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Woitalla D, Buhmann C, Hilker-Roggendorf R, Höglinger G, Koschel J, Müller T, Weise D. Correction to: Role of dopamine agonists in Parkinson's disease therapy. J Neural Transm (Vienna) 2023:10.1007/s00702-023-02695-6. [PMID: 37702775 DOI: 10.1007/s00702-023-02695-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Affiliation(s)
- D Woitalla
- Department of Neurology, Katholische Kliniken Der Ruhrhalbinsel, Essen, Germany.
| | - C Buhmann
- Department of Neurology, Universitätsklinikum Hamburg, Hamburg, Germany
| | | | - G Höglinger
- Department of Neurology, Medizinische Hochschule Hannover, Hannover, Germany
| | - J Koschel
- Department of Neurology Parkinson-Klinik Ortenau, Wolfach, Germany
| | - T Müller
- Department of Neurology, Alexianer St. Joseph Krankenhaus, Berlin, Germany
| | - D Weise
- Department of Neurology, Asklepios Fachklinikum Stadtroda, Stadtroda, Germany
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Woitalla D, Buhmann C, Hilker-Roggendorf R, Höglinger G, Koschel J, Müller T, Weise D. Role of dopamine agonists in Parkinson's disease therapy. J Neural Transm (Vienna) 2023; 130:863-873. [PMID: 37165120 DOI: 10.1007/s00702-023-02647-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/27/2023] [Indexed: 05/12/2023]
Abstract
Dopamine agonists are an important component of Parkinson's therapy. When weighing up the various therapy options, therapy with levodopa has recently been increasingly preferred due to its stronger efficacy and the ostensibly lower rate of side effects. The advantage of the lower incidence of motor complications during therapy with dopamine agonists was neglected. The occurrence of side effects can be explained by the different receptor affinity to the individual dopaminergic and non-dopaminergic receptors of the individual dopamine agonists. However, the different affinity to individual receptors also explains the different effect on individual Parkinson symptoms and can, therefore, contribute to a targeted use of the different dopamine agonists. Since comparative studies on the differential effect of dopamine agonists have only been conducted for individual substances, empirical knowledge of the differential effect is of great importance. Therefore, the guidelines for the treatment of Parkinson's disease do not consider the differential effect of the dopamine agonists. The historical consideration of dopamine agonists within Parkinson's therapy deserves special attention to be able to classify the current discussion about the significance of dopamine agonists.
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Affiliation(s)
- D Woitalla
- Department of Neurology, Katholische Kliniken Der Ruhrhalbinsel, Essen, Germany.
| | - C Buhmann
- Department of Neurology, Universitätsklinikum Hamburg, Hamburg, Germany
| | | | - G Höglinger
- Department of Neurology, Medizinische Hochschule Hannover, Hannover, Germany
| | - J Koschel
- Department of Neurology Parkinson-Klinik Ortenau, Wolfach, Germany
| | - T Müller
- Department of Neurology, Alexianer St. Joseph Krankenhaus, Berlin, Germany
| | - D Weise
- Department of Neurology, Asklepios Fachklinikum Stadtroda, Stadtroda, Germany
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Csoti I, Herbst H, Urban P, Woitalla D, Wüllner U. Polypharmacy in Parkinson’s disease: risks and benefits with little evidence. J Neural Transm (Vienna) 2019; 126:871-878. [DOI: 10.1007/s00702-019-02026-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/01/2019] [Indexed: 12/27/2022]
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Richter D, Woitalla D, Muhlack S, Gold R, Tönges L, Krogias C. EPV 1. Coronal examination plane in transcranial sonography improves the discrimination between Parkinson’s disease and essential tremor. Additional benefits by sonographic determination of the tremor frequency. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Recke A, Oei A, Hübner F, Fechner K, Graf J, Hagenah J, May C, Woitalla D, Salmen A, Zillikens D, Gold R, Schlumberger W, Schmidt E. Parkinson disease and multiple sclerosis are not associated with autoantibodies against structural proteins of the dermal-epidermal junction. Br J Dermatol 2016; 175:407-9. [PMID: 26972435 DOI: 10.1111/bjd.14538] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A Recke
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - A Oei
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - F Hübner
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - K Fechner
- Institute of Experimental Immunology, Euroimmun Inc., Lübeck, Germany
| | - J Graf
- Departments of Neurology, University of Lübeck, Lübeck, Germany
| | - J Hagenah
- Departments of Neurology, University of Lübeck, Lübeck, Germany
| | - C May
- Medizinisches Proteom-Center, Ruhr-Universität Bochum, Bochum, Germany
| | - D Woitalla
- Department of Neurology, Katholische Kliniken Ruhrhalbinsel GmbH, Essen, Germany
| | - A Salmen
- Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - R Gold
- Department of Neurology, St. Josef Hospital, Ruhr-University, Bochum, Germany
| | - W Schlumberger
- Institute of Experimental Immunology, Euroimmun Inc., Lübeck, Germany
| | - E Schmidt
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
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Buhmann C, Bass H, Hahne M, Jost W, Redecker C, Schwarz M, Woitalla D. Das idiopathische Parkinson-Syndrom an der Grenze von ambulanter zu stationärer Versorgung. Fortschr Neurol Psychiatr 2016; 84 Suppl 1:S36-40. [DOI: 10.1055/s-0042-103325] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- C. Buhmann
- Neurologische Klinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - H. Bass
- Privatärztliches Zentrum, Frankfurt
| | - M. Hahne
- Neurologische Klinik, Klinik GmbH Bad Neustadt
| | - W. Jost
- Parkinson-Klinik Ortenau, Wolfach
| | - C. Redecker
- Neurologische Klinik, Universitätsklinikum Jena
| | - M. Schwarz
- Neurologische Klinik, Klinikum Dortmund gGbmH, Dortmund
| | - D. Woitalla
- Neurologische Klinik, Katholische Kliniken Ruhrhalbinsel, Essen
