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Camerucci E, Lyons KE, Pahwa R. Predicting Depression in Parkinson's Disease Using Commonly Available PD Questionnaires. J Clin Med 2024; 13:2069. [PMID: 38610834 PMCID: PMC11012860 DOI: 10.3390/jcm13072069] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 02/05/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Depression is common in patients with Parkinson's disease (PD) and significantly impacts both the patients and their caregivers. The associations between depression and the responses from commonly used questionnaires for PD patients were assessed. New patients presenting to the Movement Disorder Center completed a number of questionnaires, including assessments of the motor and non-motor symptoms of PD, including depression. Methods: The PD patients were grouped according to severity of depression: none, mild, and moderate-severe, based on the Geriatric Depression Scale (GDS) scores. The mean scores of the Unified PD Rating Scale (UPDRS), Montreal Cognitive Assessment (MoCA), Epworth Sleepiness Scale (ESS), Non-motor Symptoms Scale (NMSS), PD Quality of life (PDQ-39), Hoehn and Yahr score (H&Y), levodopa equivalent daily dose (LEDD), and number of antidepressants used were collected. There were 1214 PD patients included. Results: Increasing depression scores were associated with worsening motor symptoms (according to the UPDRS and H&Y), non-motor symptoms (according to the NMSS), cognition (according to the MoCA), sleepiness (according to the ESS), and quality of life (according to the PDQ-39) (all p-values of p < 0.001). Only half of the patients with mild or moderate-severe depression were taking antidepressants, and the LEDD increased with depression severity. The risk of depression increased by 16% and 5% for every 1-point increase in the NMSS and PDQ-39 scores, respectively. Conclusions: Depression is often unrecognized and undertreated and should be assessed regularly in PD patients, especially in those who demonstrate changes in motor or non-motor symptoms.
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Affiliation(s)
- Emanuele Camerucci
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (K.E.L.)
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Camerucci E, Elder BD, Shu Y, Messina SA, Gunter JL, Graff-Radford J, Jones DT, Botha H, Cutsforth-Gregory JK, Jack CR, Huston J, Cogswell PM. Field strength difference in extent of artifacts induced by CERTAS Plus valves in patients with idiopathic normal pressure hydrocephalus. Neuroradiol J 2023; 36:665-673. [PMID: 37118867 PMCID: PMC10649542 DOI: 10.1177/19714009231173099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND AND PURPOSE : Post-shunt MRI is usually performed at 1.5T under the general assumption that shunt-related susceptibility artifacts would be greater at higher field strengths. PURPOSE The purpose is to show that imaging post-shunt idiopathic normal pressure hydrocephalus (iNPH) patients at 3T is feasible and with reduced artifacts as compared to 1.5T. METHODS We manually measured transverse dimensions of artifact at the levels of lateral ventricles, cerebral aqueduct, and cerebellar hemisphere. Areas/volumes of artifacts were calculated assuming an elliptic/ellipsoid shape. Relative extent of shunt-related artifact between field strengths was rated by 3 readers on a 5-point Likert scale. A Wilcoxon Signed Rank Test was used to compare artifact at 1.5T vs 3T for each sequence, with a significance level set at p < 0.05. RESULTS Artifact areas were calculated in 22 iNPH patients; artifacts were on average smaller at 3T vs 1.5T on MPRAGE, DWI, and GRE sequences. On T2 FLAIR and T2 FSE, artifacts at 3T were larger than 1.5T. On the qualitative analysis, artifact effects were less at 3T vs 1.5T on DWI, greater at 3T on T2 FSE, and had mixed results on GRE. CONCLUSION Our results indicate feasibility of post-shunt imaging with the CERTAS Plus valve at 3T based on shunt-related artifact that is less than or equal in extent to that on 1.5T on most standard clinical imaging sequences. Our findings, corroborated by the qualitative image review, suggest that dedicated clinical imaging sequences for devices may allow for reduction in artifact extent at both 1.5T and 3T.
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Affiliation(s)
| | - Benjamin D Elder
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Yunhong Shu
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - John Huston
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Shan X, Murphy MC, Sui Y, Camerucci E, Zheng K, Manduca A, Ehman RL, Huston J, Yin Z. Magnetic Resonance Elastography-Based Technique to Assess the Biomechanics of the Skull-Brain Interface: Repeatability and Age-Sex Characteristics. J Neurotrauma 2023; 40:2193-2204. [PMID: 37233723 PMCID: PMC10623075 DOI: 10.1089/neu.2022.0460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Increasing concerns have been raised about the long-term negative effects of subconcussive repeated head impact (RHI). To elucidate RHI injury mechanisms, many efforts have studied how head impacts affect the skull-brain biomechanics and have found that mechanical interactions at the skull-brain interface dampen and isolate brain motions by decoupling the brain from the skull. Despite intense interest, in vivo quantification of the functional state of the skull-brain interface remains difficult. This study developed a magnetic resonance elastography (MRE) based technique to non-invasively assess skull-brain mechanical interactions (i.e., motion transmission and isolation function) under dynamic loading. The full MRE displacement data were separated into rigid body motion and wave motion. The rigid body motion was used to calculate the brain-to-skull rotational motion transmission ratio (Rtr) to quantify skull-brain motion transmissibility, and the wave motion was used to calculate the cortical normalized octahedral shear strain (NOSS) (calculated based on a partial derivative computing neural network) to evaluate the isolation capability of the skull-brain interface. Forty-seven healthy volunteers were recruited to investigate the effects of age/sex on Rtr and cortical NOSS, and 17 of 47 volunteers received multiple scans to test the repeatability of the proposed techniques under different strain conditions. The results showed that both Rtr and NOSS were robust to MRE driver variations and had good repeatability, with intraclass correlation coefficient (ICC) values between 0.68 and 0.97 (fair to excellent). No age or sex dependence were observed with Rtr, whereas a significant positive correlation between age and NOSS was found in the cerebrum, frontal, temporal, and parietal lobes (all p < 0.05), but not in the occipital lobe (p = 0.99). The greatest change in NOSS with age was found in the frontal lobe, one of the most frequent locations of traumatic brain injury (TBI). Except for the temporal lobe (p = 0.0087), there was no significant difference in NOSS between men and women. This work provides motivation for utilizing MRE as a non-invasive tool for quantifying the biomechanics of the skull-brain interface. It evaluated the age and sex dependence and may lead to a better understanding of the protective role and mechanisms of the skull-brain interface in RHI and TBI, as well as improve the accuracy of computational models in simulating the skull-brain interface.
