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Kegelmeyer DA, Kostyk SK, Fritz NE, Scharre DW, Young GS, Tan Y, Schubert R, Reilmann R, Kloos AD. Immediate effects of treadmill walking in individuals with Lewy body dementia and Huntington's disease. Gait Posture 2021; 86:186-191. [PMID: 33756407 DOI: 10.1016/j.gaitpost.2021.03.016] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 01/11/2021] [Accepted: 03/07/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Treadmill training may improve gait disorders associated with neurodegenerative diseases. In Parkinson's disease (PD), treadmill training alters gait patterns after one session, and long-term training improves gait parameters, fall risk, and quality of life. RESEARCH QUESTION What is the feasibility and safety of using this intervention for people with Lewy body dementia (LBD) or Huntington's disease (HD)? METHODS In this observational study, 10 individuals with HD, 8 individuals with LBD, and 10 control individuals walked for 20 min on a treadmill using a speed dependent protocol starting at a slow comfortable speed and increasing incrementally toward their normal overground speed. Feasibility was determined by compliance to protocol and safety by no incidents of abnormal vital signs or expressions of distress. Changes in gait measures, Timed Up and Go (TUG) scores and quantitative motor function measures (Q-Motor; precision grasp force variability, finger and foot tapping frequency) before and after treadmill walking were analyzed using linear models. RESULTS Treadmill training is feasible and safe in LBD and HD; although, participants could not initiate treadmill walking at their comfortable overground speeds, and only 3 participants with HD were able to achieve their overground walking speed within the 20-minute session. No changes in gait measures, TUG times, and Q-Motor measures were found among LBD and HD participants after treadmill walking, although control participants demonstrated significant increases in several gait measures, and foot tap frequency (estimated difference = 0.290; p = 0.026). SIGNIFICANCE Longer and more frequent treadmill sessions may be needed to see gait and motor function effects in LBD and HD. Motor and cognitive impairments associated with these diseases may make them less amenable to the effects of treadmill training.
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Affiliation(s)
- Deb A Kegelmeyer
- The Ohio State University, College of Medicine, Division of Physical Therapy, Columbus, OH, United States.
| | - Sandra K Kostyk
- The Ohio State University, College of Medicine, Department of Neurology, Columbus, OH, United States; The Ohio State University, College of Medicine, Department of Neuroscience, Columbus, OH, United States.
| | - Nora E Fritz
- The Ohio State University, College of Medicine, Division of Physical Therapy, Columbus, OH, United States.
| | - Douglas W Scharre
- The Ohio State University, College of Medicine, Department of Neurology, Columbus, OH, United States.
| | - Gregory S Young
- The Ohio State University, Center for Biostatistics, Columbus, OH, United States.
| | - Yubo Tan
- The Ohio State University, Center for Biostatistics, Columbus, OH, United States.
| | | | - Ralf Reilmann
- George Huntington Institute, Technology Park, Germany; Dept. of Radiology, University of Muenster, Muenster, Germany; Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.
| | - Anne D Kloos
- The Ohio State University, College of Medicine, Division of Physical Therapy, Columbus, OH, United States.
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Lassen LB, Reimer L, Ferreira N, Betzer C, Jensen PH. Protein Partners of α-Synuclein in Health and Disease. Brain Pathol 2018; 26:389-97. [PMID: 26940507 DOI: 10.1111/bpa.12374] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [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: 11/06/2015] [Revised: 01/04/2016] [Accepted: 01/11/2016] [Indexed: 12/30/2022] Open
Abstract
α-synuclein is normally situated in the nerve terminal but it accumulates and aggregates in axons and cell bodies in synucleinopathies such as Parkinson's disease. The conformational changes occurring during α-synucleins aggregation process affects its interactions with other proteins and its subcellular localization. This review focuses on interaction partners of α-synuclein within different compartments of the cell with a focus on those preferentially binding aggregated α-synuclein. The aggregation state of α-synuclein also affects its catabolism and we hypothesize impaired macroautophagy is involved neuronal excretion of α-synuclein species responsible for the prion-like spreading of α-synuclein pathology.