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Kerasnoudis A, Pitarokoili K, Woitalla D, Gold R, Yoon MS. P189. Sarcoid neuropathy: Correlation of nerve ultrasound, electrophysiological and clinical findings. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kerasnoudis A, Woitalla D, Gold R, Pitarokoili K, Yoon MS. Sarcoid neuropathy: Correlation of nerve ultrasound, electrophysiological and clinical findings. J Neurol Sci 2014; 347:129-36. [DOI: 10.1016/j.jns.2014.09.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 09/15/2014] [Accepted: 09/19/2014] [Indexed: 01/17/2023]
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Klucken J, Herting B, Hilker R, Schulz J, Vieregge P, Woitalla D, Wolz M, Reichmann H. Parkinson-Syndrom(e) - Neue Konzepte für eine sich ausbreitende Erkrankung? Akt Neurol 2013. [DOI: 10.1055/s-0033-1349432] [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] [Indexed: 10/26/2022]
Affiliation(s)
- J. Klucken
- Molekulare Neurologie, Universitätsklinikum Erlangen
| | - B. Herting
- Klinik für Neurologie und Gerontoneurologie, Diakonie-Klinikum Schwäbisch Hall
| | - R. Hilker
- Klinik für Neurologie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt
| | - J. Schulz
- Neurologische Klinik, Universitätsklinikum der RWTH Aachen
| | - P. Vieregge
- Klinik für Neurologie, Klinikum Lippe-Lemgo GmbH
| | - D. Woitalla
- Neurologische Klinik, Universitätsklinikum der Ruhr-Universität Bochum
| | - M. Wolz
- Klinik für Neurologie, Elblandklinikum Meißen
| | - H. Reichmann
- Klinik und Poliklinik für Neurologie, Carl Gustav Carus Universität Dresden
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Goehler H, Kowald A, Turewicz M, Stephan C, Meyer HE, Lueking A, Schottstedt V, Woitalla D, Hoffmann R, Gold R, Saft C. F08 The autoimmune profile of Huntington's disease patients: a pilot study. J Neurol Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Woitalla D, Goetze O. Treatment approaches of gastrointestinal dysfunction in Parkinson's disease, therapeutical options and future perspectives. J Neurol Sci 2011; 310:152-8. [PMID: 21798561 DOI: 10.1016/j.jns.2011.06.050] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 06/15/2011] [Accepted: 06/27/2011] [Indexed: 12/14/2022]
Abstract
Gastrointestinal (GI) dysfunction is a common but underestimated feature in Parkinson's disease (PD). Out of the multimodal spectrum of treatment options, there currently are only a few pharmacological treatments available to improve gastrointestinal motility and symptoms. Because enteric nervous function is mainly regulated by transmitters different from those involved in the brain, dopamine replacement is not a treatment option in PD patients. This article focuses on the known regulative mechanism of GI function and presents known and upcoming treatment options for GI dysfunction in PD.
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Affiliation(s)
- D Woitalla
- Department of Neurology, St. Josef Hospital, Ruhr-University-Bochum, Germany.
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Abstract
BACKGROUND German health politicians claim that maintenance and thus quality of life (QoL) of patients with chronic disease do not differ between the various healthcare insurance systems in Germany. Patient organizations i.e. the Deutsche Parkinson Vereinigung for patients with Parkinson's disease (PD), physicians, patients themselves and their carers controversially discuss this opinion making by politicians. METHODS We performed a survey to analyse the relations between QoL, insurance, disability and caregiver burden in 2603 patients with PD and their carers. RESULTS Insurance with private reimbursement provides a significant better self-reported patient disability and QoL according to the various employed rating instruments in patients with PD. Government employees with PD, who have additional private insurance, demand for significant shorter intervals of care giving by their carers. In general, caregiver burden did not significantly differ between patients with PD of the different healthcare insurance systems. CONCLUSION At least in Germany, obligatory medical insurance with associated state regulation of health care is inferior to private reimbursement insurance in various domains of QoL.
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Affiliation(s)
- T Müller
- Department of Neurology, St Josef Hospital, Ruhr University Bochum, Gudrunstrasse, Bochum, Germany.
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Woitalla D, Braak H, Del Tredici K, Fogel W, Hagenah J, Oertel W, Berg D. [Transcraniel ultrasound in the differential diagnosis of Parkinson's disease]. Fortschr Neurol Psychiatr 2010; 78 Suppl 1:S25-30. [PMID: 20195938 DOI: 10.1055/s-0029-1245167] [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] [Indexed: 10/19/2022]
Abstract
Imaging of the brain structure with transcranial ultrasound has become an important tool for the diagnosis and differential diagnosis of Parkinson's Disease. In up to 90 % of parkinsonian patients abnormal echogenity of the substantia nigra could be demonstrated. Particularly in the early diagnosis in subjects with only very mild extrapyramidal features and in the differential diagnosis to other neurodegenerative disorders with parkinsonian features, such as the parkinsonian variant of multisystematrophy (MSA-P) and progressive supranuclear paralysis (PSP) ultrasound has a high diagnostic yield. Because of a prevalence of about 10 % in the normal population, the evidence of an abnormal echogenity of the substantia nigra has to be interpreted carefully in the context of a clinical examination. Although there are a number of studies indicating that in some of these subjects a vulnerability of the nigrostriatal system can be found, the meaning of an abnormal echogenicity of the substantia nigra in the healthy population needs to be further elucidated in already ongoing research projects.
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Affiliation(s)
- D Woitalla
- Neurologische Universitätsklinik der Ruhr-Universität Bochum im St. Josef Hospital, Bochum.