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Affiliation(s)
- Xiang Shan
- Department of Radiology and Mayo Clinic, Rochester, Minnesota, USA
| | | | - Yi Sui
- Department of Radiology and Mayo Clinic, Rochester, Minnesota, USA
| | | | - Keni Zheng
- Department of Radiology and Mayo Clinic, Rochester, Minnesota, USA
| | - Armando Manduca
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Richard L. Ehman
- Department of Radiology and Mayo Clinic, Rochester, Minnesota, USA
| | - John Huston
- Department of Radiology and Mayo Clinic, Rochester, Minnesota, USA
| | - Ziying Yin
- Department of Radiology and Mayo Clinic, Rochester, Minnesota, USA
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Piat C, Mullan AF, Stang CD, Hajeb M, Camerucci E, Turcano P, Martin PR, Bower JH, Savica R. Risk of hospitalization in synucleinopathies and impact of psychosis. Front Aging Neurosci 2023; 15:1274821. [PMID: 37810618 PMCID: PMC10557428 DOI: 10.3389/fnagi.2023.1274821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Background Few studies have investigated the risk of hospitalization among patients with synucleinopathies (Parkinson disease, Dementia with Lewy Bodies, Parkinson disease dementia, Multiple System Atrophy) with associated psychosis and the impact of antipsychotic treatments on hospital admissions and duration of the stay. Objective To determine the risk of hospitalization among patients with synucleinopathies and in patients with associated psychosis. To evaluate the impact of antipsychotic treatments on hospital admission of patients with synucleinopathies and psychosis in an incident cohort study in Olmsted County, Minnesota (MN). Methods We used the Rochester Epidemiology Project (REP) to define an incident cohort of patients with clinically diagnosed synucleinopathies (1991-2010) in Olmsted County, MN. A movement disorder specialist reviewed all medical records to confirm the clinical diagnosis of synucleinopathies using the NINDS/NIMH unified diagnostic criteria. Results We included 416 incident cases of clinically diagnosed synucleinopathies from 2,669 hospitalizations. 409 patients (98.3%) were admitted to the hospital at least once for any cause after the onset of parkinsonism. The median number of hospitalizations for a single patient was 5. In total, 195 (46.9%) patients met the criteria for psychosis: patients with psychosis had a 49% (HR = 1.49, p < 0.01) increased risk of hospitalization compared to patients without psychosis. Among patients with psychosis, 76 (39%) received antipsychotic medication. Treatment with antipsychotic medications did not affect the risk of hospitalization (HR = 0.93, p = 0.65). The median length of hospitalization among the entire cohort was 1 (IQR 0-4) day. There was no difference between hospitalization length for patients with no psychosis and patients with active psychosis (RR = 1.08, p = 0.43) or patients with resolved psychosis (RR = 0.79, p = 0.24). Conclusion Psychosis increases the risk of hospitalization in patients with clinically defined synucleinopathies; however, it does not affect the length of hospital stays in our cohort. Antipsychotic treatment does not affect the risk of hospitalization in our study.
