes in brain activity were observed when task-based fMRI was analyzed. After real AMPS, RS functional connectivity between basal ganglia and sensory-related brain areas increased (insular and somatosensory cortices). Gait velocity also increased after real AMPS. A positive correlation was found between gait velocity and the increased connectivity between sensory, motor and supplementary motor cortices. CONCLUSION Plantar sensory stimulation through AMPS was not able to modify brain activity. AMPS increased the RS brain connectivity mainly in areas related to sensory processing and sensorimotor integration. Plantar stimulation could be a way to improve plantar sensitivity and consequently ameliorate gait performance. However, the mechanisms behind the way AMPS influences brain pathways are still not completely known.
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Affiliation(s)
- Aline Souza Pagnussat
- Graduate Program in Rehabilitation Sciences Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
- Movement Analysis and Rehabilitation Laboratory Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
| | - Ana Paula Salazar
- Graduate Program in Rehabilitation Sciences Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
- Movement Analysis and Rehabilitation Laboratory Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
| | - Camila Pinto
- Graduate Program in Rehabilitation Sciences Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
- Movement Analysis and Rehabilitation Laboratory Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
| | - Ritchele Redivo Marchese
- Graduate Program in Rehabilitation Sciences Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
- Movement Analysis and Rehabilitation Laboratory Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
| | - Carlos R. M. Rieder
- Graduate Program in Rehabilitation Sciences Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
| | | | - Alexandre R. Franco
- Center for Biomedical Imaging and Neuromodulation Nathan S. Kline Institute for Psychiatric Research Orangeburg NY USA
- Center for the Developing Brain Child Mind Institute New York NY USA
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Santos-Lobato BL, Schumacher-Schuh AF, Rieder CRM, Hutz MH, Borges V, Ferraz HB, Mata IF, Zabetian CP, Tumas V. Diagnostic prediction model for levodopa-induced dyskinesia in Parkinson's disease. Arq Neuropsiquiatr 2020; 78:206-216. [PMID: 32294749 DOI: 10.1590/0004-282x20190191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 11/10/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND There are currently no methods to predict the development of levodopa-induced dyskinesia (LID), a frequent complication of Parkinson's disease (PD) treatment. Clinical predictors and single nucleotide polymorphisms (SNP) have been associated to LID in PD. OBJECTIVE To investigate the association of clinical and genetic variables with LID and to develop a diagnostic prediction model for LID in PD. METHODS We studied 430 PD patients using levodopa. The presence of LID was defined as an MDS-UPDRS Part IV score ≥1 on item 4.1. We tested the association between specific clinical variables and seven SNPs and the development of LID, using logistic regression models. RESULTS Regarding clinical variables, age of PD onset, disease duration, initial motor symptom and use of dopaminergic agonists were associated to LID. Only CC genotype of ADORA2A rs2298383 SNP was associated to LID after adjustment. We developed two diagnostic prediction models with reasonable accuracy, but we suggest that the clinical prediction model be used. This prediction model has an area under the curve of 0.817 (95% confidence interval [95%CI] 0.77‒0.85) and no significant lack of fit (Hosmer-Lemeshow goodness-of-fit test p=0.61). CONCLUSION Predicted probability of LID can be estimated with reasonable accuracy using a diagnostic clinical prediction model which combines age of PD onset, disease duration, initial motor symptom and use of dopaminergic agonists.
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Affiliation(s)
- Bruno Lopes Santos-Lobato
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências Comportamentais, Ribeirão Preto SP, Brazil.,Universidade de São Paulo, Núcleo de Apoio à Pesquisa em Neurociência Aplicada, São Paulo SP, Brazil
| | | | | | - Mara H Hutz
- Universidade Federal do Rio Grande do Sul, Departamento de Genética, Porto Alegre RS, Brazil
| | - Vanderci Borges
- Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil
| | | | - Ignacio F Mata
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,University of Washington, Department of Neurology, Seattle, WA, USA
| | - Cyrus P Zabetian
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,University of Washington, Department of Neurology, Seattle, WA, USA
| | - Vitor Tumas
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências Comportamentais, Ribeirão Preto SP, Brazil.,Universidade de São Paulo, Núcleo de Apoio à Pesquisa em Neurociência Aplicada, São Paulo SP, Brazil
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7
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Affiliation(s)
- Carlos R M Rieder
- Universidade Federal Ciências da Saúde de Porto Alegre, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre RS, Brasil.,Hospital de Clínicas de Porto Alegre, Porto Alegre RS, Brasil
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8
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Gomes MF, Carvalho Neto EGD, Kowacs F, Rieder CRM. Non-ketotic hyperosmolar hyperglycemic chorea. Rev Assoc Med Bras (1992) 2019; 65:127-129. [DOI: 10.1590/1806-9282.65.2.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 06/20/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Fernando Kowacs
- Federal University of Health Sciences of Porto Alegre, Brasil
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9
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Gomes Carvalho Neto E, Coletto A, Biazus PG, Pereira Dos Santos I, Rieder CRM, de Castro Ribeiro M. Neuroparacoccidioidomycosis. Neurol Neuroimmunol Neuroinflamm 2019; 6:e519. [PMID: 30568997 PMCID: PMC6278888 DOI: 10.1212/nxi.0000000000000519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 10/02/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Euripedes Gomes Carvalho Neto
- Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (E.G.C.N., A.C., P.G.B., I.P.d.S.); Movement Disorders Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (C.R.M.R.); and Neuroimmunology Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (M.d.C.R.)
| | - Aline Coletto
- Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (E.G.C.N., A.C., P.G.B., I.P.d.S.); Movement Disorders Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (C.R.M.R.); and Neuroimmunology Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (M.d.C.R.)
| | - Paula Ghidini Biazus
- Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (E.G.C.N., A.C., P.G.B., I.P.d.S.); Movement Disorders Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (C.R.M.R.); and Neuroimmunology Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (M.d.C.R.)
| | - Iuri Pereira Dos Santos
- Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (E.G.C.N., A.C., P.G.B., I.P.d.S.); Movement Disorders Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (C.R.M.R.); and Neuroimmunology Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (M.d.C.R.)
| | - Carlos R M Rieder
- Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (E.G.C.N., A.C., P.G.B., I.P.d.S.); Movement Disorders Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (C.R.M.R.); and Neuroimmunology Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (M.d.C.R.)
| | - Marlise de Castro Ribeiro
- Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (E.G.C.N., A.C., P.G.B., I.P.d.S.); Movement Disorders Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (C.R.M.R.); and Neuroimmunology Division, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre (M.d.C.R.)
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10
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Morello ANDC, Beber BC, Fagundes VC, Cielo CA, Rieder CRM. Dysphonia and Dysarthria in People With Parkinson's Disease After Subthalamic Nucleus Deep Brain Stimulation: Effect of Frequency Modulation. J Voice 2018; 34:477-484. [PMID: 30454944 DOI: 10.1016/j.jvoice.2018.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 10/24/2018] [Accepted: 10/25/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE Subthalamic nucleus deep brain stimulation (STN-DBS) parameters, for example the frequency of stimulation, seem to affect speech and voice aspects. However, this influence is not well understood. This study aimed to investigate the impact of low- and high-frequency STN-DBS on voice and speech for people with Parkinson's disease. METHODS Nineteen individuals with Parkinson's disease who received bilateral STN-DBS were assessed for motor performance (Unified Parkinson's Disease Rating Scale-III), perceptual evaluation of voice (grade, roughness, breathiness, asthenia, strain, and instability [GRBASI]), dysarthria assessment, and computerized acoustic analysis of voice upon receiving low-frequency (60 Hz) and high-frequency (130 Hz) STN-DBS. RESULTS In the GRBASI protocol, asthenia, and instability were significantly better at 130 Hz of stimulation. In the dysarthria evaluation, the phonation aspect, articulation, and grade of dysarthria showed deterioration at the same high-frequency condition. There was no significant difference for any vocal acoustic measures. CONCLUSION The high-frequency of STN-DBS may affect speech and voice differently, leading to an amelioration of the vocal production, but with adverse effects in the speech control.