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Timmermann L, Pauls KAM, Wieland K, Jech R, Kurlemann G, Sharma N, Gill SS, Haenggeli CA, Hayflick SJ, Hogarth P, Leenders KL, Limousin P, Malanga CJ, Moro E, Ostrem JL, Revilla FJ, Santens P, Schnitzler A, Tisch S, Valldeoriola F, Vesper J, Volkmann J, Woitalla D, Peker S. Dystonia in neurodegeneration with brain iron accumulation: outcome of bilateral pallidal stimulation. ACTA ACUST UNITED AC 2010; 133:701-12. [PMID: 20207700 PMCID: PMC2842517 DOI: 10.1093/brain/awq022] [Citation(s) in RCA: 160] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Neurodegeneration with brain iron accumulation encompasses a heterogeneous group of rare neurodegenerative disorders that are characterized by iron accumulation in the brain. Severe generalized dystonia is frequently a prominent symptom and can be very disabling, causing gait impairment, difficulty with speech and swallowing, pain and respiratory distress. Several case reports and one case series have been published concerning therapeutic outcome of pallidal deep brain stimulation in dystonia caused by neurodegeneration with brain iron degeneration, reporting mostly favourable outcomes. However, with case studies, there may be a reporting bias towards favourable outcome. Thus, we undertook this multi-centre retrospective study to gather worldwide experiences with bilateral pallidal deep brain stimulation in patients with neurodegeneration with brain iron accumulation. A total of 16 centres contributed 23 patients with confirmed neurodegeneration with brain iron accumulation and bilateral pallidal deep brain stimulation. Patient details including gender, age at onset, age at operation, genetic status, magnetic resonance imaging status, history and clinical findings were requested. Data on severity of dystonia (Burke Fahn Marsden Dystonia Rating Scale-Motor Scale, Barry Albright Dystonia Scale), disability (Burke Fahn Marsden Dystonia Rating Scale-Disability Scale), quality of life (subjective global rating from 1 to 10 obtained retrospectively from patient and caregiver) as well as data on supportive therapy, concurrent pharmacotherapy, stimulation settings, adverse events and side effects were collected. Data were collected once preoperatively and at 2-6 and 9-15 months postoperatively. The primary outcome measure was change in severity of dystonia. The mean improvement in severity of dystonia was 28.5% at 2-6 months and 25.7% at 9-15 months. At 9-15 months postoperatively, 66.7% of patients showed an improvement of 20% or more in severity of dystonia, and 31.3% showed an improvement of 20% or more in disability. Global quality of life ratings showed a median improvement of 83.3% at 9-15 months. Severity of dystonia preoperatively and disease duration predicted improvement in severity of dystonia at 2-6 months; this failed to reach significance at 9-15 months. The study confirms that dystonia in neurodegeneration with brain iron accumulation improves with bilateral pallidal deep brain stimulation, although this improvement is not as great as the benefit reported in patients with primary generalized dystonias or some other secondary dystonias. The patients with more severe dystonia seem to benefit more. A well-controlled, multi-centre prospective study is necessary to enable evidence-based therapeutic decisions and better predict therapeutic outcomes.
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Affiliation(s)
- L Timmermann
- Klinik und Poliklinik für Neurologie, Uniklinik Köln, Kerpener Str. 62, 50924 Köln, Germany.
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Woitalla D, Götze O. Der Gastrointestinaltrakt in der Parkinson-Therapie. Akt Neurol 2009. [DOI: 10.1055/s-0029-1220456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Goetze O, Woitalla D. The role of MPTP in Parkinson's disease: Connecting brain and gut? Exp Neurol 2008; 210:281-5. [DOI: 10.1016/j.expneurol.2008.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Revised: 12/13/2007] [Accepted: 01/03/2008] [Indexed: 10/22/2022]
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Müller T, Götze O, Woitalla D. Gastrointestinale Störungen bei Morbus Parkinson. Akt Neurol 2007. [DOI: 10.1055/s-2007-970907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gerlach M, Hendrich A, Hueber R, Jost W, Riederer P, Winkler J, Woitalla D. Potenzielle Biomarker der Parkinsonkrankheit. Akt Neurol 2007. [DOI: 10.1055/s-2007-970928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Müller T, Ander L, Kolf K, Woitalla D, Muhlack S. Comparison of 200 mg retarded release levodopa/carbidopa – with 150 mg levodopa/carbidopa/entacapone application: pharmacokinetics and efficacy in patients with Parkinson’s disease. J Neural Transm (Vienna) 2007; 114:1457-62. [PMID: 17564755 DOI: 10.1007/s00702-007-0773-x] [Citation(s) in RCA: 16] [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: 01/09/2007] [Accepted: 05/22/2007] [Indexed: 11/28/2022]
Abstract
The interval of line tracing performance is more associated to basal ganglia function due to the dependence on bradykinesia and rigidity. The other component of this task, the precision of execution of complex movement sequences, is more related to attention. We compared the motor response after once dosing of 200 mg retarded release LD (levodopa)/CD (carbidopa) and of 150 mg LD/CD/EN (entacapone) by rating of motor symptoms, by measurement of LD- and 3-O-methyldopa (3-OMD) plasma concentrations and by the outcomes of a line tracing task. Thirteen treated patients with Parkinson's disease (PD) took one of the two tested LD formulations on two consecutive days under randomised, double blind, identical standardised conditions. No significant differences appeared regarding rated motor response and LD plasma concentrations, but 3-OMD only significantly went up after LD/CD intake. LD/CD/EN was superior to LD/CD regarding the attention related components of line tracing probably due to a hypothetically increased dopamine occurrence at the prefrontal cortex, which guides human behaviour.
