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Santos-García D, Castro ES, de Deus Fonticoba T, Panceiras MJF, Enriquez JGM, González JMP, Bartolomé CC, Planellas LL, Caldentey JG, Caballol N, Legarda I, López IC, Manzanares LL, Rivera MAÁ, Catalán MJ, Nogueira V, Borrué C, Sauco MÁ, Vela L, Cubo E, Castrillo JCM, Alonso PS, Losada MGA, Ariztegui NL, Gastón MI, Kulisevsky J, Pagonabarraga J, Seijo M, Martínez JR, Valero C, Kurtis M, Ardura JG, Prieto C, Mir P, Martinez-Martin P. Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson's Disease. J Geriatr Psychiatry Neurol 2021; 34:642-658. [PMID: 33043810 DOI: 10.1177/0891988720964250] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The aim of the present study was to examine the frequency of self-reported sleep problems and their associated factors in a large cohort of PD patients. METHODS PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort were included in this cross-sectional study. Sleep problems were assessed by the Spanish version of the Parkinson's disease Sleep Scale version 1 (PDSS-1). An overall score below 82 or a score below 5 on at least 1 item was defined as sleep problems. RESULTS The frequency of sleep problems was nearly double in PD patients compared to controls: 65.8% (448/681) vs 33.5% (65/206) (p < 0.0001). Mean total PDSS score was lower in PD patients than controls: 114.9 ± 28.8 vs 132.8 ± 16.3 (p < 0.0001). Quality of life (QoL) was worse in PD patients with sleep problems compared to those without: PDQ-39SI, 19.3 ± 14 vs 13 ± 11.6 (p < 0.0001); EUROHIS-QoL8, 3.7 ± 0.5 vs 3.9 ± 0.5 (p < 0.0001). Non-motor symptoms burden (NMSS; OR = 1.029; 95%CI 1.015-1.043; p < 0.0001) and impulse control behaviors (QUIP-RS; OR = 1.054; 95%CI 1.009-1.101; p = 0.018) were associated with sleep problems after adjustment for age, gender, disease duration, daily equivalent levodopa dose, H&Y, UPDRS-III, UPDRS-IV, PD-CRS, BDI-II, NPI, VAS-Pain, VAFS, FOGQ, and total number of non-antiparkinsonian treatments. CONCLUSION Sleep problems were frequent in PD patients and were related to both a worse QoL and a greater non-motor symptoms burden in PD. These findings call for increased awareness of sleep problems in PD patients.
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Affiliation(s)
| | - E Suárez Castro
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - T de Deus Fonticoba
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | | | | | - J M Paz González
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - C Cores Bartolomé
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | | | - N Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - I Legarda
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - I Cabo López
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - M A Ávila Rivera
- Consorci Sanitari Integral, Hospital General de L´Hospitalet, L´Hospitalet de Llobregat, Barcelona, Spain
| | - M J Catalán
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - V Nogueira
- Hospital Da Costa de Burela, Lugo, Spain
| | - C Borrué
- Hospital Infanta Sofía, Madrid, Spain
| | | | - L Vela
- Fundación Hospital de Alcorcón, Madrid, Spain
| | - E Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | | | | | - M G Alonso Losada
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | | | - M I Gastón
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | | | - M Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - C Valero
- Hospital Arnau de Vilanova, Valencia, Spain
| | - M Kurtis
- Hospital Ruber Internacional, Madrid, Spain
| | | | - C Prieto
- Hospital Rey Juan Carlos, Madrid, Spain
| | - P Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - P Martinez-Martin
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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Rodríguez-Sanz A, Peña-Llamas E, Alonso-Cánovas A, Alonso-Frech FA, Borrue-Fernández C, Catalán MJ, Fanjul-Arbós S, García-Cobos E, García-Ramos R, García Ruiz-Espiga P, Herreros-Rodríguez J, Kurtis-Urra M, López-Lozano JJ, López-Manzanares L, Martínez-Castrillo JC, Martínez-Fernández R, Mata M, Pérez-Sánchez JR, Posada IJ, Rojo A, Romero-Muñoz JP, Ruiz-Huete C, Sánchez-Alonso MP, Vivancos-Matellano F, En Representación Del Grupo de Trastornos Del Movimiento de la Asociación Madrileña de Neurología ERDGDTDMDLAMDN. [Clinical experience in the treatment of motor fluctuations in Parkinson's disease. Delphi consensus of a group of experts in movement disorders]. Rev Neurol 2020; 71:407-420. [PMID: 33205387 DOI: 10.33588/rn.7111.2020088] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Motor fluctuations are one of the most common complications