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Affiliation(s)
- Capucine Piat
- Mayo Clinic Department of Neurology, Rochester, MN, United States
| | - Aidan F. Mullan
- Mayo Clinic Department of Health Sciences Research, Rochester, MN, United States
| | - Cole D. Stang
- Mayo Clinic Department of Neurology, Rochester, MN, United States
| | - Mania Hajeb
- Mayo Clinic Department of Neurology, Rochester, MN, United States
| | - Emanuele Camerucci
- Department of Neurology, Kansas University Medical Center, Kansas City, KS, United States
| | | | - Peter R. Martin
- Mayo Clinic Department of Health Sciences Research, Rochester, MN, United States
| | - James H. Bower
- Mayo Clinic Department of Neurology, Rochester, MN, United States
| | - Rodolfo Savica
- Mayo Clinic Department of Neurology, Rochester, MN, United States
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Camerucci E, Mullan AF, Bower JH, Bharucha AE, Turcano P, Stang CD, Benarroch EE, Boeve BF, Ahlskog JE, Savica R. Lifelong constipation in Parkinson's disease and other clinically defined alpha-synucleinopathies: A population-based study in Southeast Minnesota. Parkinsonism Relat Disord 2023; 107:105244. [PMID: 36630736 PMCID: PMC10262204 DOI: 10.1016/j.parkreldis.2022.105244] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Epidemiological studies show correlations between constipation and development of Parkinson's disease (PD); however, few studies have explored the association between constipation and dementia with Lewy bodies (DLB), Parkinson's disease dementia (PDD), and multiple system atrophy (MSA). We sought to explore the lifelong association of constipation and PD, DLB, PDD, and MSA (α-Synucleinopathies), compared to age- and sex-matched controls. METHODS Using the Rochester Epidemiology Project (REP), we established an incident cohort of clinically defined α-synucleinopathies. A movement-disorder specialist reviewed all medical charts to establish clinical diagnoses. RESULTS We identified 453 incident cases of clinically diagnosed α-synucleinopathies and an identical number of age- and sex-matched controls in Olmsted County (MN), 1991-2010. There were 303 cases of PD; 80, DLB; 54, PDD; and 16, MSA. Approximately 50% of α-synucleinopathies of all types reported constipation, compared to 27% in controls. The earliest pre-motor onset constipation was in DLB (median, 3.76 years prior to α-synucleinopathies motor-symptom onset); latest onset post-motor constipation was in PD (median, 5.15 years after motor-symptom onset). PD also had the highest longstanding constipation rate (18.2%). All α-synucleinopathies had higher odds of constipation compared to controls, except for MSA (p = 0.09), likely due to a limited sample size. CONCLUSION PD, DLB, and PDD had higher odds of constipation compared to controls; PD had the most widespread onset of lifelong constipation, both longstanding and pre- or post-motor onset symptoms. Our results indicate that constipation rates do not differ among α-synucleinopathies but do differ in terms of temporal onset compared to disease onset.
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Affiliation(s)
- Emanuele Camerucci
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; Department of Neurology, University of Kansas Medical Center (KUMC), Kansas City, MO, USA
| | - Aidan F Mullan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - James H Bower
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Adil E Bharucha
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | | | - Cole D Stang
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; University of Minnesota Medical School, Duluth, MN, USA
| | | | | | - J Eric Ahlskog
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
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McCarter SJ, Camerucci E, Mullan AF, Stang CD, Turcano P, St. Louis EK, Boeve BF, Savica R. Sleep Disorders in Early-Onset Parkinsonism: A Population-Based Study. J Parkinsons Dis 2023; 13:1175-1183. [PMID: 37742659 PMCID: PMC10657686 DOI: 10.3233/jpd-230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Sleep disturbances are common in parkinsonian disorders; however, whether sleep disorders affect individuals with early-onset parkinsonism and whether they differ from individuals with typical-onset parkinsonism is unknown. OBJECTIVE To compare the prevalence and incidence of sleep disorders before and after parkinsonian motor symptom onset between individuals with early onset parkinsonism (age ≤50 at motor symptom onset) and typical-onset parkinsonism (age >50 at motor symptom onset). METHODS We used a population-based, 1991 to 2015 incident-cohort study of parkinsonism including 38 patients with early-onset and 1,001 patients with typical-onset parkinsonism. Presence or absence and type of sleep disorder as well as the relationship between motor and sleep symptoms were abstracted from the medical records. Rates of sleep disorders before and after onset of parkinsonism were compared with logistic regression and Cox proportional hazards models. RESULTS The prevalence of sleep disorders prior to the onset of parkinsonism in early vs. typical parkinsonism (24% vs. 16% p = 0.19) and incidence of sleep disorders after parkinsonism onset (5.85 cases per 100 person-years vs. 4.11 cases per 100 person-years; HR 1.15 95% CI: 0.74-1.77) were similar between the two groups. Early-onset parkinsonism had a higher risk for developing post-motor insomnia compared with typical-onset parkinsonism (HR 1.73, 95% CI: 1.02-2.93); the risk for developing all other sleep disorders considered was similar between groups. CONCLUSION Sleep disorders are common in individuals with early-onset parkinsonism and occur with similar frequency to those with typical-onset parkinsonism, except for insomnia, which was more frequent in the early-onset group.