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Affiliation(s)
- T Müller
- St. Josef Hospital, Department of Neurology, Ruhr University Bochum, Bochum, Germany.
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Müller T, Woitalla D, Russ H, Hock K, Haeger DA. Prevalence and treatment strategies of dyskinesia in patients with Parkinson's disease. J Neural Transm (Vienna) 2007; 114:1023-6. [PMID: 17417738 DOI: 10.1007/s00702-007-0718-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [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: 02/13/2007] [Accepted: 03/07/2007] [Indexed: 10/23/2022]
Abstract
A study into the prevalence and treatment of dyskinesia in Parkinson's disease (PD) patients was performed with 380 PD specialists' completed interviews relating to PD and retrospectively completed 1900 patient record forms for patients with dyskinesia. Physicians reported, that 34% of their PD patients experience dyskinesia, 57% of dyskinetic PD patients were affected by moderately-to-completely disabling dyskinesia. Treatment of dyskinesia was looked upon as not satisfactory, fractionating of levodopa dose was used as first choice therapeutic option of dyskinesia.
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Affiliation(s)
- T Müller
- Department of Neurology, St Josef Hospital, Ruhr University, Bochum, Germany.
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Woitalla D, Müller T. Medikamentöse Therapie des Parkinson-Syndroms in Deutschland. Ergebnisse der nationalen Umfrage. Akt Neurol 2007. [DOI: 10.1055/s-2007-987908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schlitter AM, Woitalla D, Mueller T, Epplen JT, Dekomien G. The LRRK2 gene in Parkinson's disease: mutation screening in patients from Germany. J Neurol Neurosurg Psychiatry 2006; 77:891-2. [PMID: 16788020 PMCID: PMC2117481 DOI: 10.1136/jnnp.2005.083022] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Franck T, Krueger R, Woitalla D, Müller T, Engelender S, Riess O. Mutation analysis of the seven in absentia homolog 1 (SIAH1) gene in Parkinson’s disease. J Neural Transm (Vienna) 2006; 113:1903-8. [PMID: 16752048 DOI: 10.1007/s00702-006-0480-z] [Citation(s) in RCA: 11] [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: 08/10/2005] [Accepted: 02/25/2006] [Indexed: 11/26/2022]
Abstract
Seven in absentia homolog 1 (SIAH-1) is a member of the RING-finger-containing E3 ubiquitin ligases. Two substrates of SIAH-1 are alpha-synuclein and synphilin-1, both of these proteins are involved in Parkinson's disease (PD). Recently, mutations in Parkin, another E3 ubiquitin ligase which ubiquinates synphilin-1 and glycosylated alpha-synuclein, have been defined as a major cause of autosomal recessive PD. The potential role of SIAH-1 in PD is further underlined as SIAH-1 protein is a component of the Lewy bodies and as it plays a role in apoptosis caused by nitric oxide (NO) induced oxidative stress. Thus, we performed a mutation screening of the SIAH-1 gene in PD patients. However, screening a large sample of 209 familial and sporadic PD patients we could not find any disease causing mutation. We therefore conclude that genetic alterations of SIAH-1 do not significantly contribute to the pathogenesis of PD.
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Affiliation(s)
- T Franck
- Department of Medical Genetics, University of Tuebingen, Tuebingen, Germany
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Abstract
Predictors of gastric emptying (GE) in patients with idiopathic Parkinson's disease (PD) of a solid and liquid meal are not well defined. For measurement of GE 80 patients with PD were randomly assigned to receive either a solid meal (250 kcal) containing 13C-octanoate (n = 40) or a liquid meal (315 kcal) with 13C-acetate (n = 40). All patient groups were off medication affecting motility and were matched for age, gender, body mass index, disease duration and severity, using Unified Parkinson's Disease Rating Scale (UPDRS). Gastric emptying was compared with a healthy control group (n = 40). Multiple regression analysis was used to determine predictors of gastric emptying. Exactly 88% and 38% of PD patients had delayed GE of solids and liquids respectively. Solid and liquid emptying was similar in women and men. There were no differences in GE in PD patients < 65 years of age when compared with patients > or = 65 years. Multiple regression analysis showed that motor handicaps such as rigour and action tremor are independent predictors of solid GE (r = 0.68, P < 0.001). The severity of motor impairment, but not any other neurological symptom, as assessed by UPDRS is associated with gastroparesis in PD and solid emptying is more likely to be delayed.
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Affiliation(s)
- O Goetze
- Department of Medicine I, St Josef-Hospital, Ruhr-University of Bochum, Bochum, Germany.
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Müller T, Erdmann C, Muhlack S, Bremen D, Przuntek H, Goetze O, Woitalla D. Pharmacokinetic behaviour of levodopa and 3-O-methyldopa after repeat administration of levodopa/carbidopa with and without entacapone in patients with Parkinson's disease. J Neural Transm (Vienna) 2006; 113:1441-8. [PMID: 16604302 DOI: 10.1007/s00702-006-0442-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [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: 03/15/2005] [Accepted: 12/20/2005] [Indexed: 11/28/2022]
Abstract
Addition of the catechol-O-methyltransferase (COMT) inhibitor entacapone (EN) prolongs plasma metabolism of levodopa (LD). Objectives were to determine the clinical response after EN addition and the plasma degradation of LD and 3-O-methyldopa [3-OMD]. Not optimum treated hospitalised patients with Parkinson's disease received the same LD dosage on the first day only with carbidopa (CD) and on the second day with CD and EN (t.i.d.) within a standardised setting. We scored motor symptoms and measured LD- and 3-OMD levels on both days at fixed moments. Motor impairment significant better improved probably due to significant higher maximum concentrations [C(max)] and computed area under the curve values of LD levels during the LD/CD/EN condition. Time to C(max) of LD was significantly delayed after the first two LD/CD/EN intakes. An impact of EN on 3-OMD levels appeared. A possibly augmented LD absorption and a prolonged LD metabolism after EN supplementation may contribute to a more continuous LD delivery to the brain.