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Affiliation(s)
- Aline Nunes Da Cruz Morello
- Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Bárbara Costa Beber
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Valéria Carvalho Fagundes
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil; Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Carlos R M Rieder
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil; Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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11
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Soares NM, Pereira GM, Altmann V, de Almeida RMM, Rieder CRM. Cortisol levels, motor, cognitive and behavioral symptoms in Parkinson's disease: a systematic review. J Neural Transm (Vienna) 2018; 126:219-232. [PMID: 30374595 DOI: 10.1007/s00702-018-1947-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/22/2018] [Indexed: 12/19/2022]
Abstract
Parkinson's disease (PD) is a progressive and multifactorial neurodegenerative disease. It has been suggested that a dysregulation of the hypothalamic-pituitary-adrenal axis (HPA) occurs in PD. Furthermore, this dysregulation may be involved in triggering, exacerbation or progression of disease. The objective of this study was to systematically review the literature regarding cortisol levels and their relation with motor, cognitive and behavioral symptoms in patients with PD. A systematic search was performed in PubMed and Embase databases, according to PRISMA norms. Twenty-one studies were included, which evaluated baseline levels of cortisol and motor, cognitive, behavioral symptoms, drugs administration or deep brain stimulation to PD treatment. Sample size ranged from 7 to 249 individuals. In 14 studies that assessed cortisol levels in PD patients, seven showed elevation of cortisol levels. In relation to symptomatology, high levels of cortisol were associated with worst functional scores evaluated by UPDRS, depression and behavior in risk preference. Medication interactions showed an influence on the regulation of cortisol release, mainly, conventional drugs used in the PD's treatment, such as levodopa. The results found in this review point to a possible relationship between cortisol levels and symptoms in PD, indicating that an HPA axis dysfunction related to cortisol level occurs in PD.
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Affiliation(s)
- Nayron Medeiros Soares
- Medical Science Post Graduation Program, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, RS, Brazil.
- Institute of Psychology, Laboratory of Psychology, Neuroscience and Behavior (LPNeC), Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600, Porto Alegre, RS, Brazil.
- Hospital de Clinicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil.
- Federal University of Health Science of Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, RS, Brazil.
| | - Gabriela Magalhães Pereira
- Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre, RS, Brazil
- Institute of Psychology, Laboratory of Psychology, Neuroscience and Behavior (LPNeC), Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600, Porto Alegre, RS, Brazil
| | - Vivian Altmann
- Institute of Biosciences, Federal University of Rio Grande do Sul, Av. Bento Gonçalves, 9500, Porto Alegre, RS, Brazil
- Hospital de Clinicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil
| | - Rosa Maria Martins de Almeida
- Institute of Psychology, Laboratory of Psychology, Neuroscience and Behavior (LPNeC), Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600, Porto Alegre, RS, Brazil
| | - Carlos R M Rieder
- Medical Science Post Graduation Program, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, RS, Brazil
- Hospital de Clinicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil
- Federal University of Health Science of Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, RS, Brazil
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12
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Pagnussat AS, Kleiner AFR, Rieder CRM, Frantz A, Ehlers J, Pinto C, Dorneles G, Netto CA, Peres A, Galli M. Plantar stimulation in parkinsonians: From biomarkers to mobility - randomized-controlled trial. Restor Neurol Neurosci 2018. [PMID: 29526852 DOI: 10.3233/rnn-170744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The decrease of Brain-Derived Neurotrophic Factor (BDNF) serum levels has been related to the pathophysiology of several neurodegenerative diseases as well as to neural plasticity and rehabilitation. Automated Mechanical Peripheral Stimulation (AMPS) has been investigated as a complementary therapy for Parkinson Disease (PD). OBJECTIVES (1) to investigate the effects of AMPS on BDNF and Cortisol serum levels of subjects with PD; (2) to evidence the interplay between BDNF and Cortisol serum levels and the functional mobility improvement after AMPS treatment. METHODS Thirty-three subjects with PD were randomized into two groups: effective stimulation (AMPS, n = 16) or placebo stimulation (AMPS SHAM, n = 17). Fourteen healthy aged-matched subjects were included as a reference group. Each AMPS group received eight sessions of treatment using a commercial medical device (Gondola™). BDNF and Cortisol serum levels, spatiotemporal gait parameters and TUG test were assessed at baseline and after eight sessions of treatment. RESULTS After the treatment, AMPS group showed significantly higher levels of BDNF and lower levels of Cortisol compared to AMPS SHAM. AMPS group also showed a positive effect on gait pattern as a higher improvement on gait velocity, stride length, and TUG performance was shown. CONCLUSION Effective AMPS treatment increased BDNF and decreased Cortisol serum levels and produced improvements in functional mobility.
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Affiliation(s)
- Aline Souza Pagnussat
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Ana F R Kleiner
- Politecnico di Milano, Dipartimento di Elettronica, Informazione e Bioingegneria, Milan, Italy
| | - Carlos R M Rieder
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Anapaula Frantz
- Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Jaira Ehlers
- Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Camila Pinto
- Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Gilson Dorneles
- Cellular and Molecular Immunology Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Carlos Alexandre Netto
- Department of Biochemistry, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Alessandra Peres
- Cellular and Molecular Immunology Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Research Center, Methodist University Center IPA, Porto Alegre, Brazil
| | - Manuela Galli
- Politecnico di Milano, Dipartimento di Elettronica, Informazione e Bioingegneria, Milan, Italy.,"Gait Analysis Lab" IRCCS San Raffaele Pisana, Rome, Italy
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13
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Cornejo-Olivas M, Torres L, Velit-Salazar MR, Inca-Martinez M, Mazzetti P, Cosentino C, Micheli F, Perandones C, Dieguez E, Raggio V, Tumas V, Borges V, Ferraz HB, Rieder CRM, Shumacher-Schuh A, Velez-Pardo C, Jimenez-Del-Rio M, Lopera F, Chang-Castello J, Andreé-Munoz B, Waldherr S, Yearout D, Zabetian CP, Mata IF. Erratum: Variable frequency of LRRK2 variants in the Latin American research consortium on the genetics of Parkinson's disease (LARGE-PD), a case of ancestry. NPJ Parkinsons Dis 2018; 4:3. [PMID: 29367946 PMCID: PMC5775434 DOI: 10.1038/s41531-017-0025-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
[This corrects the article DOI: 10.1038/s41531-017-0020-6.].
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Affiliation(s)
- Mario Cornejo-Olivas
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurologicas, Lima, Peru.,Northern Pacific Global Health Research Training Consortium, Bethesda, MD USA
| | - Luis Torres
- Movement Disorders Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru.,4Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Mario R Velit-Salazar
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurologicas, Lima, Peru.,5Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Miguel Inca-Martinez
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Pilar Mazzetti
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurologicas, Lima, Peru.,4Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Carlos Cosentino
- Movement Disorders Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru.,4Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Federico Micheli
- 6Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Claudia Perandones
- 6Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Elena Dieguez
- 7Neurology Institute, Universidad de la Republica, Montevideo, Uruguay
| | - Victor Raggio
- 8Department of Genetics, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Vitor Tumas
- 9Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Vanderci Borges
- 10Movement Disorders Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP Brazil
| | - Henrique B Ferraz
- 10Movement Disorders Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP Brazil
| | | | | | - Carlos Velez-Pardo
- 12Neruroscience Research Group, Medical Research Institute, Universidad de Antioquia, Medellin, Colombia
| | - Marlene Jimenez-Del-Rio
- 12Neruroscience Research Group, Medical Research Institute, Universidad de Antioquia, Medellin, Colombia
| | - Francisco Lopera
- 12Neruroscience Research Group, Medical Research Institute, Universidad de Antioquia, Medellin, Colombia
| | - Jorge Chang-Castello
- Department of Genetics, School of Medicine, Universidad de Guayaquil, Hospital Luis Vernaza, Guayaquil, Ecuador
| | | | - Sarah Waldherr
- 15Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA USA.,16Department of Neurology, University of Washington, Seattle, WA USA
| | - Dora Yearout
- 15Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA USA.,16Department of Neurology, University of Washington, Seattle, WA USA
| | - Cyrus P Zabetian
- 15Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA USA.,16Department of Neurology, University of Washington, Seattle, WA USA
| | - Ignacio F Mata
- 15Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA USA.,16Department of Neurology, University of Washington, Seattle, WA USA
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14
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Romann AJ, Beber BC, Olchik MR, Rieder CRM. Different outcomes of phonemic verbal fluency in Parkinson's disease patients with subthalamic nucleus deep brain stimulation. Arq Neuropsiquiatr 2017; 75:216-220. [PMID: 28489140 DOI: 10.1590/0004-282x20170024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 01/06/2017] [Indexed: 11/22/2022]
Abstract
Subthalamic nucleus deep brain stimulation (STN-DBS) is a surgical technique to treat motor symptoms in patients with Parkinson's disease (PD). Studies have shown that STN-DBS may cause a decline in verbal fluency performance. We aimed to verify the effects of STN-DBS on the performance of phonemic verbal fluency in Brazilian PD patients. Sixteen participants were evaluated on the Unified Parkinson's Disease Rating Scale - Part III and for phonemic fluency ("FAS" version) in the conditions of on- and off-stimulation. We identified two different patterns of phonemic verbal fluency outcomes. The results indicate that there may be no expected pattern of effect of bilateral STN-DBS in the phonemic fluency, and patients may present with different outcomes for some reason not well understood.