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Affiliation(s)
- Stuart J. McCarter
- Mayo Clinic Department of Neurology, Rochester, MN, USA
- Mayo Clinic Center for Sleep Medicine, Rochester, MN, USA
| | | | - Aidan F. Mullan
- Mayo Clinic Department of Quantitative Health Sciences, Rochester, MN, USA
| | - Cole D. Stang
- Mayo Clinic Department of Neurology, Rochester, MN, USA
| | | | - Erik K. St. Louis
- Mayo Clinic Department of Neurology, Rochester, MN, USA
- Mayo Clinic Center for Sleep Medicine, Rochester, MN, USA
| | | | - Rodolfo Savica
- Mayo Clinic Department of Neurology, Rochester, MN, USA
- Mayo Clinic Department of Quantitative Health Sciences, Rochester, MN, USA
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Camerucci E, Mullan AF, Turcano P, Bower J, Piat C, Ahlskog J, Savica R. 40-Year Incidence of Early-Onset Parkinson's Disease in Southeast Minnesota. J Parkinsons Dis 2023; 13:893-898. [PMID: 37522219 PMCID: PMC10578273 DOI: 10.3233/jpd-230049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Parkinson's disease (PD) most commonly surfaces at middle age. An earlier onset is named early-onset Parkinson's disease (EOPD), but the exact definition is a matter of ongoing scientific debate. OBJECTIVE To investigate 40-year EOPD incidence trends in a population-based cohort of parkinsonism in Olmsted County, Minnesota. METHODS We used the Rochester Epidemiology Project (REP) to identify all incident EOPD cases in Olmsted County, 1976-2015. A movement-disorder specialist reviewed all cases to confirm the EOPD diagnosis. For EOPD definition, we used two age cut-offs: motor-symptom onset at or before 50 and 55 years. RESULTS EOPD incidence was 1.43/100,000 person-years for ≤55 and 0.55/100,000 for ≤50 years. Men had a higher incidence in both groups [1.84 vs. 1.03 (p = 0.04); and 0.70 vs. 0.40 (p = 0.24), respectively]. EOPD incidence of patients with motor-symptom onset before age 55 increased from 1.02/100.000 person-year 1976-1985, to 1.32/100.000 person-year 2006-2015. A similar trend was observed when ≤50 years cut-off was used (0.28/100,000 person-years 1976-1985, to 0.59/100,000 person-year 2006-2015). However, negative binomial regression found no significant change in incidence per 10 years (RR = 1.04 and 1.24 in the two groups). Incidence was consistently higher in men than women. Median time from EOPD-symptom onset to death was shorter in the EOPD ≤55 group (21.9 years) compared to the EOPD ≤50 group (25.6 years). CONCLUSION We observed an increased trend in the incidence of EOPD with both cut-off ages. Overall, incidence of EOPD was 1.43 (≤55) and 0.55 (≤50) cases per 100,000 person-years, higher in men.
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Affiliation(s)
- Emanuele Camerucci
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Pierpaolo Turcano
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - James Bower
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Capucine Piat
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - J.E. Ahlskog
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- University of Kansas Medical Center, Kansas City, KS, USA
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Camerucci E, Mullan AF, Turcano P, Stang CD, Bower J, Savica R. 40-Year incidence of early-onset Parkinson's disease (EOPD) in Southeast Minnesota. Parkinsonism Relat Disord 2022; 104:64-67. [PMID: 36244163 DOI: 10.1016/j.parkreldis.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/23/2022] [Accepted: 09/07/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Parkinson's disease (PD) most commonly surfaces at middle age. Earlier onset is characterized as Early-onset Parkinson's disease (EOPD), but the exact definition has been a matter of ongoing scientific debate. We investigated 40-year EOPD incidence trends in a population-based cohort of parkinsonism in Olmsted County, MN. METHODS We used the Rochester Epidemiology Project (REP) to identify all incident EOPD cases in Olmsted County between 1976 and 2015. A movement-disorder specialist reviewed all cases to confirm the EOPD diagnosis. For EOPD definition, we used two age cut-offs: 50 and 55 years. RESULTS EOPD incidence was 1.43/100,000 person-years for ≤55 and 0.55/100,000 for ≤50 years. Men had a higher incidence than women in both groups [1.84 vs 1.03 (p = 0.04); and 0.70 vs 0.40 (p = 0.24), respectively]. EOPD incidence diagnosed before age 55 increased each decade: from 1.02/100.000 person-year 1976-1985, to 1.32/100.000 person-year 2006-2015. A similar trend was observed when ≤50 years of age cut off was used (0.28/100,000 person-years 1976-1985, to 0.59/100,000 person-year 2006-2015). Incidence was consistently higher in men than women. Median time from EOPD-symptoms onset to death was shorter in the EOPD ≤55 group (21.9 years) compared to the EOPD ≤50 group (25.6 years). CONCLUSION We observed an increased trend in the incidence of EOPD, both in ≤55 and ≤ 50 years of age. Overall, incidence of EOPD was 1.43 (≤55) and 0.55 (≤50) cases per 100,000 person-years, and although not significant, was higher in men than in women.
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Affiliation(s)
| | - Aidan F Mullan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Cole D Stang
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - James Bower
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.