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Affiliation(s)
- Louise Berkhoudt Lassen
- DANDRITE-Danish Research Institute of Translational Neuroscience & Department of Biomedicine, University of Aarhus, Aarhus, Denmark
| | - Lasse Reimer
- DANDRITE-Danish Research Institute of Translational Neuroscience & Department of Biomedicine, University of Aarhus, Aarhus, Denmark
| | - Nelson Ferreira
- DANDRITE-Danish Research Institute of Translational Neuroscience & Department of Biomedicine, University of Aarhus, Aarhus, Denmark
| | - Cristine Betzer
- DANDRITE-Danish Research Institute of Translational Neuroscience & Department of Biomedicine, University of Aarhus, Aarhus, Denmark
| | - Poul Henning Jensen
- DANDRITE-Danish Research Institute of Translational Neuroscience & Department of Biomedicine, University of Aarhus, Aarhus, Denmark
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Ko WKD, Bezard E. Experimental animal models of Parkinson's disease: A transition from assessing symptomatology to α-synuclein targeted disease modification. Exp Neurol 2017; 298:172-179. [PMID: 28764902 DOI: 10.1016/j.expneurol.2017.07.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 07/28/2017] [Indexed: 12/13/2022]
Abstract
With the understanding that α-synuclein plays a major role in the pathogenesis of Parkinson's disease (PD), novel animal models have been developed for conducting preclinical research in screening novel disease modifying therapies. Advancements in research techniques in α-synuclein targeted disease modification have utilised methods such as viral mediated expression of human α-synuclein, as well as the inoculation of pathogenic α-synuclein species from Lewy Bodies of PD patients, for accurately modelling progressive self-propagating neurodegeneration. In applying these cutting-edge research tools with sophisticated trial designs in preclinical drug trials, a useful platform has emerged for developing candidate agents with disease modifying actions, promising a greater chance of success for clinical translation. In this article, we describe the transition of well-established animal models of PD symptomatology to newly developed models of PD pathogenesis, with specific focus on methods of viral-mediated and inoculation of pathogenic α-synuclein, that aim to aid scientific translation of neuroprotective strategies.
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Affiliation(s)
- Wai Kin D Ko
- Motac Neuroscience Ltd, Manchester, United Kingdom.
| | - Erwan Bezard
- Motac Neuroscience Ltd, Manchester, United Kingdom; Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, F-33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, F-33000 Bordeaux, France
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Wouters H, Van Campen JPCM, Appels BA, Beijnen JH, Zwinderman AH, Van Gool WA, Schmand B. Individualized evaluation of cholinesterase inhibitors effects in dementia with adaptive cognitive testing. Int J Methods Psychiatr Res 2016; 25:190-8. [PMID: 26299847 PMCID: PMC6877216 DOI: 10.1002/mpr.1484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/01/2014] [Revised: 04/20/2015] [Accepted: 05/05/2015] [Indexed: 11/05/2022] Open
Abstract
Computerized Adaptive Testing (CAT) of cognitive function, selects for every individual patient, only items of appropriate difficulty to estimate his or her level of cognitive impairment. Therefore, CAT has the potential to combine brevity with precision. We retrospectively examined the evaluation of treatment effects of cholinesterase inhibitors by CAT using longitudinal data from 643 patients from a Dutch teaching hospital who were diagnosed with Alzheimer disease or Lewy Body disease. The Cambridge Cognitive Examination (CAMCOG) was administered before treatment initiation and after intervals of six months of treatment. A previously validated CAT was simulated using 47 CAMCOG items. Results demonstrated that the CAT required a median number of 17 items (inter-quartile range 16-20), or a corresponding 64% test reduction, to estimate patients' global cognitive impairment levels. At the same time, intraclass correlations between global cognitive impairment levels as estimated by CAT or based on all 47 CAMCOG items, ranged from 0.93 at baseline to 0.91-0.94 at follow-up measurements. Slightly more people had substantial decline on the original CAMCOG (N = 31/285, 11%) than on the CAT (N = 17/285, 6%). We conclude that CAT saves time, does not lose much precision, and therefore deserves a role in the evaluation of treatment effects in dementia. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Hans Wouters
- Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, The Netherlands
| | - Jos P C M Van Campen
- Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, The Netherlands.