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Affiliation(s)
- Aline Juliane Romann
- Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Medicina: Ciências Médicas, Porto Alegre RS, Brasil
| | - Bárbara Costa Beber
- Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Medicina: Ciências Médicas, Porto Alegre RS, Brasil.,Faculdade Nossa Senhora de Fátima, Faculdade de Fonoaudiologia, Caxias do Sul RS, Brasil
| | - Maira Rozenfeld Olchik
- Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Medicina: Ciências Médicas, Porto Alegre RS, Brasil.,Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Porto Alegre RS, Brasil
| | - Carlos R M Rieder
- Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Medicina: Ciências Médicas, Porto Alegre RS, Brasil.,Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Porto Alegre RS, Brasil.,Universidade Federal Ciências da Saúde, Porto Alegre RS, Brasil
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15
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Ayres A, Jotz GP, Rieder CRM, Olchik MR. Benefit from the Chin-Down Maneuver in the Swallowing Performance and Self-Perception of Parkinson's Disease Patients. Parkinsons Dis 2017; 2017:7460343. [PMID: 28203475 PMCID: PMC5288524 DOI: 10.1155/2017/7460343] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 11/27/2016] [Indexed: 11/22/2022]
Abstract
Aims. To verify the effectiveness of the maneuver application in swallowing therapy with PD. Materials and Method. We performed an open-label trial, with three groups compounds by PD individuals: the experimental group, control group, and orientation group. The study included PD patients with dysphagia. A cognitive screening, through a questionnaire about depression and quality of life, was conducted. Swallowing assessment was performed through (1) fiberoptic endoscopic evaluation of swallowing (FEES); (2) clinical evaluation and Functional Oral Intake Scale (FOIS); and (3) assessment of the quality life related to swallowing (SWALQOL). A therapeutic program, which consisted of chin-down postural maneuver and orientations on feeding, was applied. Both groups (EG and OG) received on-month therapeutic program. Results. A significant improvement in swallowing, evaluated by clinical assessment, was observed in solid (p < 0.001) and liquid (p = 0.022) consistencies in EG when compared to OG and CG. Patients in EG presented improvement in QoL, with the significant difference in comparison with the other groups, about domain frequency of symptoms (p = 0.029) in SWALQOL questionnaire. Conclusion. The postural maneuver chin-down improved swallowing performance and self-perception, but not the laryngeal signs. This trial is registered with registration number NCT02973698.
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Affiliation(s)
- Annelise Ayres
- Postgraduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Geraldo Pereira Jotz
- Postgraduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Carlos R. M. Rieder
- Postgraduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Department of Neurology and Postgraduate Program in Rehabilitation, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Maira Rozenfeld Olchik
- Department of Surgery and Orthopaedics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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16
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Fagundes VDC, Rieder CRM, da Cruz AN, Beber BC, Portuguez MW. Deep Brain Stimulation Frequency of the Subthalamic Nucleus Affects Phonemic and Action Fluency in Parkinson's Disease. Parkinsons Dis 2016; 2016:6760243. [PMID: 28050309 PMCID: PMC5165157 DOI: 10.1155/2016/6760243] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 10/20/2016] [Indexed: 11/17/2022]
Abstract
Introduction. Deep brain stimulation of the subthalamic nucleus (STN-DBS) in Parkinson's disease (PD) has been linked to a decline in verbal fluency. The decline can be attributed to surgical effects, but the relative contributions of the stimulation parameters are not well understood. This study aimed to investigate the impact of the frequency of STN-DBS on the performance of verbal fluency tasks in patients with PD. Methods. Twenty individuals with PD who received bilateral STN-DBS were evaluated. Their performances of verbal fluency tasks (semantic, phonemic, action, and unconstrained fluencies) upon receiving low-frequency (60 Hz) and high-frequency (130 Hz) STN-DBS were assessed. Results. The performances of phonemic and action fluencies were significantly different between low- and high-frequency STN-DBS. Patients showed a decrease in these verbal fluencies for high-frequency STN-DBS. Conclusion. Low-frequency STN-DBS may be less harmful to the verbal fluency of PD patients.
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Affiliation(s)
- Valéria de Carvalho Fagundes
- Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Brain Institute of Rio Grande do Sul (InsCer), Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Carlos R. M. Rieder
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Federal University of Health Sciences from Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Aline Nunes da Cruz
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | | | - Mirna Wetters Portuguez
- Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Brain Institute of Rio Grande do Sul (InsCer), Porto Alegre, RS, Brazil
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17
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Artigas NR, Franco C, Leão P, Rieder CRM. Postural instability and falls are more frequent in Parkinson’s disease patients with worse trunk mobility. Arq Neuro-Psiquiatr 2016; 74:519-23. [DOI: 10.1590/0004-282x20160074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 04/06/2016] [Indexed: 11/21/2022]
Abstract
ABSTRACT Postural instability and axial rigidity are frequent symptoms of the Parkinson’s disease (PD). Objective Correlate the occurrence of falls and the activity of rolling over in bed with performance on the Trunk Mobility Scale (TMS) in patients with PD, and determine whether this instrument score can predict the risk of falls. Method This is a cross-sectional study. Assessed patients reported the frequency of falls in the previous year and whether they had difficulties rolling over in bed. Then, the following scales were applied: TMS, Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III and Schwab and England Activities of Daily Living. Results Eighty-five patients were analyzed. Patients with a history of falling showed worse performance in the TMS (p < 0.01). There is a significant correlation between TMS and the activity of rolling over in bed (p < 0.01). Conclusion PD fallers present worse scores in TMS, and there is a significant correlation between difficulty rolling over in bed and TMS score.
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Affiliation(s)
| | | | - Paula Leão
- Centro Universitário Metodista do IPA, Brasil
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18
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Altmann V, Schumacher-Schuh AF, Rieck M, Callegari-Jacques SM, Rieder CRM, Hutz MH. Influence of genetic, biological and pharmacological factors on levodopa dose in Parkinson's disease. Pharmacogenomics 2016; 17:481-8. [PMID: 27019953 DOI: 10.2217/pgs.15.183] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
AIM Levodopa is first-line treatment of Parkinson's disease motor symptoms but, dose response is highly variable. Therefore, the aim of this study was to determine how much levodopa dose could be explained by biological, pharmacological and genetic factors. PATIENTS & METHODS A total of 224 Parkinson's disease patients were genotyped for SV2C and SLC6A3 polymorphisms by allelic discrimination assays. Comedication, demographic and clinical data were also assessed. RESULTS All variables with p < 0.20 were included in a multiple regression analysis for dose prediction. The final model explained 23% of dose variation (F = 11.54; p < 0.000001). CONCLUSION Although a good prediction model was obtained, it still needs to be tested in an independent sample to be validated.
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Affiliation(s)
- Vivian Altmann
- Departamento de Genética, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Mariana Rieck
- Departamento de Genética, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Carlos R M Rieder
- Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Mara H Hutz
- Departamento de Genética, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Medeiros MS, Schumacher-Schuh A, Cardoso AM, Bochi GV, Baldissarelli J, Kegler A, Santana D, Chaves CMMBS, Schetinger MRC, Moresco RN, Rieder CRM, Fighera MR. Iron and Oxidative Stress in Parkinson's Disease: An Observational Study of Injury Biomarkers. PLoS One 2016; 11:e0146129. [PMID: 26751079 PMCID: PMC4709097 DOI: 10.1371/journal.pone.0146129] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 12/14/2015] [Indexed: 11/19/2022] Open
Abstract
Parkinson's disease (PD) is characterized by progressive motor impairment attributed to progressive loss of dopaminergic neurons in the substantia nigra (SN) pars compacta. In addition to an accumulation of iron, there is also an increased production of reactive oxygen/nitrogen species (ROS/RNS) and inflammatory markers. These observations suggest that iron dyshomeostasis may be playing a key role in neurodegeneration. However, the mechanisms underlying this metal-associated oxidative stress and neuronal damage have not been fully elucidated. To determine peripheral levels of iron, ferritin, and transferrin in PD patients and its possible relation with oxidative/nitrosative parameters, whilst attempting to identify a profile of peripheral biomarkers in this neurological condition. Forty PD patients and 46 controls were recruited to compare serum levels of iron, ferritin, transferrin, oxidative stress markers (superoxide dismutase (SOD), catalase (CAT), nitrosative stress marker (NOx), thiobarbituric acid reactive substances (TBARS), non-protein thiols (NPSH), advanced oxidation protein products (AOPP), ferric reducing ability of plasma (FRAP) and vitamin C) as well as inflammatory markers (NTPDases, ecto-5’-nucleotidase, adenosine deaminase (ADA), ischemic-modified albumin (IMA) and myeloperoxidase). Iron levels were lower in PD patients, whereas there was no difference in ferritin and transferrin. Oxidative stress (TBARS and AOPP) and inflammatory markers (NTPDases, IMA, and myeloperoxidase) were significantly higher in PD, while antioxidants FRAP, vitamin C, and non-protein thiols were significantly lower in PD. The enzymes SOD, CAT, and ecto-5’-nucleotidase were not different among the groups, although NOx and ADA levels were significantly higher in the controls. Our data corroborate the idea that ROS/RNS production and neuroinflammation may dysregulate iron homeostasis and collaborate to reduce the periphery levels of this ion, contributing to alterations observed in the pathophysiology of PD.