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Affiliation(s)
- T Müller
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
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Schlitter AM, Kurz M, Larsen JP, Woitalla D, Müller T, Epplen JT, Dekomien G. Parkin gene variations in late-onset Parkinson's disease: comparison between Norwegian and German cohorts. Acta Neurol Scand 2006; 113:9-13. [PMID: 16367892 DOI: 10.1111/j.1600-0404.2005.00532.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 11/28/2022]
Abstract
OBJECTIVES Mutations in the Parkin gene can cause autosomal recessive early-onset Parkinson's disease (PD). Recently, Parkin mutations were also suggested to play a role in the commoner late-onset forms of PD. METHODS We compared a German cohort of PD patients (95) with a Norwegian cohort of PD patients (96). Both cohorts have predominant late-onset form of PD. Mutation and polymorphism frequencies were compared via single-strand conformation polymorphism and sequence analyses. RESULTS Three heterozygous missense mutations (Arg256Cys, Arg402Cys and Thr240Met) were found in late-onset PD patients in the German patient cohort (1.6%). A missense mutation (Arg402Cys) was also found in one of 149 healthy control subjects (0.3%). Only one heterozygous missense mutation (Arg256Cys) was identified in a Norwegian patient suffering from late-onset PD (0.5%). The frequencies of four known single nucleotide polymorphisms significantly differ between the two distant European populations. CONCLUSION The results support the hypothesis that heterozygous mutations in the Parkin gene may act as susceptibility alleles for late-onset forms of PD in rare cases.
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Affiliation(s)
- A M Schlitter
- Department of Human Genetics, Ruhr-University Bochum, 44780 Bochum, Germany
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Müsch P, Konietzka S, Woitalla D, Przuntek H, Muhlac S. Effizienz von schnell löslichem Amantadinsulfat auf einfache und komplexe Bewegungen. Akt Neurol 2005. [DOI: 10.1055/s-2005-866698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Erdmann C, Muhlack S, Bremen D, Woitalla D, Przuntek H. Die Effizienz von Levodopa/Carbidopa/Entacapone auf komplexe Bewegungsabläufe bei Parkinson-Patienten. Akt Neurol 2005. [DOI: 10.1055/s-2005-866678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bauer P, Bob A, Mäckle-Jentsch I, Berg D, Woitalla D, Müller T, Berger K, Krüger R, Rieß O. Mutationssuche im Pael-Rezeptor-Gen bei Parkinson-Patienten. Akt Neurol 2005. [DOI: 10.1055/s-2005-866627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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31
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Voß B, Hellwig K, Stein FJ, Woitalla D, Przuntek H. Behandlungserfolg und tägliche Medikamentenkosten in Spezialkliniken für Morbus Parkinson. Akt Neurol 2005. [DOI: 10.1055/s-2005-866617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Glass AS, Huynh DP, Franck T, Woitalla D, Müller T, Pulst SM, Berg D, Krüger R, Riess O. Screening for mutations in synaptotagmin XI in Parkinson's disease. J Neural Transm Suppl 2004:21-8. [PMID: 15354386 DOI: 10.1007/978-3-7091-0579-5_3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Parkinson's disease (PD) is characterized by selective degeneration of neurons in the substantia nigra and subsequent dysfunction of dopaminergic neurotransmission. Genes identified in familial forms of PD encode proteins that are linked to the ubiquitin-proteasome system indicating the pathogenic relevance of disturbed protein degradation in PD. Some of them, i.e. alpha-synuclein, parkin and synphilin-1, have been implicated in presynaptic neurotransmission based on their localization in synaptic vesicles. Synaptotagmin XI is linked to the pathogenesis of PD based on its identification as a substrate of the ubiquitin-E3-ligase parkin. Moreover synaptotagmin XI is involved in the maintainance of synaptic function and represents a component of Lewy bodies (LB) in brains of PD patients. Therefore, we performed a detailed mutation analysis of the synaptotagmin XI gene in a large sample of 393 familial and sporadic PD patients. We did not find any disease causing mutations arguing against a major role of mutations in the synaptotagmin XI gene in the pathogenesis of PD.
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Affiliation(s)
- A S Glass
- Department of Medical Genetics, University of Tübingen, Tübingen, Germany
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Abstract
Instrumental assessment of movements with a computer based device reflect the clinical response of patients with Parkinson's disease (PD) to dopaminergic stimulation. We investigated associations between levodopa plasma levels, scored motor symptoms of upper limbs and instrumental test outcomes after dopaminergic stimulation. Clinical rating scores, test outcomes for simple and complex motion series significantly improved after oral application of 250 mg of a water soluble, fast absorbed levodopa/benserazide preparation, which induced a significant increase of levodopa in plasma during a two hour interval. There was a significant association between the computed area under the curve-values of levodopa plasma concentrations and test results for simple-, but not for complex movement sequences. Performance of complex motion series additionally ask for concomitant cognitive efforts with consecutive hypothetical involvement of extranigral non dopaminergic systems. In contrast, practice of simple movements is more directly associated to the predominantly dopamine regulated motor system.