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Camerucci E, Graff-Radford J, Jones DT, Elder BD, Gunter JL, Cutsforth-Gregory JK, Botha H, Murphy MC, Johnson DR, Davidge-Pitts C, Jack CR, Huston J, Cogswell PM. Change in Morphological Features of Enlarged Subarachnoid Spaces Following Treatment in Idiopathic Normal Pressure Hydrocephalus. J Magn Reson Imaging 2022; 57:1443-1450. [PMID: 35894392 DOI: 10.1002/jmri.28340] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 03/21/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Focally enlarged sulci (FES) are areas of proposed extraventricular fluid entrapment that may occur within idiopathic normal pressure hydrocephalus (iNPH) with radiographic evidence of disproportionately enlarged subarachnoid-space hydrocephalus (DESH), and should be differentiated from atrophy. PURPOSE To evaluate for change in FES size and pituitary height after shunt placement in iNPH. STUDY TYPE Retrospective. SUBJECTS A total of 125 iNPH patients who underwent shunt surgery and 40 age-matched controls. FIELD STRENGTH/SEQUENCE 1.5 T and 3 T. Axial T2w FLAIR, 3D T1w MPRAGE, 2D sagittal T1w. ASSESSMENT FES were measured in three dimensions and volume was estimated by assuming an ellipsoid shape. Pituitary gland height was measured in the mid third of the gland in iNPH patients and controls. STATISTICAL TESTS Wilcoxon signed-rank test for comparisons between MRI measurements; Wilcoxon rank sum test for comparison of cases/controls. Significance level was P < 0.05. RESULTS Fifty percent of the patients had FES. FES volume significantly decreased between the pre and first postshunt MRI by a median of 303 mm3 or 30.0%. Pituitary gland size significantly increased by 0.48 mm or 14.4%. FES decreased significantly by 190 mm3 or 23.1% and pituitary gland size increased significantly by 0.25 mm or 6% between the first and last postshunt MRI. DATA CONCLUSION Decrease in size of FES after shunt placement provides further evidence that these regions are due to disordered cerebrospinal fluid (CSF) dynamics and should not be misinterpreted as atrophy. A relatively smaller pituitary gland in iNPH patients that normalizes after shunt is a less-well recognized feature of altered CSF dynamics. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
| | | | - David T Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Benjamin D Elder
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Derek R Johnson
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Caroline Davidge-Pitts
- Department of Medicine, Division of Endocrinology, Diabetes, Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - John Huston
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Lucien F, Benarroch EE, Mullan A, Ali F, Boeve BF, Mielke MM, Petersen RC, Kim Y, Stang C, Camerucci E, Ross OA, Wszolek ZK, Knopman D, Bower J, Singer W, Savica R. Poly (ADP-Ribose) and α-synuclein extracellular vesicles in patients with Parkinson disease: A possible biomarker of disease severity. PLoS One 2022; 17:e0264446. [PMID: 35395000 PMCID: PMC8993007 DOI: 10.1371/journal.pone.0264446] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 02/10/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND/OBJECTIVE Despite multiple attempts, no surrogate biomarker of Parkinson disease (PD) has been definitively identified. Alternatively, identifying a non-invasive biomarker is crucial to understanding the natural history, severity, and progression of PD and to guide future therapeutic trials. Recent work highlighted alpha synuclein-containing extracellular vesicles and Poly (ADP-ribose) polymerase (PARP-1) activity as drivers of PD pathogenesis and putative PD biomarkers. This exploratory study evaluated the role of alpha-synuclein-positive extracellular vesicles and PARP-1 activity in the plasma of PD patients as non-invasive markers of the disease's severity and progression. METHODS We collected plasma of 57 PD patients (discovery cohort 20, replication cohort 37) and compared it with 20 unaffected individuals, 20 individuals with clinically diagnosed Alzheimer's disease, and 20 individuals with dementia with Lewy bodies. We analyzed alpha-synuclein-positive extracellular vesicles from platelet-free plasma by nanoscale flow cytometry and blood concentrations of poly ADP-ribose using sandwich ELISA kits. RESULTS Median concentration of α-synuclein extracellular vesicles was significantly higher in PD patients compared to the other groups (Kruskal-Wallis, p < .0001). In the discovery cohort, patients with higher α-synuclein extracellular vesicles had a higher Unified Parkinson Disease Rating Scale score (UPDRS III median = 22 vs. 5, p = 0.045). Seven out of 20 patients (35%) showed detectable PAR levels, with positive patients showing significantly higher levels of α-synuclein extracellular vesicles. In the replication cohort, we did not observe a significant difference in the PAR-positive cases in relationship with UPDRS III. CONCLUSIONS Non-invasive determination of α-synuclein-positive extracellular vesicles may provide a potential non-invasive marker of PD disease severity, and longitudinal studies are needed to evaluate the role of α-synuclein-positive extracellular vesicles as a marker of disease progression.
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Affiliation(s)
- Fabrice Lucien
- Department of Urology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Eduardo E. Benarroch
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Aidan Mullan
- Department of Health Science Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Farwa Ali
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Bradley F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Michelle M. Mielke
- Department of Health Science Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Ronald C. Petersen
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Yohan Kim
- Department of Urology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Cole Stang
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Emanuele Camerucci
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Owen A. Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Department of Clinical Genomics, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Zbigniew K. Wszolek
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, United States of America
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - James Bower
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Wolfgang Singer
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Health Science Research, Mayo Clinic, Rochester, Minnesota, United States of America
- * E-mail:
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11