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Affiliation(s)
- Marcio S. Medeiros
- Neurology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Arthur Schumacher-Schuh
- Neurology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Andreia Machado Cardoso
- Natural and Exact Sciences Center, Graduate Program in Life Sciences: Toxicological Biochemistry, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Guilherme Vargas Bochi
- Department of Clinical and Toxicological Analyses, Universidade Federal de Santa Maria, Health Sciences Center, Santa Maria, Rio Grande do Sul, Brazil
| | - Jucimara Baldissarelli
- Natural and Exact Sciences Center, Graduate Program in Life Sciences: Toxicological Biochemistry, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Aline Kegler
- Natural and Exact Sciences Center, Graduate Program in Life Sciences: Toxicological Biochemistry, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
- Neuropsychiatry Department, University Hospital, Universidade Federal de Santa Maria, Health Sciences Center, Santa Maria, Rio Grande do Sul, Brazil
| | - Daniel Santana
- Neuropsychiatry Department, University Hospital, Universidade Federal de Santa Maria, Health Sciences Center, Santa Maria, Rio Grande do Sul, Brazil
| | | | - Maria Rosa Chitolina Schetinger
- Natural and Exact Sciences Center, Graduate Program in Life Sciences: Toxicological Biochemistry, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Rafael Noal Moresco
- Department of Clinical and Toxicological Analyses, Universidade Federal de Santa Maria, Health Sciences Center, Santa Maria, Rio Grande do Sul, Brazil
| | - Carlos R. M. Rieder
- Neurology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Michele Rechia Fighera
- Natural and Exact Sciences Center, Graduate Program in Life Sciences: Toxicological Biochemistry, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
- Neuropsychiatry Department, University Hospital, Universidade Federal de Santa Maria, Health Sciences Center, Santa Maria, Rio Grande do Sul, Brazil
- * E-mail:
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Fernandes GC, Rieder CRM, Vedolin L, Campos L, Koltermann T. Author Response. Neurology 2015; 85:655. [PMID: 26505051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
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21
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Saute JAM, Rieder CRM, Castilhos RM, Monte TL, Schumacher-Schuh AF, Donis KC, D'Ávila R, Souza GN, Russo AD, Furtado GV, Gheno TC, Souza DOG, Saraiva-Pereira ML, Portela LVC, Camey S, Torman VBL, Jardim LB. Planning future clinical trials in Machado Joseph disease: Lessons from a phase 2 trial. J Neurol Sci 2015; 358:72-6. [PMID: 26297649 DOI: 10.1016/j.jns.2015.08.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 07/24/2015] [Accepted: 08/12/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND In a recent phase 2 clinical trial in spinocerebellar ataxia type 3/Machado Joseph disease (SCA3/MJD), a neurogenetic disorder without specific therapy, benefits of lithium carbonate were found only on secondary efficacy outcomes, all related to ataxic features. In order to help designing future studies, we further analyzed the trial data searching for treatment response modifiers and metric properties of spinocerebellar ataxia (SCA) scales. METHODS Efficacy analysis was performed with the Neurological Examination Score for the Assessment of Spinocerebellar Ataxia (NESSCA) and the Scale for the Assessment and Rating of Ataxia (SARA) subscores and with the subgroup of patients with independent gait according to the 8-meter walking-time (8MW). Interactions of clinical/molecular findings with treatment response, minimally important differences (MIDs), and sample size estimations for NESSCA, SARA, Spinocerebellar Ataxia Functional Index (SCAFI) and Composite Cerebellar Functional Score (CCFS) were evaluated. RESULTS 62 SCA3/MJD patients had been randomly assigned (1:1) for the double-blind, placebo-controlled trial. While cerebellar NESSCA (range: 0-7 points) differed between groups 0.64 points (95% CI 0.23 to 1.05, p<0.001) over the whole 48weeks of study, favoring lithium, no effect was found on non-ataxia subscores. Among patients able to perform the 8MW on baseline, NESSCA (p=0.010) and SCAFI (p=0.015) differed between groups favoring lithium. Finally, estimated sample sizes for the scales were provided. CONCLUSION Lithium efficacy on cerebellar NESSCA, and on SCAFI and CCFS in the primary analysis, together with the lack of effect on non-ataxia features suggests that lithium should be tested in phase 3 trials in SCA3/MJD and that ataxia scales should be preferred to multisystem neurological instruments as the primary outcome. The inclusion of early stage patients is advisable in future clinical trials in SCA3/MJD. TRIAL REGISTRATION clinicaltrials.gov identifier: NCT01096082.
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Affiliation(s)
- Jonas Alex Morales Saute
- Post-Graduation Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Medical Genetics Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Carlos R M Rieder
- Post-Graduation Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Neurology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Raphael Machado Castilhos
- Post-Graduation Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Instituto Nacional de Genética Médica Populacional (INAGEMP), Brazil
| | - Thais Lampert Monte
- Post-Graduation Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Neurology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | | | - Karina Carvalho Donis
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Rui D'Ávila
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Gabriele Nunes Souza
- Post-Graduation Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Medical Genetics Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Aline Dutra Russo
- Post-Graduation Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Medical Genetics Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Gabriel Vasata Furtado
- Post-Graduation Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Tailise Conte Gheno
- Post-Graduation Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Diogo Onofre Gomes Souza
- Department of Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Instituto Nacional de Ciência e Tecnologia em Excitotoxicidade e Neuroproteção (INCTEN), Brazil
| | - Maria Luiza Saraiva-Pereira
- Post-Graduation Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Medical Genetics Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Luis Valmor Cruz Portela
- Department of Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Instituto Nacional de Ciência e Tecnologia em Excitotoxicidade e Neuroproteção (INCTEN), Brazil
| | - Suzi Camey
- Post-Graduation Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vanessa Bielefeld Leotti Torman
- Post-Graduation Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Laura Bannach Jardim
- Post-Graduation Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Post-Graduation Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Medical Genetics Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Instituto Nacional de Genética Médica Populacional (INAGEMP), Brazil.
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Abstract
Parkinson's disease (PD) is unique among neurodegenerative disorders because a highly effective pharmacological symptomatic treatment is available. The marked variability in drug response and in adverse profiles associated with this treatment led to the search of genetic markers associated with these features. We present a review of the literature on PD pharmacogenetics to provide a critical discussion of the current findings, new approaches, limitations and recommendations for future research. Pharmacogenetics studies in this field have assessed several outcomes and genes, with special focus on dopaminergic genes, mainly DRD2, which is the most important receptor in nigrostriatal pathway. The heterogeneity in methodological strategies employed by different studies is impressive. The question of whether PD pharmacogenetics studies will improve clinical management by causing a shift from a trial-and-error approach to a pharmacological regimen that takes into account the individual variability remains an open question. Collaborative longitudinal studies with larger sample sizes, better outcome definitions and replication studies are required.