of Parkinson's disease and their treatment is still a complex matter. Therefore, from the Neurology Movement Disorders Group we present our clinical experience in the treatment of these complications, with the intention of it being useful in decision-making in daily clinical practice. DEVELOPMENT Nineteen questions were developed based on a literature review and an open survey answered by members of this group. These issues were discussed in two phases, using the Delphi methodology. Considering the results of the survey, levodopa dose adjustment and dopamine agonists are the option with the best efficacy/tolerability ratio in the treatment of motor fluctuations. Rotigotine is useful in the motor fluctuations associated with gastroparesis, and intermittent subcutaneous apomorphine has positive effects in patients with unpredictable off periods. The most relevant adverse effect associated with dopamine agonists is impulse control disorder. Catechol-O-methyltransferase inhibitors are useful in the initial stages of motor fluctuations, especially in wearing off. Monoamine oxidase inhibitors are generally drugs that are well-tolerated and useful in motor fluctuations. If these measures are not effective, second-line treatments should be indicated on a case-by-case basis. CONCLUSION The clinical profile of patients with Parkinson's disease is paramount in deciding the most appropriate therapy for the treatment of motor fluctuations.
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Affiliation(s)
| | | | | | | | | | - M J Catalán
- Hospital Universitario Clínico San Carlos, Madrid, España
| | | | | | - R García-Ramos
- Hospital Universitario Clínico San Carlos, Madrid, España
| | | | | | | | - J J López-Lozano
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, España
| | | | | | | | - M Mata
- Hospital Universitario Infanta Sofía, Madrid, España
| | | | - I J Posada
- Hospital Universitario 12 de Octubre, Madrid, España
| | - A Rojo
- Hospital Universitario Príncipe de Asturias, 28805 Alcalá de Henares, España
| | | | - C Ruiz-Huete
- Hospital Nuestra Señora del Rosario, Madrid, España
| | - M P Sánchez-Alonso
- Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, España
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Santos-García D, de Deus Fonticoba T, Suárez Castro E, Aneiros Díaz A, Cores Bartolomé C, Feal Panceiras MJ, Paz González JM, Valdés Aymerich L, García Moreno JM, Blázquez Estrada M, Jesús S, Mir P, Aguilar M, Planellas LL, García Caldentey J, Caballol N, Legarda I, Cabo López I, López Manzanares L, Ávila Rivera MA, Catalán MJ, López Díaz LM, Borrué C, Álvarez Sauco M, Vela L, Cubo E, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Pascual-Sedano B, Seijo M, Ruíz Martínez J, Valero C, Kurtis M, González Ardura J, Prieto Jurczynska C, Martinez-Martin P. Quality of life and non-motor symptoms in Parkinson's disease patients with subthreshold depression. J Neurol Sci 2020; 418:117109. [PMID: 32927370 DOI: 10.1016/j.jns.2020.117109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The role of subthreshold depression (subD) in Parkinson's Disease (PD) is not clear. The present study aimed to compare the quality of life (QoL) in PD patients with subD vs patients with no depressive disorder (nonD). Factors related to subD were identified. MATERIAL AND METHODS PD patients and controls recruited from the COPPADIS cohort were included. SubD was defined as Judd criteria. The 39-item Parkinson's disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8) were used to assess QoL. RESULTS The frequency of depressive symptoms was higher in PD patients (n = 694) than in controls (n = 207) (p < 0.0001): major depression, 16.1% vs 7.8%; minor depression, 16.7% vs 7.3%; subD, 17.4% vs 5.8%. Both health-related QoL (PDQ-39; 18.1 ± 12.8 vs 11.6 ± 10; p < 0.0001) and global QoL (EUROHIS-QOL8; 3.7 ± 0.5 vs 4 ± 0.5; p < 0.0001) were significantly worse in subD (n = 120) than nonD (n = 348) PD patients. Non-motor Symptoms Scale (NMSS) total score was higher in subD patients (45.9 ± 32 vs 29.1 ± 25.8;p < 0.0001). Non-motor symptoms burden (NMSS;OR = 1.019;95%CI 1.011-1.028; p < 0.0001), neuropsychiatric symptoms (NPI; OR = 1.091; 95%CI 1.045-1.139; p < 0.0001), impulse control behaviors (QUIP-RS; OR = 1.035; 95%CI 1.007-1063; p = 0.013), quality of sleep (PDSS; OR = 0.991; 95%CI 0.983-0.999; p = 0.042), and fatigue (VAFS-physical; OR = 1.185; 95%CI 1.086-1.293; p < 0.0001; VAFS-mental; OR = 1.164; 95%CI 1.058-1.280; p = 0.0001) were related to subD after adjustment to age, disease duration, daily equivalent levodopa dose, motor status (UPDRS-III), and living alone. CONCLUSIONS SubD is a frequent problem in patients with PD and is more prevalent in these patients than in controls. QoL is worse and non-motor symptoms burden is greater in subD PD patients.