| | - Bregje A Appels
- Department of Medical Psychology and Hospital Psychiatry, Slotervaart Hospital, Amsterdam, The Netherlands
| | - Jos H Beijnen
- Department of Pharmacy & Pharmacology, Slotervaart Hospital, Amsterdam, The Netherlands
| | - Aeilko H Zwinderman
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands
| | - Willem A Van Gool
- Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Ben Schmand
- Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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Affiliation(s)
- Andrew Robinson
- Clinical and Cognitive Sciences Research Group, Institute of Brain, Behaviour and Mental Health, Faculty of Medical and Human Sciences, University of Manchester, Salford Royal Hospital, Salford, UK
| | - Yvonne Davidson
- Clinical and Cognitive Sciences Research Group, Institute of Brain, Behaviour and Mental Health, Faculty of Medical and Human Sciences, University of Manchester, Salford Royal Hospital, Salford, UK
| | - Julie S Snowden
- Clinical and Cognitive Sciences Research Group, Institute of Brain, Behaviour and Mental Health, Faculty of Medical and Human Sciences, University of Manchester, Salford Royal Hospital, Salford, UK
| | - David M A Mann
- Clinical and Cognitive Sciences Research Group, Institute of Brain, Behaviour and Mental Health, Faculty of Medical and Human Sciences, University of Manchester, Salford Royal Hospital, Salford, UK
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Abstract
OBJECTIVE To determine which neuropsychological test measures and which symptoms at presentation might best differentiate dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). METHODS Cases were from the Columbia University Alzheimer's Disease Research Center, and included cases with pathological diagnosis of pure DLB (n=12), mixed DLB and AD (DLB+AD n=23) and pure AD (n=89) who had Clinical Dementia Rating 0, 0.5 or 1 at their first visit. Clinical symptoms and neuropsychological test measures were compared for pure DLB, DLB+AD and pure AD using univariate analysis of covariance and separate logistic regression analyses. RESULTS Visual hallucinations, illusions and extrapyramidal tract signs were more frequent as clinical features of the early stage of pure DLB compared with AD. The pure DLB patients showed more impaired visuospatial function than pure AD or DLB+AD patients whereas memory function was more severely impaired in pure AD or DLB+AD than in pure DLB. Analysis of memory subscores suggested that failure of retrieval was the major contributor to the memory deficit of DLB. Multiple logistic regression analysis showed that visuospatial function and delayed memory recognition were independent predictors of pure DLB from pure AD and from DLB+AD. But test measures did not discriminate between DLB+AD and pure AD. CONCLUSIONS Visuospatial function was more affected in pure DLB than in AD while memory retrieval deficit was more affected in AD than in pure DLB, in the early stages of dementia. However, DLB+AD did not show significant neuropsychological difference from pure AD.
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Affiliation(s)
- Hiroshi Yoshizawa
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, , New York, NY, USA
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Abstract
Although resting tremor, cogwheel rigidity, hypokinesia/bradykinesia and postural instability usually dominate the clinical picture of sporadic Parkinson's disease (PD), both clinical and epidemiological data reveal that a wide variety of additional symptoms impair patients' quality of life considerably, parallel to the chronic progressive neurodegenerative movement disorder. Autopsy based retrospective studies have shown that α-synuclein immunoreactive Lewy pathology (LP) develops in the locus coeruleus (LC) of patients with neuropathologically confirmed sporadic PD, as well as in individuals with incidental (prodromal or premotor) Lewy body disease but not in age and gender matched controls. Using five case studies, this review discusses the possible role of LP (axonopathy, cellular dysfunction and nerve cell loss) in the LC, catecholaminergic tract and related circuitry in the development of PD-related dementia. The contribution of noradrenergic deficit to cognitive dysfunction in PD has been underappreciated. Noradrenergic therapeutic interventions might not only alleviate depressive symptoms and anxiety but also delay the onset of cognitive decline.
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Affiliation(s)
- Kelly Del Tredici
- Clinical Neuroanatomy Section, Center for Biomedical Research, Department of Neurology, University of Ulm, Helmholtzstrasse 8/1, Ulm 89081, Germany
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