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Affiliation(s)
- Artur F Schumacher-Schuh
- Departamento de Genética, Instituto de Biociências, UFRGS, Caixa Postal 15053, 91501-970, Porto Alegre, RS, Brazil
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Rieder CRM. Genetic of dystonias according the new classification. Arq Neuropsiquiatr 2015; 73:281-282. [PMID: 25992515 DOI: 10.1590/0004-282x20150058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 03/27/2015] [Indexed: 06/04/2023]
Affiliation(s)
- Carlos R M Rieder
- Unidade de Distúrbios do Movimento, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Margis R, Schönwald SV, Carvalho DZ, Gerhardt GJL, Rieder CRM. NREM sleep alpha and sigma activity in Parkinson's disease: evidence for conflicting electrophysiological activity? Clin Neurophysiol 2014; 126:951-8. [PMID: 25227218 DOI: 10.1016/j.clinph.2014.07.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 07/07/2014] [Accepted: 07/27/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Sleep EEG spectral patterns were investigated in eight newly diagnosed, non-depressed, non-demented, drug-naïve Parkinson's disease patients compared to nine controls. METHODS Mean relative spectral power density calculated for 0.25 Hz frequency bins and for classical EEG frequency bands. RESULTS Differences between patients and controls were most prominent in non-REM sleep, specially around 8.6 Hz (slow alpha), 12.5 Hz (fast alpha/slow sigma) and 15 Hz (fast sigma). Slow alpha showed lower p-values over frontal and occipital electrodes, whereas fast sigma activity was more important on central and parietal sites. Significantly increased NREM sleep alpha activity was found in left and right frontal (Mann-Whitney U=12,000, p=.021; U=14,000, p=.036), left and right central (U=14,000, p=.036), left parietal and left occipital (U=13,000, p=.027; U=15,000, p=.046) areas. Increased sigma activity was found in right frontal (U=14,000, p=.036), left central (U=12,000, p=.021), left and right parietal (U=12,000, p=.021; U=13,000, p=.027) and left occipital (U=15,000, p=.046) areas. CONCLUSIONS Concomitantly increased scalp EEG alpha and sigma activity was found during NREM sleep in initial Parkinson's disease. SIGNIFICANCE These non-REM sleep microstructure changes may represent evidence for altered electrophysiological mechanisms leading to sleep-wake instability in early disease stages.
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Affiliation(s)
- Regina Margis
- Sleep and Movement Disorders Clinics, Division of Neurology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - Suzana Veiga Schönwald
- Sleep and Movement Disorders Clinics, Division of Neurology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.
| | - Diego Zaquera Carvalho
- Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, USA
| | | | - Carlos R M Rieder
- Sleep and Movement Disorders Clinics, Division of Neurology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil; Movement Disorders Center, Division of Neurology, Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil; Curso de Pós-Graduação em Medicina, Ciências Médicas da Universidade Federal do Rio Grande do Sul, Brazil
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Maciel ROH, Cardoso FEC, Chana-Cuevas P, Cosentino C, Fernandez W, Rieder CRM, Serrano-Duenas M, Weiser R. Care of patients with Huntington's disease in South America: a survey. Arq Neuro-Psiquiatr 2013; 71:368-70. [DOI: 10.1590/0004-282x20130040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 12/27/2012] [Indexed: 11/22/2022]
Abstract
Huntington's disease (HD) is a rare neurodegenerative disease with a multitude of symptoms, which requires access to specialized multidisciplinary care for adequate management. The aim of this study was to survey the characteristics of care in various HD centers in South America (SA). Methods A questionnaire was sent to 24 centers involved in the care for HD patients in SA. Results Of the total 24 centers, 19 (79.2%) are academic units. The majority of centers (62.5%) are general movement disorders clinics. Multidisciplinary care is available in 19 (79.2%) centers and in 20 (83.3%) care is provided free of charge. Genetic testing and counseling are available in 25 and 66.6% of centers, respectively. The majority of centers (83.3%) have no institutional support for end-stage care. Conclusions Although HD centers in SA are committed to providing multidisciplinary care, access to genetic counseling and end-stage care are lacking in most centers.
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Siebert M, Donis KC, Socal M, Rieder CRM, Emmel VE, Vairo F, Michelin-Tirelli K, França M, D'Abreu AC, Bettencourt C, Lima M, Lopes Cendes I, Saraiva-Pereira ML, Jardim LB. Glucocerebrosidase gene variants in parkinsonian patients with Machado Joseph/spinocerebellar ataxia 3. Parkinsonism Relat Disord 2011; 18:185-90. [PMID: 22001711 DOI: 10.1016/j.parkreldis.2011.09.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 09/19/2011] [Accepted: 09/28/2011] [Indexed: 01/24/2023]
Abstract
UNLABELLED Machado-Joseph disease/spinocerebellar ataxia type 3 (MJD/SCA3) may rarely presents a parkinsonian phenotype. Considering that mutations in the glucocerebrosidase (GBA) gene have been associated with Parkinson disease, we investigated whether these would be more prevalent in MJD/SCA3 patients with parkinsonian manifestations than in those without them. METHODS MJD/SCA3 patients with parkinsonian features were identified and compared to relatives and to a MJD/SCA3 control group with no such features. The GBA gene was sequenced and, in a subset of patients and in normal volunteers, GBA enzyme activity was measured. RESULTS We have identified nine index MJD/SCA3 patients with parkinsonian manifestations. Overall, GBA sequence variations were found in 3/9 MJD/SCA3 index cases with parkinsonian manifestations (33%) and in 0/40 MJD/SCA3 controls without parkinsonism (p=0.03, Fisher exact test). The GBA sequence variations found were p.K(-27)R, p.E326K, and p.T369M. The latter two sequence variations were also found in two symptomatic relatives with no parkinsonian manifestations. A MJD/SCA3 relative belonging to the first positive pedigree and carrier of the p.K(-27)R mutation also presented parkinsonian manifestations. GBA activity in MJD/SCA3 patients was similar to those found in the normal control group. CONCLUSION Sequence variations at the GBA gene may play a role as a minor, modifying gene of MJD/SCA3 phenotype. This hypothetical role was not related to changes in GBA activity in peripheral leukocytes.
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Affiliation(s)
- M Siebert
- Biotechnology Centre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Abstract
The present study demonstrates that blood samples can be used as a source of miRNA identification associated to Parkinson's disease (PD). A set of six differentially expressed microRNAs were identified. They form two groups according to their expression profile in control, non-treated, early-onset and treated Parkinson's disease subjects. While miR-1, miR-22* and miR-29 expression levels allowed to distinguish non-treated PD from healthy subjects, miR-16-2*, miR-26a2* and miR30a differentiated treated from untreated patients. This study is innovative in contributing to the development of effective PD biomarkers.
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Affiliation(s)
- Regina Margis
- Neurology Section, Movement Disorders Unit, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, 90035-00 Porto Alegre, RS, Brazil
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Margis R, Margis R, Rieder CRM. Identification of blood microRNAs associated to Parkinsonĭs disease. J Biotechnol 2011; 152:96-101. [PMID: 21295623 DOI: 10.1016/j.jbiotec.2011.01.023] [Citation(s) in RCA: 209] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 01/13/2011] [Indexed: 12/16/2022]
Abstract
The present study demonstrates that blood samples can be used as a source of miRNA identification associated to Parkinson's disease (PD). A set of six differentially expressed microRNAs were identified. They form two groups according to their expression profile in control, non-treated, early-onset and treated Parkinson's disease subjects. While miR-1, miR-22* and miR-29 expression levels allowed to distinguish non-treated PD from healthy subjects, miR-16-2*, miR-26a2* and miR30a differentiated treated from untreated patients. This study is innovative in contributing to the development of effective PD biomarkers.
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Affiliation(s)
- Regina Margis
- Neurology Section, Movement Disorders Unit, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, 90035-00 Porto Alegre, RS, Brazil
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Santin R, Fonseca VF, Bleil CB, Rieder CRM, Hilbig A. Olfactory function and Parkinson's disease in Southern Brazil. Arq Neuropsiquiatr 2010; 68:252-7. [PMID: 20464295 DOI: 10.1590/s0004-282x2010000200019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 11/09/2009] [Indexed: 11/22/2022]
Abstract
UNLABELLED The idiopathic Parkinson disease (IPD) is traditionally diagnosed by motor signs, but non-motor symptoms and signs are frequent and may help in the clinical diagnosis. PURPOSE To evaluate the olfactory function in Brazilian healthy subjects, patients with early-onset PD (EOPD) and late-onset PD (LOPD) using the Sniffin' Sticks odor-identification test (SST). METHOD We studied 70 patients with IPD (19 EOPD and 51 LOPD) and 70 controls matched for gender, age and years of schooling. Subjects with dementia and loss of smell for other reasons were excluded. RESULTS The SST showed a significant difference (p<0.001) between groups: control groups (12.0 + or - 0.3), EOPD (8.3 + or - 0.7), and LOPD (6.7 + or - 0.4) when the groups were adjusted for gender, age, disease duration, and years of schooling. CONCLUSION Both groups of IPD patients presented olfactory impairments, but those whose symptoms started before 45 years-old (EOPD) had better sense of smell than the LOPD patients.