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Affiliation(s)
- D Santos-García
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - T de Deus Fonticoba
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - E Suárez Castro
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - A Aneiros Díaz
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - C Cores Bartolomé
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | - J M Paz González
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - L Valdés Aymerich
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | | | - S Jesús
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - P Mir
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - M Aguilar
- Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | | | | | - N Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - I Legarda
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - I Cabo López
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - M A Ávila Rivera
- Consorci Sanitari Integral, Hospital General de L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M J Catalán
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - L M López Díaz
- Complejo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - C Borrué
- Hospital Infanta Sofía, Madrid, Spain
| | | | - L Vela
- Fundación Hospital de Alcorcón, Madrid, Spain
| | - E Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | | | | | - M G Alonso Losada
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | | | - I Gastón
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - B Pascual-Sedano
- Hospital de Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - M Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - C Valero
- Hospital Arnau de Vilanova, Valencia, Spain
| | - M Kurtis
- Hospital Ruber Internacional, Madrid, Spain
| | | | | | - P Martinez-Martin
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; CIBERNED, Instituto de Salud Carlos III, Madrid. COPPADIS Study Group, Spain
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Santos-García D, de Deus Fonticoba T, Suárez Castro E, Aneiros Díaz A, McAfee D, Catalán MJ, Alonso-Frech F, Villanueva C, Jesús S, Mir P, Aguilar M, Pastor P, García Caldentey J, Esltelrich Peyret E, Planellas LL, Martí MJ, Caballol N, Hernández Vara J, Martí Andrés G, Cabo I, Ávila Rivera MA, López Manzanares L, Redondo N, Martinez-Martin P, McAfee D. Non-motor symptom burden is strongly correlated to motor complications in patients with Parkinson's disease. Eur J Neurol 2020; 27:1210-1223. [PMID: 32181979 DOI: 10.1111/ene.14221] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 09/12/2019] [Accepted: 03/05/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE The objective of this study was to analyze the relationship between motor complications and non-motor symptom (NMS) burden in a population of patients with Parkinson's disease (PD) and also in a subgroup of patients with early PD. METHODS Patients with PD from the COPPADIS cohort were included in this cross-sectional study. NMS burden was defined according to the Non-Motor Symptoms Scale (NMSS) total score. Unified Parkinson's Disease Rating Scale (UPDRS) part IV was used to establish motor complication types and their severity. Patients with ≤5 years of symptoms from onset were included as patients with early PD. RESULTS Of 690 patients with PD (62.6 ± 8.9 years old, 60.1% males), 33.9% and 18.1% presented motor fluctuations and dyskinesia, respectively. The NMS total score was higher in patients with motor fluctuations (59.2 ± 43.1 vs. 38.3 ± 33.1; P < 0.0001) and dyskinesia (63.5 ± 40.7 vs. 41.4 ± 36.3; P < 0.0001). In a multiple linear regression model and after adjustment for age, sex, disease duration, Hoehn & Yahr stage, UPDRS-III score and levodopa equivalent daily dose, UPDRS-IV score was significantly related to a higher NMSS total score (β = 0.27; 95% confidence intervals, 2.81-5.61; P < 0.0001), as it was in a logistic regression model on dichotomous NMSS total score (≤40, mild or moderate vs. >40, severe or very severe) (odds ratio, 1.31; 95% confidence intervals, 1.17-1.47; P < 0.0001). In the subgroup of patients with early PD (n = 396; mean disease duration 2.7 ± 1.5 years), motor fluctuations were frequent (18.1%) and similar results were obtained. CONCLUSIONS Motor complications were frequent and were associated with a greater NMS burden in patients with PD even during the first 5 years of disease duration.