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Affiliation(s)
- S Muhlack
- Department of Neurology, St Josef Hospital, Ruhr University, Bochum, Germany
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Duan Y, Lipkovich I, Ahmed S, Ahl J, Hardy T, Haldane D, Baker R, Tohen M, Liu-Seifert H, Healey K, Kinon BJ, Ahmed S, Lipkovich IA, Tohen MF, Hoffmann V, Ding D, Frank E, Shi L, Shin J, Novick D, Berg P, Ascher-Svanum H, Haro JM, Gasquet I, Tziveleskis S, Blandini F, Armentero MT, Fancellu R, Nappi G, White D, Jensen M, Arnason B, Frank S, Kieburtz K, Holloway R, Wilson R, Zimmerman C, Kim S, Elm JJ, Tilley BC, Palesch YY, Guimaraes P, Goetz C, Ravina B, Keiburtz K, Leventer SM, Raudibaugh K, Keogh JC, Kucharik RF, O’Hara D, Ye N, Galbraith K, Speicher B, Keim KL, Atri A, Lopresti ML, Sherman SJ, Schendan HE, Hasselmo ME, Stern CE, Jankovic J, Hunter C, Vuong KD, Horowski R, Beneš H, Woitalla D, Przuntek H, Tack J, Uhl G, Bennett JP, Villarete LH, Liu CP, Weiner HL, Tong MJ, Rassoulpour A, Wu HQ, Guidetti P, Scharfman HE, McKhann GM, Goodman RR, Bertram EH, Schwarcz R, Bibbiani F, Kielaite A, Costantini L, Chase T, Avila I, Oh JD, Castañeda E, Smith CPS, Chase TN, Wang X, Andringa G, Bara-Jimenez W, Encarnacio E, Morris M, Bridgeman A, Bennett C, Thomas M, Ashizawa T, Weickert T, Goldberg T, Mishara A, Apud J, Kolachana B, Egan M, Weinberger D. Abstracts from ASENT 2004 Annual Meeting March 11–13, 2004. NeuroRx 2004. [DOI: 10.1602/neurorx.1.4.506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Hering R, Petrovic S, Mietz EM, Holzmann C, Berg D, Bauer P, Woitalla D, Müller T, Berger K, Krüger R, Riess O. Extended mutation analysis and association studies ofNurr1(NR4A2) in Parkinson disease. Neurology 2004; 62:1231-2. [PMID: 15079038 DOI: 10.1212/01.wnl.0000118285.18383.90] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- R Hering
- Department of Medical Genetics, Hertie Institute of Clinical Brain Research, University of Tübingen, Germany
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Woitalla D, Kuhn W, Müller T. MTHFR C677T polymorphism, folic acid and hyperhomocysteinemia in levodopa treated patients with Parkinson’s disease. Focus on Extrapyramidal Dysfunction 2004:15-20. [PMID: 15354385 DOI: 10.1007/978-3-7091-0579-5_2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Certain mutations (TT homozygous; CT heterozygous; CC wild-type) of the methylenetetrahydrofolate (MTHFR) gene and long-term levodopa application in patients with Parkinson's disease (PD) support onset of hyperhomocysteinemia. Total plasma homocysteine (t-hcys) depends on B6, B12, folic acid, all of which support remyelination from t-hcys to methionine. Objective of this trial were to compare B6, B12, folic acid and t-hcys levels in plasma of 83 levodopa treated PD patients and 44 controls. PD patients with the CT or TT genotype had significant higher t-hcys levels than controls or PD patients with the CC allele. Concentrations of B6 or B12 did not differ, but folic acid was significant higher in PD patients with the CT mutation. We recommend MTHFR genotyping, t-hcys monitoring and early vitamin supplementation in PD patients. The folic acid increase in PD patients with the CT allele is hypothetically due to an endogenous upregulation of folic acid absorption to decrease t-hcys.
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Affiliation(s)
- D Woitalla
- Department of Neurology, St Josef Hospital, Ruhr University, Bochum, Germany
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37
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Müller T, Benz S, Börnke C, Muhlack S, Woitalla D, Przuntek H. Worsened motor test performance following acute apomorphine injection in previously untreated patients with Parkinson’s disease. Focus on Extrapyramidal Dysfunction 2004:79-87. [PMID: 15354392 DOI: 10.1007/978-3-7091-0579-5_9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Instrumental tests and clinical rating assess motor disability in Parkinson's disease (PD) patients. Previous long-term dopaminergic substitution influences the behaviour following acute dopaminergic stimulation. Objective of this study was to investigate the motor response following an apomorphine application in previously untreated-, treated- and before treated PD patients, who received placebo. Outcomes of instrumental tests worsened in previously untreated-, but not in before treated PD patients after apomorphine injection and in the PD subjects under the placebo condition. Generally, rating scores of motor symptoms significantly improved after apomorphine administration, whereas placebo application showed no effects. Tolerance to sedative effects of apomorphine in treated PD patients or sensitivity of employed motor tests to presynaptic dopaminergic autoreceptor mediated inhibition of endogenous dopamine release or postsynaptic dopaminergic overstimulation with resulting decreased cognitive function in previously untreated PD patients hypothetically caused this discrepancy between outcomes of subjective clinical rating and objective motor test performance.
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Affiliation(s)
- Th Müller
- Department of Neurology, St Josef Hospital, Ruhr University, Bochum, Germany.
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Abstract
Transdermal delivery of dopamine agonists (DA) is a promising therapeutic concept, which aims to ameliorate frequency and intensity of motor fluctuations in patients with Parkinson's disease (PD). We treated 8 PD patients with unpredictable on-off phenomena with lisuride patches (release: 2-5 microg lisuride base/cm2/hour in mice) in addition to their preexisting antiparkinsonian drug regime up to a period of 8 days. In order to quantify the intensity and frequency of motor fluctuations, we determined the motor changing rate (MCR), which corresponds to the patient's self rating of motor function, performed every thirty minutes, divided through the number of scored intervals minus 1. Additional lisuride patch application significantly (p = 0.023) improved the MCR compared to baseline. Relevant side effects were transient skin irritations in four patients. Our observational study demonstrates the safety, tolerability and efficacy of transdermal lisuride delivery in the treatment of motor complications.