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Camerucci E, Campeau NG, Trzasko JD, Gray EM, Bernstein MA, Cogswell PM, Shu Y, Foo TK, Huston J. Improved Brain MR Imaging from a Compact, Lightweight 3T Scanner with High-Performance Gradients. J Magn Reson Imaging 2022; 55:166-175. [PMID: 34184362 PMCID: PMC8806246 DOI: 10.1002/jmri.27812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND A low-cryogen, compact 3T (C3T) MRI scanner with high-performance gradients capable of simultaneously achieving 80 mT/m gradient amplitude and 700 T/m/second slew rate has been in use to study research patients since March 2016 but has not been implemented in the clinical practice. PURPOSE To compare head MRI examinations obtained with the C3T system and a conventional whole-body 3T (WB3T) scanner in seven parameters across five commonly used brain imaging sequences. STUDY TYPE Prospective. SUBJECTS Thirty patients with a clinically indicated head MRI. SEQUENCE 3T; T1 FLAIR, T1 MP-RAGE, 3D T2 FLAIR, T2 FSE, and DWI. ASSESSMENT All patients tolerated the scans well. Three board-certified neuroradiologists scored the comparative quality of C3T and WB3T images in blinded fashion using a five-point Likert scale in terms of: signal-to-noise ratio, lesion conspicuity, motion artifact, gray/white matter contrast, cerebellar folia, susceptibility artifact, and overall quality. STATISTICAL TEST Left-sided, right-sided, and two-sided Wilcoxon signed rank test; Fisher's method. A P value <0.05 was considered statistically significant. RESULTS The C3T system performed better than the WB3T in virtually all comparisons, except for motion artifacts for the T1 FLAIR and T1 MP-RAGE sequences, where the WB3T system was deemed better. When combining all sequences together, the C3T system outperformed the WB3T system in all image quality parameters evaluated, except for motion artifact (P = 0.13). DATA CONCLUSION The C3T scanner provided better overall image quality for all sequences, and performed better in all individual categories, except for motion artifact on the T1 FLAIR and T1 MP-RAGE. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
| | | | | | - Erin M. Gray
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Yunhong Shu
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - John Huston
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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12
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Stang CD, Mullan AF, Camerucci E, Hajeb M, Turcano P, Martin P, Mielke MM, Josephs KA, Splett M, Abler V, Boeve BF, Bower JH, Savica R. Incidence, Prevalence, and Mortality of Psychosis Associated with Parkinson's Disease (1991-2010). J Parkinsons Dis 2022; 12:1319-1327. [PMID: 35213389 PMCID: PMC9336204 DOI: 10.3233/jpd-213035] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Parkinson's disease (PD)-associated psychosis is a well-known non-motor complication, occurring years after diagnosis of PD. Incidence data vary across different studies highlighting a need for long-term observation and clinical definition. OBJECTIVE To determine the incidence of psychosis in patients with PD and to investigate their survival in an incident cohort study from 1991-2010 in Olmsted County, MN. METHODS We used the Rochester Epidemiology Project to define an incident-cohort study of parkinsonism (1991-2010) in Olmsted County, MN. A movement-disorder specialist reviewed the electronic medical records and applied diagnosis criteria to PD. Psychosis was diagnosed using of NINDS/NIMH unified criteria. RESULTS We identified 669 cases of parkinsonism; 297 patients were clinically diagnosed with PD. 114/297 (38.4%) patients had evidence of psychosis (60% male); the median onset age of psychosis was 79.4 years. The incidence of Parkinson's disease psychosis (PDP) was 4.28/100 person-years. PDP patients had a 71% increased risk of death compared to PD patients. In PD patients without psychosis, men had 73.4% increased risk of death compared to women, whereas no significant sex difference was observed among PDP men vs. women. Of 114 patients diagnosed with psychosis, 59 were treated with antipsychotics. There was no significant difference in survival between treated and untreated patients. CONCLUSION PDP increased the odds of death compared to PD patients. Men with PD without psychosis had greater odds of death compared to women; however, in PD with psychosis the odds of death were comparable among sexes. Lastly, treatment with anti-psychotics did not significantly affect survival.
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Affiliation(s)
- Cole D. Stang
- Mayo Clinic Department of Neurology, Rochester, Minnesota, USA
| | - Aidan F. Mullan
- Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota, USA
| | | | - Mania Hajeb
- Mayo Clinic Department of Neurology, Rochester, Minnesota, USA
| | | | - Peter Martin
- Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota, USA
| | - Michelle M. Mielke
- Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota, USA
| | | | | | - Victor Abler
- ACADIA Pharmaceuticals Inc., San Diego, California, USA
| | | | - James H. Bower
- Mayo Clinic Department of Neurology, Rochester, Minnesota, USA
| | - Rodolfo Savica
- Mayo Clinic Department of Neurology, Rochester, Minnesota, USA,Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota, USA,Corresponding Author: Rodolfo Savica, MD, PhD, Department of Neurology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, (507) 284-2120/
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13
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Camerucci E, Stang CD, Turcano P, Tipton PW, Bower JH, Hassan A, Klassen BT, Savica R. Deep Brain Stimulation and Treatment Outcomes of Young- and Late-Onset (≤55 Years) Parkinson's Disease: A Population-Based Study. Front Neurol 2021; 12:784398. [PMID: 34956065 PMCID: PMC8702827 DOI: 10.3389/fneur.2021.784398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: No studies have reported the rate of motor complications (MC) and response to medical and surgical treatment in a population-based cohort of young-onset Parkinson's Disease (YOPD) patients and a cohort of sex-matched late-onset Parkinson's Disease (LOPD). Objective: To assess the outcomes of dopaminergic treatment in YOPD and LOPD, explore treatment-induced MC, medical adjustment, and rate of deep brain stimulation (DBS). Methods: We used the expanded Rochester Epidemiology Project (eREP) to investigate a population-based cohort of YOPD between 2010 and 2015 in 7 counties in Minnesota. Cases with onset ≤55 years of age were included as YOPD. An additional sex-matched cohort of LOPD (onset at ≥56 years of age) was included for comparison. All medical records were reviewed to confirm the diagnoses. Results: In the seven counties 2010–15, there were 28 YOPD patients, which were matched with a LOPD cohort. Sixteen (57%) YOPD had MC, as compared to 9 (32%) LOPD. In YOPD, 9 had motor fluctuations (MF) and Levodopa-induced dyskinesia (LID) together, whereas 3 had LID only and 4 MF only. In LOPD, 3 had MF and LID, 3 MF only, and 3 LID only. Following medical treatment for MC, 6/16 YOPD (38%) and 3/9 (33%) LOPD had symptoms resolution. In YOPD, 11/16 (69%) were considered for DBS implantation, in LOPD they were 2/9 (22%), but only 7 (6 YOPD and 1 LOPD) underwent the procedure. YOPD had significantly higher rates in both DBS candidacy and DBS surgery (respectively, p = 0.03 and p = 0.04). Among DBS-YOPD, 5/6 (83%) had positive motor response to the surgery; the LOPD case had a poor response. We report the population-based incidence of both YOPD with motor complications and YOPD undergoing DBS, which were 1.17 and 0.44 cases per 100,000 person-years, respectively. Conclusion: Fifty-seven percent of our YOPD patients and 32% of the LOPD had motor complications. Roughly half of both YOPD and LOPD were treatment resistant. YOPD had higher rates of DBS candidacy and surgery. Six YOPD and 1 LOPD underwent DBS implantation and most of them had a positive motor response after the surgery.