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Affiliation(s)
- D Santos-García
- Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain
| | - T de Deus Fonticoba
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - E Suárez Castro
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - A Aneiros Díaz
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - D McAfee
- University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | - S Jesús
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Universidad de Sevilla/CSIC, Sevilla, Spain
| | - P Mir
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Universidad de Sevilla/CSIC, Sevilla, Spain
| | - M Aguilar
- Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | - P Pastor
- Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | | | | | - L L Planellas
- Hospital Clínic de Barcelona, Fundació Clínic, IDIBAPS, CIBERNED, Barcelona, Spain
| | - M J Martí
- Hospital Clínic de Barcelona, Fundació Clínic, IDIBAPS, CIBERNED, Barcelona, Spain
| | - N Caballol
- Hospital de Sant Joan Despí Moisés Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
| | | | | | - I Cabo
- Hospital de Pontevedra, Pontevedra, Spain
| | - M A Ávila Rivera
- Hospital General de l'Hospitalet, Consorci Sanitari Integral, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - N Redondo
- Hospital Universitario de la Princesa, Madrid, Spain
| | - P Martinez-Martin
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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Santos García D, Jesús S, Aguilar M, Planellas LL, García Caldentey J, Caballol N, Legarda I, Hernández Vara J, Cabo I, López Manzanares L, González Aramburu I, Ávila Rivera MA, Catalán MJ, López Díaz L, Puente V, García Moreno JM, Borrué C, Solano Vila B, Álvarez Sauco M, Vela L, Escalante S, Cubo E, Carrillo Padilla F, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Kulisevsky J, Menéndez González M, Seijo M, Rúiz Martínez J, Valero C, Kurtis M, Fábregues‐Boixar O, González Ardura J, Prieto Jurczynska C, Martinez‐Martin P, Mir P, Adarmes Astrid D, Almeria M, Alonso Cánovas A, Alonso Frech F, Aneiros Díaz A, Arnáiz S, Arribas S, Ascunce Vidondo A, Bernardo Lambrich N, Bejr‐Kasem H, Blázquez Estrada M, Botí M, Cabello González C, Cámara Lorenzo A, Carrillo F, Casas E, Clavero P, Cortina Fernández A, Cots Foraster A, Crespo Cuevas A, de Deus Fonticoba T, Díez‐Fairen M, Erro E, Estelrich Peyret E, Fernández Guillán N, Gámez P, Gallego M, García Campos C, Gómez Garre MP, González Aloy J, González García B, González Palmás MJ, González Toledo GR, Golpe Díaz A, Grau Solá M, Guardia G, Horta‐Barba A, Infante J, Labandeira C, Labrador MA, Lacruz F, Lage Castro M, López Seoane B, Macías Y, Mata M, Martí Andres G, Martí MJ, McAfee D, Meitín MT, Méndez del Barrio C, Miranda Santiago J, Morales Casado MI, Moreno Diéguez A, Nogueira V, Novo Amado A, Novo Ponte S, Ordás C, Pagonabarraga J, Pareés I, Pascual‐Sedano B, Pastor P, Pérez Fuertes A, Pérez Noguera R, Prats MA, Pueyo Morlans M, Redondo Rafales N, Rodríguez Méndez L, Rodríguez Pérez AB, Roldán F, Ruíz De Arcos M, Sánchez‐Carpintero M, Sánchez Díez G, Sánchez Rodríguez A, Santacruz P, Segundo Rodríguez JC, Serarols A, Sierra Peña M, Suárez Castro E, Tartari JP, Vargas L, Vázquez Gómez R, Villanueva C, Vives B, Villar MD. COPPADIS