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Affiliation(s)
- Ricardo Santin
- Movement Disorders Outpatient Clinics, Santa Casa de Porto Alegre, RS, Brazil
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Margis R, Donis KC, Schönwald SV, Rieder CRM. WHOQOL-OLD assessment of quality of life in elderly patients with Parkinson's disease: influence of sleep and depressive symptoms. ACTA ACUST UNITED AC 2010; 32:125-31. [PMID: 20428729 DOI: 10.1590/s1516-44462010005000008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Accepted: 11/14/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Parkinson's disease is a neurodegenerative disease with a number of motor and non-motor features that can affect quality of life. In this study, we aimed to assess quality of life, as well as to evaluate the potential determinants of quality of life, such as sleep quality, motor and depressive symptoms, in elderly patients with Parkinson's disease. METHOD This was a cross-sectional study in which we applied the World Health Organization Quality of Life Assessment for Older Adults in 57 Parkinson's disease patients over 60 years of age. RESULTS Total World Health Organization Quality of Life Assessment for Older Adults score was found to be associated with Parkinson's disease severity (rs = -0.43; p < 0.001). World Health Organization Quality of Life Assessment for Older Adults scores for sensory abilities (facet 1) and social participation (facet 4) were higher among the patients with mild Parkinson's disease than among those in the more advanced stages (rs = -0.43; p < 0.001). Facet 1 scores were found to be associated with Pittsburgh Sleep Quality Index and Parkinson's Disease Sleep Scale score (rp = -0.46 and rp = 0.41; p < 0.001, respectively). The Geriatric Depression Scale score showed an association with the total score on the World Health Organization Quality of Life Assessment for Older Adults (rp = -0.70; p < 0.001) CONCLUSION Quality of life in Parkinson's disease patients can be assessed by the World Health Organization Quality of Life Assessment for Older Adults. Greater Parkinson's disease severity can worsen patient quality of life, as can the presence of depressive symptoms.
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Affiliation(s)
- Regina Margis
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Moro dos Santos C, Bisol Balardin J, Quarti Irigaray T, Schröder N, Rieder CRM, Bromberg E. Incidental Encoding Strategies Did Not Improve Contextual Memory in Parkinson’s Disease Patients. Neurorehabil Neural Repair 2009; 24:450-6. [DOI: 10.1177/1545968309355987] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. This study investigated the performance of patients with idiopathic Parkinson’s disease (PD) without dementia for incidental recognition memory and the effect of encoding strategies on contextual memory. Methods. The authors studied 21 patients with PD (ages 60-85, 12 women; Hoehn and Yahr I-III, Activities of Daily Living 70%-100%) and 22 healthy controls (ages 60-84, 18 women). Participants completed the vocabulary subtest of the Wechsler Adult Intelligence Scale and the Wisconsin Card Sorting Test (WCST). To assess the incidental recognition memory for item (object) and context (location of the object), participants of each group were assigned to 1 of 2 encoding conditions: ( a) an incidental associative instruction to bind the object to its location or ( b) a nonassociative, nonspecific instruction. Results. PD patients showed performance comparable to the control group’s on the vocabulary subtest and WCST. In contrast to controls, PD patients were unable to take advantage of the associative encoding instruction, which also had a deleterious effect on item recognition. Conclusion. This sample of participants with PD showed diminished item and context recognition memory and an impaired ability to use incidental memory encoding strategy, suggesting a compromised cognitive reserve. The fact that these alterations occurred in early stages of PD, and prior to more general cognitive alterations such as executive dysfunction, should be considered in the management of patients by using specific cognitive rehabilitation interventions.
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Affiliation(s)
| | | | | | - Nadja Schröder
- Pontifical Catholic University, Porto Alegre, RS, Brazil
| | - Carlos R. M. Rieder
- Hospital de Clínicas de Porto Alegre, Service of Neurology, Porto Alegre, Brazil
| | - Elke Bromberg
- Pontifical Catholic University, Porto Alegre, RS, Brazil,
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Hofmann KW, Schuh AFS, Saute J, Townsend R, Fricke D, Leke R, Souza DO, Portela LV, Chaves MLF, Rieder CRM. Interleukin-6 serum levels in patients with Parkinson's disease. Neurochem Res 2009; 34:1401-4. [PMID: 19214748 DOI: 10.1007/s11064-009-9921-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2009] [Indexed: 10/21/2022]
Abstract
Several lines of evidence suggest that neuroimmune mechanisms may be involved in the neurodegenerative process of Parkinson's disease (PD). Interleukin-6 (IL-6) is increased in the nigrostriatal region and in the cerebrospinal fluid of patients with PD. IL-6 serum level was evaluated in PD patients. The effects of levodopa treatment and disease severity on IL-6 were also studied. The IL-6 levels were similar between PD patients (treated and not treated) and controls. However, there was a negative correlation of IL-6 levels and the activities of daily living scale (P < 0.05), indicating that patients with more severe disease have higher levels of this cytokine. No correlation involving levodopa treatment and IL-6 serum level was found. The results suggest that only marginal effects of IL-6 occur on the peripheral immune system, and that the role of IL-6 and others neuroimmune factors needs to be well elucidated on PD.
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Affiliation(s)
- Kerly Wollmeister Hofmann
- Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, 90035-003 Porto Alegre, RS, Brazil
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Margis R, Donis K, Schönwald SV, Fagondes SC, Monte T, Martín-Martínez P, Chaudhuri KR, Kapczinski F, Rieder CRM. Psychometric properties of the Parkinson's Disease Sleep Scale--Brazilian version. Parkinsonism Relat Disord 2009; 15:495-9. [PMID: 19211294 DOI: 10.1016/j.parkreldis.2008.12.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2008] [Revised: 12/10/2008] [Accepted: 12/12/2008] [Indexed: 10/21/2022]
Abstract
Parkinson's Disease Sleep Scale (PDSS) is a specific scale for the assessment of sleep disturbances in subjects with Parkinson's Disease (PD). This cross-sectional study set out to validate the PDSS in a Brazilian Portuguese Version (PDSS-BR). Ninety-five patients with PD participated in the study; their PD symptoms were evaluated by Unified Parkinson's Disease Rating Scale (UPDRS sections I-IV) and Hoehn and Yahr scale. Patients completed Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI) and PDSS-BR. PDSS-BR internal consistency was satisfactory (Cronbach's alpha: 0.82; all PDSS-BR items were significantly and positively associated with total score). Test-retest reliability for total PDSS-BR score was 0.94. PDSS-BR score was highly correlated with sleep PSQI scale (r(s) = -0.63; p < 0.0001) and moderately with ESS (r(s) = -0.32; p < 0.001) and UPDRS sections I (r(s) = -0.38; p < 0.0001) and II (r(s) = -0.36; p < 0.0001) and BDI (r(s) = -0.55; p < 0.0001). Depressive symptoms, as determined by the BDI, were associated with significantly worse quality of nocturnal sleep, as measured by the PDSS-BR. The psychometric attributes of the PDSS-BR were satisfactory and consistent with those of previous studies. In summary, PDSS-BR can be useful for clinical and research purposes in Brazil.
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Abstract
OBJECTIVE Evaluate the influence of depressive symptoms on the recognition of emotional prosody in Parkinson's disease (PD) patients, and identify types of emotion on spoken sentences. METHODS Thirty-five PD patients and 65 normal participants were studied. Dementia was checked with the Mini Mental State Examination, Clinical Dementia Rating scale, and DSM IV. Recognition of emotional prosody was tested by asking subjects to listen to 12 recorded statements with neutral affective content that were read with a strong affective expression. Subjects had to recognize the correct emotion by one of four descriptors (angry, sad, cheerful, and neutral). The Beck Depression Inventory (BDI) was employed to rate depressive symptoms with the cutoff 14. RESULTS Total ratings of emotions correctly recognized by participants below and above the BDI cutoff were similar among PD patients and normal individuals. PD patients who correctly identified neutral and anger inflections presented higher rates of depressive symptoms (p = 0.011 and 0.044, respectively). No significant differences were observed in the normal group. CONCLUSIONS Depression may modify some modalities of emotional prosody perception in PD, by increasing the perception of non-pleasant emotions or lack of affection, such as anger or indifference.