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Affiliation(s)
- D Woitalla
- Department of Neurology, St Josef Hospital, Ruhr University Bochum, Germany.
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Woitalla D, M�ller T, Benz S, Horowski R, Przuntek H. Transdermal lisuride delivery in the treatment of Parkinson?s disease. J Neural Transm (Vienna) 2003. [DOI: 10.1007/s00702-003-0050-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sprengelmeyer R, Young AW, Mahn K, Schroeder U, Woitalla D, Büttner T, Kuhn W, Przuntek H. Facial expression recognition in people with medicated and unmedicated Parkinson's disease. Neuropsychologia 2003; 41:1047-57. [PMID: 12667540 DOI: 10.1016/s0028-3932(02)00295-6] [Citation(s) in RCA: 215] [Impact Index Per Article: 10.2] [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: 11/16/2022]
Abstract
Recognition of facial expressions of emotion was investigated in people with medicated and unmedicated Parkinson's disease (PD) and matched controls (unmedicated PD, n=16; medicated PD, n=20; controls, n=40). Participants in the medicated group showed some visual impairment (impaired contrast sensitivity) and performed less well on perception of unfamiliar face identity, but did not show significant deficits in the perception of sex, gaze direction, or familiar identity from the face. For both Parkinson's disease groups, there was evidence of impaired recognition of facial expressions in comparison to controls. These deficits were more consistently noted in the unmedicated group, who were also found to perform worse than the medicated group at recognising disgust from prototypical facial expressions, and at recognising anger and disgust in computer-manipulated images. Although both Parkinson's disease groups showed impairments of facial expression recognition, the consistently worse recognition of disgust in the unmedicated group is consistent with the hypothesis from previous studies that brain regions modulated by dopaminergic neurons are involved in the recognition of disgust.
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Affiliation(s)
- R Sprengelmeyer
- Neurologische Universitätsklinik im St. Josef-Hospital, Ruhr-Universität Bochum, Gudrunstrasse 56, D-44791 Bochum, Germany.
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Sprengelmeyer R, Young A, Mahn K, Schroeder U, Woitalla D, Büttner T, Kuhn W, Przuntek H. Corrigendum to “Facial expression recognition in people with medicated and unmedicated Parkinson’s disease” [Neuropsychologia 41 (2003) 1047–1057]. Neuropsychologia 2003. [DOI: 10.1016/s0028-3932(03)00094-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Studies on progression of Parkinson's disease (PD) mainly focus on the nigrostriatal dopaminergic decline, but not on the visual system. We determined progression of (i) disturbed color vision, assessed with the Farnsworth-Munsell 100 Hue test (FMT) and (ii) intensity of PD in 18 patients. Significant differences occurred between (i) initial FMT error scores and follow-up results 3 years later (P=0.002) and analogously (ii) scored intensity of PD (P=0.002). A relation between computed differences of FMT error scores and rated activities of daily living appeared. Deterioration of color vision progresses in PD.
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Affiliation(s)
- T Müller
- Department of Neurology, St Josef-Hospital, Ruhr-University of Bochum, 44791 Bochum, Germany.
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Abstract
One main metabolizing pathway of levodopa is O-methylation to 3-O-methyldopa (3-OMD) by catechol-O-methyltransferase (COMT). Since COMT requires Mg2+ and S-adenosylmethionine as methyl donor for this transmethylating process, COMT converts S-adenosylmethionine to S-adenosylhomocysteine and subsequent homocysteine. Objective of this study was to demonstrate relations between plasma levodopa, 3-OMD and total homocysteine in treated parkinsonian subjects. We measured homocysteine, levodopa and 3-OMD by HPLC. We compared plasma homocysteine in two groups of treated parkinsonian subjects subdivided according to their 3-OMD level. Homocysteine was significantly (p = 0.002) elevated in the group with higher 3-OMD concentrations and positively (r = 0.52, p = 0.0006) correlated to 3-OMD. Homocysteine induces vascular disease. Previous studies showed an increase of ischaemic heart- and cerebrovascular disease in treated parkinsonian patients.
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Affiliation(s)
- Th Müller
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Federal Republic of Germany.
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Krüger R, Schöls L, Müller T, Kuhn W, Woitalla D, Przuntek H, Epplen JT, Riess O. Evaluation of the gamma-synuclein gene in German Parkinson's disease patients. Neurosci Lett 2001; 310:191-3. [PMID: 11585599 DOI: 10.1016/s0304-3940(01)02127-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 11/20/2022]
Abstract
Mutations in the alpha-synuclein gene are responsible for an autosomal-dominantly inherited form of Parkinson's disease (PD) and alpha-synuclein was found to be the major component of Lewy bodies in PD. Because of the high homology to alpha-synuclein and the abundance in neuronal tissues, we investigated the gamma-synuclein gene in PD. We analyzed 262 German PD patients and 179 healthy German controls via two polymorphisms in the gamma-synuclein gene. No significant differences in the allelic or genotypic distributions of the investigated polymorphisms were observed between patients and controls. In addition no evidence for an increased risk of combined genotypes of polymorphisms in the gamma-synuclein and the alpha-synuclein gene was found. Therefore, our results do not support a major role of the gamma-synuclein gene in PD.
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Affiliation(s)
- R Krüger
- Department of Neurology, Ruhr-University, St. Josef-Hospital, Bochum, Germany.