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Affiliation(s)
| | - Cole D Stang
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Pierpaolo Turcano
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States
| | - Philip W Tipton
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - James H Bower
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Anhar Hassan
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Bryan T Klassen
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
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14
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Laporta ML, Kruthiventi SC, Stang CD, Camerucci E, Martin DP, Weingarten TN, Hanson AC, Schroeder DR, Warner DO, Savica R, Sprung J. Exposure to anesthesia is not associated with development of α-synucleinopathies: A nested case-control study. Parkinsonism Relat Disord 2021; 88:76-81. [PMID: 34147949 DOI: 10.1016/j.parkreldis.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Preclinical studies suggest that inhalational anesthetics may induce neuropathology changes in the nigrostriatal system, leading to development of α-synucleinopathies. We explored the role of general anesthesia in the development of Parkinson disease (PD) and other α-synucleinopathies. METHODS All α-synucleinopathy cases in Olmsted County, Minnesota, from January 1991, to December 2010, were identified from diagnostic codes, and then reviewed for type and index date of diagnosis. Cases were matched by sex and age (±1 year) to a referent control, a resident living in Olmsted County, and free of α-synucleinopathies before the index date (year of onset of the α-synucleinopathy). Medical records of both cases and controls were reviewed for lifetime exposure to anesthesia prior to the index date. RESULTS A total of 431 cases with clinically defined α-synucleinopathies were identified. Of these, 321 (74%) underwent 1,069 procedures under anesthesia before the diagnosis date, and in the control group, 341 (79%) underwent 986 procedures. When assessed as a dichotomous variable, anesthetic exposure was not significantly associated with α-synucleinopathies (odds ratio [OR], 0.75; 95% CI, 0.54-1.05; P=.094). No association was observed when anesthetic exposure was quantified by the number of exposures (OR, 0.64, 0.89, and 0.74, for 1, 2-3, and ≥4 exposures, respectively, compared to no exposure as the reference; P=.137) or quantified by the cumulative duration of exposure assessed as a continuous variable (OR, 1.00; 95% CI, 0.97-1.02 per 1-h increase of anesthetic exposure; P=.776). CONCLUSIONS We did not observe a significant association between exposure to general anesthesia and risk for the development of α-synucleinopathies.
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Affiliation(s)
- Mariana L Laporta
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - Cole D Stang
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - David P Martin
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Toby N Weingarten
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Andrew C Hanson
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, 55905, USA
| | - Darrell R Schroeder
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, 55905, USA
| | - David O Warner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Juraj Sprung
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
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15
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Camerucci E, Stang CD, Hajeb M, Turcano P, Mullan AF, Martin P, Ross OA, Bower JH, Mielke MM, Savica R. Early-Onset Parkinsonism and Early-Onset Parkinson's Disease: A Population-Based Study (2010-2015). J Parkinsons Dis 2021; 11:1197-1207. [PMID: 33720851 PMCID: PMC8355040 DOI: 10.3233/jpd-202464] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Early-onset Parkinson's disease (EOPD), occurring between ages 40 and 55, carries social, societal, and personal consequences and may progress, with fewer comorbidities than typical, later-onset disease. OBJECTIVE To examine the incidence and survival of EOPD and other Parkinsonism occurring before age 55 in the population-based cohort of residents in seven Minnesota counties. METHODS A movement-disorder specialist reviewed all the medical records in a 2010-2015 Parkinsonism-incident cohort to confirm diagnosis and subtypes. RESULTS We identified 27 patients diagnosed at ≤ 50 years with incident Parkinsonism 2010-15:11 (41%) cases of EOPD, 13 (48%) drug-induced Parkinsonism, and 3 (11%) other Parkinsonism; we also identified 69 incident cases of Parkinsonism ≤ 55 years, of which 28 (41%) were EOPD, 28 (41%) DIP, and 13 (19%) other Parkinsonism. Overall incidence for Parkinsonism ≤ 50 years was 1.98/100,000 person-years, and for EOPD was 0.81/100,000 person-years. In patients ≤ 55 years, Parkinsonism incidence was 5.05/100,000 person-years: in EOPD, 2.05/100,000 person-years. Levodopa-induced dyskinesia was present in 45%of EOPD (both ≤ 50 years and ≤ 55 years). Onset of cardinal motor symptoms was proximate to the diagnosis of EOPD, except for impaired postural reflexes, which occurred later in the course of EOPD. Among the 69 Parkinsonism cases ≤ 55 years, 9 (13%; all male) were deceased (only 1 case of EOPD). Men had a higher mortality risk compared to women (p = 0.049). CONCLUSION The incidence of EOPD ≤ 50 years was 0.81/100,000 person-years (1.98 in Parkinsonism all type); prior to ≤ 55 years was 2.05/100,000 person-years (5.05 in Parkinsonism all type) with higher incidence in men than women. Men with Parkinsonism, all type, had higher mortality compared to women.