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Affiliation(s)
- Adriana Vélez Feijó
- Medical Sciences Post-Graduate Course, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre RS, Brazil
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Socal MP, Bock H, Michelin-Tirelli K, Hilbig A, Saraiva-Pereira ML, Rieder CRM, Jardim LB. Parkinson's disease and the heterozygous state for glucocerebrosidase mutations among Brazilians. Parkinsonism Relat Disord 2008; 15:76-8. [PMID: 18358758 DOI: 10.1016/j.parkreldis.2008.01.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2008] [Revised: 01/24/2008] [Accepted: 01/29/2008] [Indexed: 10/22/2022]
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Rieder CRM, Schestatsky P, Socal MP, Monte TL, Fricke D, Costa J, Picon PD. A Double-blind, Randomized, Crossover Study of Prosigne Versus Botox in Patients With Blepharospasm and Hemifacial Spasm. Clin Neuropharmacol 2007; 30:39-42. [PMID: 17272968 DOI: 10.1097/01.wnf.0000236771.77021.3c] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There is a lack of evidence on the clinical efficacy and safety of the recently released Chinese botulinum toxin serotype A (Prosigne) for the treatment of focal dystonias and hemifacial spasm. Determining a more precise role of Prosigne in the treatment of such conditions is of paramount importance, because botulinum toxin type A treatments have a huge economic implication in health services, especially in developing countries. The aim of our study was to compare the efficacy and safety of Prosigne in the treatment of blepharospasm and hemifacial spasm in comparison to Botox. We performed a double-blind, randomized, crossover study enrolling 26 patients. There were no significant differences between Prosigne and Botox regarding subjective global improvement, response onset, efficacy duration, and incidence and severity of adverse events. Our results suggest that Prosigne and Botox are comparable with respect to efficacy and safety for the short-term treatment of blepharospasm and hemifacial spasm.
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Affiliation(s)
- Carlos R M Rieder
- Department of Neurology, Hospital de Clínicas de Porto Alegre, Brazil.
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Brondani R, Rieder CRM, Valente D, Araújo LF, Clausell N. Levels of vascular cell adhesion molecule-1 and endothelin-1 in ischemic stroke: a longitudinal prospective study. Clin Biochem 2006; 40:282-4. [PMID: 17098218 DOI: 10.1016/j.clinbiochem.2006.09.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2006] [Revised: 08/29/2006] [Accepted: 09/23/2006] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To determine levels of vascular cellular adhesion molecule (VCAM)-1 and endothelin (ET)-1 in patients with stroke. DESIGN AND METHODS Thirty-four patients were prospectively studied. Plasma levels of VCAM-1 and ET-1 were measured by ELISA within 72 h of the event, at 7 and 90 days. RESULTS Levels of VCAM-1 increased overtime, whereas ET-1 values were initially and persistently elevated. CONCLUSIONS Increased circulating levels of VCAM-1 and ET-1 are present during stroke.
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Affiliation(s)
- Rosane Brondani
- Division of Neurology, Hospital de Clínicas de Porto Alegre, Graduate Program in Clinical Medicine, Universidade Federal do Rio Grande do Sul, RS, Brazil
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Schestatsky P, Zanatto VC, Margis R, Chachamovich E, Reche M, Batista RG, Fricke D, Rieder CRM. Quality of life in a Brazilian sample of patients with Parkinson's disease and their caregivers. Rev Bras Psiquiatr 2006; 28:209-11. [PMID: 17063221 DOI: 10.1590/s1516-44462006000300013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Accepted: 05/28/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: Parkinson's disease is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. METHOD: A cross-sectional study was performed in which quality of life was assessed by the WHOQOL-BREF questionnaire in 21 patients with Parkinson's disease and their respective caregivers. RESULTS: Significant differences between patients and caregivers were found in physical (p < 0.001) and psychological (p = 0.002) domains. In the Parkinson's disease group there was a significant inverse correlation between the psychological domain and duration of disease (p = 0.01), as well as between social domain and severity of disease (p = 0.001). There was a positive correlation between physical domain scores and number of people living in the same house (p = 0.02). The only significant finding in the group of caregivers was an inverse correlation between the social domain and the patients´ age (p = 0.04). CONCLUSION: Duration, severity of the disease and the number of people living in the same house were the most important predictors of quality of life of Parkinson's disease patients. The age of the patients was the only significant predictor found in the caregivers' quality of life. In order to complement our findings, further short-form questionnaires should be validated for Brazilian samples of Parkinson's disease.
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Affiliation(s)
- Pedro Schestatsky
- Department of Neurology, Medical School, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos 2600, 90035-003 Porto Alegre, RS, Brazil.
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Schestatsky P, Ehlers JA, Rieder CRM, Gomes I. Evaluation of sympathetic skin response in Parkinson's disease. Parkinsonism Relat Disord 2006; 12:486-91. [PMID: 16867313 DOI: 10.1016/j.parkreldis.2006.05.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2005] [Revised: 03/20/2006] [Accepted: 05/16/2006] [Indexed: 11/30/2022]
Abstract
There is no clear definition on the role of sympathetic skin response (SSR) in the evaluation of patients with Parkinson's disease (PD). We recorded the SSR of the palms of 64 controls and 46 patients with PD to electrical stimulation of the median nerve at the wrist. We analyzed onset latency and peak-to-peak amplitude. A study of parasympathetic function (R-R interval analysis) was also undertaken. We found that patients with PD had more absent SSRs than controls. The mean amplitude of the SSR was significantly reduced in both lower and upper limbs of PD patients in comparison with control subjects (p<0.001). The onset latency was longer in the lower limbs of these patients in respect to the control group (p<0.003). There was a significant inverse correlation between SSR amplitudes and age, severity and late onset of the disease. There was no association of these parameters with dysautonomic symptoms or R-R interval variation. In conclusion, there is a significant association between altered SSR and PD and an inverse correlation in this group of patients between SSR values and older age, greater severity and later onset of disease. Therefore, the study of SSR may provide valuable information on cholinergic sympathetic function in patients with PD.
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Affiliation(s)
- Pedro Schestatsky
- Programa de Pós-graduação em Medicina: Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Brazil.
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Trott A, Jardim LB, Ludwig HT, Saute JAM, Artigalás O, Kieling C, Wanderley HYC, Rieder CRM, Monte TL, Socal M, Alonso I, Ferro A, Carvalho T, do Céu Moreira M, Mendonça P, Ferreirinha F, Silveira I, Sequeiros J, Giugliani R, Saraiva-Pereira ML. Spinocerebellar ataxias in 114 Brazilian families: clinical and molecular findings. Clin Genet 2006; 70:173-6. [PMID: 16879203 DOI: 10.1111/j.1399-0004.2006.00656.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
We studied the sudomotor skin response (SSR) in patients with Parkinson's disease with and without symptomatic hyperhidrosis. The study was carried out in 13 patients who complained of excessive sweating and in 37 patients who did not have excessive sweating. Patients were matched for age, sex, degree of impairment, duration of the disease, and number and severity of autonomic disturbances. Excessive sweating involved mainly the face, head, and trunk. The SSR was recorded from the palm of the hands to electrical stimulation of the median nerve at the wrist. We analyzed onset latency, peak to peak amplitude, and waveform. Patients with hyperhidrosis had more often absent responses (chi(2) = 5.292; P = 0.021), their responses were of lower mean amplitude (analysis of variance [ANOVA]; F[2,101] = 11.678; P < 0.001), and they had a reduced number of responses with a predominantly negative component (chi(2) = 8.493; P = 0.004) than patients who did not complain of sweating disturbances. Our results indicate that excessive sweating in Parkinson's disease concurs with decreased activation of sweat glands in the palms of the hands and suggests that axial hyperhidrosis could be a compensatory phenomenon for reduced sympathetic function in the extremities.
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Affiliation(s)
- Pedro Schestatsky
- Unidade de EMG, Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre
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Tort ABL, Portela LVC, Rockenbach IC, Monte TL, Pereira ML, Souza DO, Rieder CRM, Jardim LB. S100B and NSE serum concentrations in Machado Joseph disease. Clin Chim Acta 2005; 351:143-8. [PMID: 15563883 DOI: 10.1016/j.cccn.2004.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2004] [Revised: 08/23/2004] [Accepted: 08/23/2004] [Indexed: 11/22/2022]
Abstract
BACKGROUND NSE and S100B are considered as neuronal and glial peripheral markers of central nervous system pathologies, respectively. We evaluated the potential use of S100B and NSE serum concentrations as peripheral markers of symptomatic patients with Machado Joseph disease (MJD). METHODS We measured S100B and NSE peripheral concentrations of 22 MJD patients and compared with healthy subjects concentrations. The correlations of both markers with CAG repeat size, age of onset, disease duration, and the scores of the Extended Disability Status Scale of Kurtzke, Unified Parkinson's Disease Rating Scale, and the Montgomery-Asberg depression rating scale were also assessed. RESULTS S100B serum concentrations between control and MJD subjects were not statistically different, whereas NSE serum concentrations were higher in MJD patients than in control subjects (p=0.00001). S100B presented a moderate correlation with disease duration and depression score, whereas NSE presented a moderate correlation with depression score and a good negative correlation with EDSS score. CONCLUSIONS Symptomatic MJD patients present increased concentrations of NSE and normal concentrations of S100B in blood.