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Müller T, Woitalla D, Hauptmann B, Fowler B, Kuhn W. Decrease of methionine and S-adenosylmethionine and increase of homocysteine in treated patients with Parkinson's disease. Neurosci Lett 2001; 308:54-6. [PMID: 11445284 DOI: 10.1016/s0304-3940(01)01972-3] [Citation(s) in RCA: 58] [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: 10/18/2022]
Abstract
Levodopa is administered with dopa decarboxylase inhibitors (DDI) to prevent its peripheral degradation. This increases conversion of levodopa to 3-O-methyldopa (3-OMD) by catechol-O-methyltransferase (COMT). S-adenosylmethionine (SAM), which is synthesized from adenosine triphosphate and methionine (MET), serves as methyl donor for this O-metabolisation of levodopa with resulting conversion of SAM to total homocysteine (tHcy) via S-adenosylhomocysteine (SAH). Previous studies showed augmented plasma levels of tHcy in long-term levodopa/DDI-treated patients with Parkinson's disease (PP). Objective of this study was to compare MET, SAM, levodopa, 3-OMD, tHcy and SAH in plasma of 20 levodopa/DDI treated PP and corresponding controls. A significant decrease of MET respectively SAM and an increase of tHcy appeared in PP. SAH with its short half-life did not differ. Levodopa/DDI long-term treatment contributes to altered levels of substrates of the O-methylation cycle in PP.
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Affiliation(s)
- T Müller
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Gudrunstrasse 56, D-44791, Bochum, Germany.
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Krüger R, Kuhn W, Leenders KL, Sprengelmeyer R, Müller T, Woitalla D, Portman AT, Maguire RP, Veenma L, Schröder U, Schöls L, Epplen JT, Riess O, Przuntek H. Familial parkinsonism with synuclein pathology: Clinical and PET studies of A30P mutation carriers. Neurology 2001; 56:1355-62. [PMID: 11376188 DOI: 10.1212/wnl.56.10.1355] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The authors identified the second known mutation in the alpha-synuclein(SNCA) gene, an alanine-to-proline exchange in amino acid position 30 (A30P), that cosegregates with the disease in one German family with autosomal dominantly inherited parkinsonism (ADP). The authors studied carriers of the A30P mutation to compare the phenotype of this mutation with idiopathic PD (IPD) and to assess nigrostriatal dopaminergic function in symptomatic and preclinical mutation carriers. METHODS The pedigree of the A30P family spans five generations with five affected individuals. The authors performed detailed neurologic examinations followed by mutation analysis in 11 living individuals. In three mutation carriers, two individuals with definite PD and one person at risk for PD, they used L-[18]F-fluoro-3,4-dihydroxyphenylalanine (F-DOPA), [11]C-raclopride (RAC), and [18]F-fluorodeoxyglucose (FDG) PET to investigate presynaptic dopaminergic function, dopamine D2 receptors, and cerebral energy metabolism. The authors studied the cognitive functions of carriers of the A30P mutation using neuropsychological screening. RESULTS PET studies revealed striatal presynaptic dopaminergic alterations consistent with sporadic IPD in two affected family members and no evidence for nigrostriatal dopaminergic dysfunction in one presymptomatic mutation carrier. Neuropsychological testing in four mutation carriers provided evidence for cognitive impairment as a frequent and early symptom of the A30P mutation; this is also supported by regional cerebral energy metabolism alterations in the clinically presymptomatic subject. CONCLUSIONS The phenotype of the A30P mutation in the SNCA gene is similar to that of sporadic IPD, including a high variability of the age at disease onset, ranging from 54 to 76 years. The follow-up of presymptomatic carriers of the A30P mutation may give insight into preclinical disease stages and early manifestations of PD.
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Affiliation(s)
- R Krüger
- Department of Neurology, St. Josef-Hospital, Ruhr-University, Bochum, Germany.
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Krüger R, Hardt C, Tschentscher F, Jäckel S, Kuhn W, Müller T, Werner J, Woitalla D, Berg D, Kühnl N, Fuchs GA, Santos EJ, Przuntek H, Epplen JT, Schöls L, Riess O. Genetic analysis of immunomodulating factors in sporadic Parkinson's disease. J Neural Transm (Vienna) 2001; 107:553-62. [PMID: 11072751 DOI: 10.1007/s007020070078] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Immunomodulating factors have been shown to play a role in the pathogenesis of Parkinson's disease (PD) by biochemical methods. In order to investigate functionally important genes of the tumor necrosis factor alpha (TNFalpha) pathway we studied the frequency of DNA polymorphisms in the interleukin 6 (IL6), the TNFalpha, and the TNFalpha receptor 1 (TNFR1) genes in 264 sporadic German PD patients and in 183 age and sex matched German healthy controls. Analyzing the TNFalpha-308 polymorphism we found heterozygous individuals carrying alleles 1 and 2 more frequently in patients with a relative risk of 1.56 (p = 0.046, p(c) = 0.13, chi2 = 3.98). In contrast, the frequency of the B/2 haplotype described by the TNFR1-609 and TNFRI+36 polymorphisms was significantly decreased in our PD patients group (p = 0.0097, p(c) = 0.048, chi2 = 6.69) with a relative risk reduced to 0.52. Our results suggest an involvement of immunomodulating factors in the pathogenesis of sporadic PD as revealed by a molecular genetic approach.
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Affiliation(s)
- R Krüger
- Department of Molecular Human Genetics, University of Würzburg, Federal Republic of Germany.
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Kuhn W, Hummel T, Woitalla D, Müller T. Plasma homocysteine and MTHFR C677T genotype in levodopa-treated patients with PD. Neurology 2001; 56:281; author reply 281-2. [PMID: 11271164] [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: 02/19/2023] Open
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Brattstrom L, Kuhn W, Hummel T, Woitalla D, Muller T, Yasui K, Kowa H, Nakaso K, Takeshima T, Nakashima K. Plasma homocysteine and MTHFR C677T genotype in levodopa-treated patients with PD. Neurology 2001. [DOI: 10.1212/wnl.56.2.281] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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