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Affiliation(s)
| | - Cole D. Stang
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mania Hajeb
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Aidan F. Mullan
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Peter Martin
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Owen A. Ross
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
- Department of Clinical Genomics, Mayo Clinic, Jacksonville, Florida, USA
| | - James H. Bower
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle M. Mielke
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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16
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Stang CD, Mullan AF, Hajeb M, Camerucci E, Turcano P, Martin P, Mielke MM, Josephs KA, Bower JH, St Louis EK, Boeve BF, Savica R. Timeline of Rapid Eye Movement Sleep Behavior Disorder in Overt Alpha-Synucleinopathies. Ann Neurol 2020; 89:293-303. [PMID: 33155696 DOI: 10.1002/ana.25952] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim was to analyze the timeline, prevalence, and survival of rapid eye movement (REM) sleep behavior disorder (RBD) in patients who developed alpha-synucleinopathies (Parkinson disease, dementia with Lewy bodies, and Parkinson disease dementia) compared with age- and sex-matched controls in a population-based incident-cohort study. METHODS We used a population-based, 1991 to 2010 incident-cohort study of alpha-synucleinopathies. A movement-disorder specialist reviewed medical records to confirm diagnoses. RBD was diagnosed by reported dream-enactment symptoms or polysomnography. Probable RBD and polysomnographically confirmed RBD were analyzed separately and combined. RESULTS Among the 444 incident cases of alpha-synucleinopathy, 86 were clinically diagnosed with RBD (19.8%), including 30 (35%) by polysomnography and 56 (65%) as probable. The prevalence of idiopathic RBD at alpha-synucleinopathy diagnosis was 3.4%, increasing to 23.8% after 15 years. Cumulative lifetime incidence was 53 times greater in alpha-synucleinopathy patients than in controls (odds ratio [OR] = 53.1, 95% confidence interval [CI]: 13.0-217.2, p < 0.0001), higher in dementia with Lewy bodies than in Parkinson disease (OR = 2.57, 95% CI: 1.50-4.40, p = 0.0004), and higher in men than in women with Parkinson disease, dementia with Lewy bodies, or Parkinson disease dementia (OR = 3.70, 95% CI: 2.07-6.62, p < 0.0001), but did not increase mortality risk. INTERPRETATION Our cohort had RBD incidence of 3.4%. Overall RBD increased to 23.8% after 15 years, with an overall incidence of 2.5 cases per 100 person-years. With 53 times greater lifetime incidence in alpha-synucleinopathy patients than in controls, RBD was more likely to develop in dementia with Lewy bodies than in Parkinson disease or Parkinson disease dementia, and in men than in women, but did not increase mortality risk within our cohort. ANN NEUROL 2021;89:293-303.
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Affiliation(s)
- Cole D Stang
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Aidan F Mullan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Mania Hajeb
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Peter Martin
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Michelle M Mielke
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - James H Bower
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Erik K St Louis
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.,Division of Pulmonary and Critical Care Medicine, Mayo Center for Sleep Medicine, Rochester, MN, USA.,Mayo Clinic Health System, Skemp Franciscan Health, La Crosse, WI, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.,Division of Pulmonary and Critical Care Medicine, Mayo Center for Sleep Medicine, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
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17
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Plutino A, Camerucci E, Ranaldi V, Baldinelli S, Fiori C, Silvestrini M, Luzzi S. Insight in frontotemporal dementia and progressive supranuclear palsy. Neurol Sci 2020; 41:2135-2142. [PMID: 32128648 DOI: 10.1007/s10072-020-04290-z] [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: 11/07/2019] [Accepted: 02/10/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Progressive supranuclear palsy (PSP) and behavioural variant frontotemporal dementia - (bv-FTD) share common neuropsychological features except for online monitoring awareness. Therefore, the aim of our study is to explore if this assessment could be used in standard clinical practice. MATERIALS AND METHODS We retrospectively analyse 93 subjects (27 FTD, 25 PSP, 42 healthy controls). Neuropsychological and instrumental examinations were performed for each patient. RESULTS FTD patients made fewer self-corrections than PSP patients despite a similar number of total errors. We also performed ROC curves: the area under the curve (AUC) is 0.79. A model for a logistic regression was also developed: the only significant predictor is the number of self-corrections (p = 0.004 β = 1244). DISCUSSION AND CONCLUSIONS In conclusion, our findings show online awareness is more compromised in FTD patients than in PSP patients. This difference could be useful for making a differential diagnosis between the two diseases: for each extra point in number of self-corrections the probability of suffering from PSP increases by about three and a half times (OR 3.47).
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Affiliation(s)
- Andrea Plutino
- Neurological Clinic, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy.
| | - Emanuele Camerucci
- Neurological Clinic, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Valentina Ranaldi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Sara Baldinelli
- Neurological Clinic, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Chiara Fiori
- Neurological Clinic, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Mauro Silvestrini
- Neurological Clinic, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Simona Luzzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
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