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Affiliation(s)
- Adriano B L Tort
- Departamento de Bioquímica, ICBS, UFRGS, Ramiro Barcelos 2600 anexo, CEP 90035-003, Porto Alegre, Brazil.
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Abstract
Progressive multifocal leukoencephalopathy (PML) is caused by replication of JC virus in oligodendrocytes of immunocompromised patients. Common manifestations are focal motor and sensory deficits, gait abnormalities, speech and language disturbances, cognitive disorders, headache, and visual impairment. Although the occurrence of movement disorders is rare in PML, bradykinesia, rigidity, dystonia, myoclonic jerks and myoclonic ataxia have been described. Head tremor associated with PML has not been previously reported. We report two cases of PML in whom head tremor was present.
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Affiliation(s)
- Carlos R M Rieder
- Department of Neurology, Hospital de Clínicas, Porto Alegre, RS, Brazil.
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Schaf DV, Tort ABL, Fricke D, Schestatsky P, Portela LVC, Souza DO, Rieder CRM. S100B and NSE serum levels in patients with Parkinson's disease. Parkinsonism Relat Disord 2005; 11:39-43. [PMID: 15619461 DOI: 10.1016/j.parkreldis.2004.07.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2004] [Revised: 07/01/2004] [Accepted: 07/01/2004] [Indexed: 10/26/2022]
Abstract
We evaluated S100B protein and neuron-specific enolase (NSE) serum levels in Parkinson's disease (PD) patients and their correlation with the severity of disease. The levels of S100B (P=0.16) and NSE (P=0.39) between PD and controls were similar. However, S100B levels correlated positively with the Hoehn and Yahr scale (r=0.368; P=0.02) and negatively with the Activities of Daily Living (ADL) scale (r=-0.431; P=0.006). Therefore, S100B and NSE may not have a diagnostic role in PD, but S100B may have a potential role as a marker of disease progression. The study of S100B may also contribute to elucidate the controversial role of glial cells in PD.
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Affiliation(s)
- Débora V Schaf
- Departamento de Bioquímica, ICBS, UFRGS, Ramiro Barcelos 2600 - ANEXO, 90035-003 Porto Alegre, RS, Brazil
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Rieder CRM, dos Santos Souza MP, de Freitas RM, Fricke D. Superficial siderosis of the central nervous system associated with parkinsonism. Parkinsonism Relat Disord 2004; 10:443-5. [PMID: 15465404 DOI: 10.1016/j.parkreldis.2004.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2004] [Revised: 04/13/2004] [Accepted: 04/16/2004] [Indexed: 11/27/2022]
Affiliation(s)
- Carlos R M Rieder
- Department of Neurology, Movement Disorders Clinic, Hospital de Clínicas de Porto Alegre, RS, Brazil
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Ferraz HB, Quagliato EAB, Rieder CRM, Silva DJ, Teive HAG, Barbosa ER, Cardoso F, Limongi JCP, Bezerra JMF, Andrade LAF, Allam N, Prado RCP, Tomas V. Comments on the paper "High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson's disease patients. C.G. Coimbra and V.B.C. Junqueira. Brazilian Journal of Medical and Biological Research, 36: 1409-1417, 2003". Braz J Med Biol Res 2004; 37:1297-9; discussion 1299-302. [PMID: 15334194 DOI: 10.1590/s0100-879x2004000900002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- H B Ferraz
- Setor de Distúrbios do Movimento, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Rieder CRM, Williams AC, Ramsden DB. Selegiline increases heme oxygenase-1 expression and the cytotoxicity produced by dopamine treatment of neuroblastoma SK-N-SH cells. Braz J Med Biol Res 2004; 37:1055-62. [PMID: 15264013 DOI: 10.1590/s0100-879x2004000700015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Increased dopamine catabolism may be associated with oxidative stress and neuronal cell death in Parkinson's disease. The present study was carried out to examine the effect of dopamine on the expression of heme oxygenase-1 and -2 (HO-1 and HO-2) in human neuroblastomas (SK-N-SH cell line) and the effects of selegiline and antioxidants on this expression. Cells were kept with close control of pH and were incubated with varying concentrations of dopamine (0.1-100 microM) for 24 h. HO-1 and HO-2 cDNA probes were prepared by reverse transcription-polymerase chain reaction amplification. The mRNA expression of HO-1 and HO-2 was measured by Northern blot analysis. The levels of HO-1 mRNA increased after dopamine treatment, in a dose-dependent manner, in all cell lines studied, whereas levels of the two HO-2 transcripts did not. The HO-1 and HO-2 protein expression was analyzed by Western blotting. HO-1 protein was undetectable in untreated SK-N-SH cells and increased after treatment with dopamine. In contrast, the HO-2 protein (36 kDa) was detected in untreated cells and the levels did not change as a result of treatment. Alpha-tocopherol (10-100 microM) and ascorbic acid (100 microM) did not attenuate the effects of dopamine. Selegiline (10 microM) produced significant increase (P < 0.01) in the induction of HO-1 by dopamine (more than six times the control values). The increased expression of HO-1 following dopamine treatment indicates that dopamine produces oxidative stress in this cell line.
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Affiliation(s)
- C R M Rieder
- Departamento de Neurologia, Hospital de Cínicas de Porto Alegre, Porto Alegre, RS, Brazil.
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Rieder CRM, Rebouças RG, Ferreira MP. Holmes tremor in association with bilateral hypertrophic olivary degeneration and palatal tremor: chronological considerations. Case report. Arq Neuropsiquiatr 2003; 61:473-7. [PMID: 12894288 DOI: 10.1590/s0004-282x2003000300028] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hypertrophic olivary degeneration (HOD) is a rare type of neuronal degeneration involving the dento-rubro-olivary pathway and presents clinically as palatal tremor. We present a 48 year old male patient who developed Holmes' tremor and bilateral HOD five months after brainstem hemorrhage. The severe rest tremor was refractory to pharmacotherapy and botulinum toxin injections, but was markedly reduced after thalamotomy. Magnetic resonance imaging permitted visualization of HOD, which appeared as a characteristic high signal intensity in the inferior olivary nuclei on T2- and proton-density-weighted images. Enlargement of the inferior olivary nuclei was also noted. Palatal tremor was absent in that moment and appears about two months later. The delayed-onset between insult and tremor following structural lesions of the brain suggest that compensatory or secondary changes in nervous system function must contribute to tremor genesis. The literature and imaging findings of this uncommon condition are reviewed.
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Affiliation(s)
- Carlos R M Rieder
- Clínica de Distúrbios do Movimento, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
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Monte TL, Rieder CRM, Tort AB, Rockenback I, Pereira ML, Silveira I, Ferro A, Sequeiros J, Jardim LB. Use of fluoxetine for treatment of Machado-Joseph disease: an open-label study. Acta Neurol Scand 2003; 107:207-10. [PMID: 12614314 DOI: 10.1034/j.1600-0404.2003.02132.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
CONTEXT Machado-Joseph Disease (MJD/SCA3) is an autosomal dominant spinocerebellar degeneration that evolves to disability and death. Experimental data have shown that serotonin is an important cerebellar neurotransmitter and that impairment of the serotoninergic cerebellar system can induce cerebellar ataxia. OBJECTIVES To evaluate the efficacy of fluoxetine, a serotonin reuptake inhibitor, in treating neurologic dysfunction in patients with MJD. PATIENTS AND METHODS Thirteen MJD patients were treated with fluoxetine (20 mg/day) and were followed-up for 6 weeks. Outcome measures included functional capacity, standardized neurologic and cognitive ratings. The Montgomery-Asberg depression rating scale was used to control depressive symptoms. RESULTS There was no significant improvement in motor abilities after 6 weeks of treatment. CONCLUSIONS These results suggest that fluoxetine has no benefit in motor function of patients with MJD/SCA3.
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Affiliation(s)
- T L Monte
- Neurology, Hospital de Clínicas de Porto Alegre, Brazil
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