‐2015 (
CO
hort of Patients with PArkinson's
DI
sease in Spain, 2015): an ongoing global Parkinson's disease project about disease progression with more than 1000 subjects included. Results from the baseline evaluation. Eur J Neurol 2019; 26:1399-1407. [DOI: 10.1111/ene.14008] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/23/2019] [Indexed: 01/03/2023]
Affiliation(s)
- D. Santos García
- CHUAC, Complejo Hospitalario Universitario de A Coruña A CoruñaSpain
| | - S. Jesús
- Hospital Universitario Virgen del Rocío SevillaSpain
| | - M. Aguilar
- Hospital Universitari Mutua de Terrassa Terrassa Barcelona Spain
| | | | | | - N. Caballol
- Consorci Sanitari Integral Hospital Moisés Broggi Sant Joan Despí Barcelona Spain
| | - I. Legarda
- Hospital Universitario Son Espases Palma de MallorcaSpain
| | | | - I. Cabo
- Complejo Hospitalario Universitario de Pontevedra (CHOP) PontevedraSpain
| | | | | | - M. A. Ávila Rivera
- Consorci Sanitari Integral Hospital General de L'Hospitalet, L'Hospitalet de Llobregat Barcelona Spain
| | - M. J. Catalán
- Hospital Universitario Clínico San Carlos Madrid Spain
| | - L. López Díaz
- Complejo Hospitalario Universitario de Orense (CHUO) Orense Spain
| | | | | | | | - B. Solano Vila
- Institut d'Assistència Sanitària (IAS) – Institut Català de la Salut Girona Spain
| | | | - L. Vela
- Fundación Hospital de Alcorcón MadridSpain
| | - S. Escalante
- Hospital de Tortosa Verge de la Cinta (HTVC) Tortosa Tarragona Spain
| | - E. Cubo
- Complejo Asistencial Universitario de Burgos Burgos Spain
| | - F. Carrillo Padilla
- Hospital Universitario de Canarias San Cristóbal de la LagunaSanta Cruz de Tenerife Spain
| | | | | | - M. G. Alonso Losada
- Hospital Álvaro Cunqueiro Complejo Hospitalario Universitario de Vigo (CHUVI) Vigo Spain
| | | | - I. Gastón
- Complejo Hospitalario de Navarra Pamplona Spain
| | | | | | - M. Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP) PontevedraSpain
| | | | - C. Valero
- Hospital Arnau de Vilanova Valencia Spain
| | - M. Kurtis
- Hospital Ruber Internacional Madrid Spain
| | | | | | | | - P. Martinez‐Martin
- Centro Nacional de Epidemiología y CIBERNED Instituto de Salud Carlos III Madrid Spain
| | - P. Mir
- Hospital Universitario Virgen del Rocío SevillaSpain
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Mayo-de-Las-Casas C, Jordana-Ariza N, Garzón-Ibañez M, Balada-Bel A, Bertrán-Alamillo J, Viteri-Ramírez S, Reguart N, Muñoz-Quintana MA, Lianes-Barragan P, Camps C, Jantús E, Remon-Massip J, Calabuig S, Aguiar D, Gil ML, Viñolas N, Santos-Rodríguez AK, Majem M, García-Peláez B, Villatoro S, Pérez-Rosado A, Monasterio JC, Ovalle E, Catalán MJ, Campos R, Morales-Espinosa D, Martínez-Bueno A, González-Cao M, González X, Moya-Horno I, Sosa AE, Karachaliou N, Rosell R, Molina-Vila MA. Large scale, prospective screening of EGFR mutations in the blood of advanced NSCLC patients to guide treatment decisions. Ann Oncol 2018; 28:2248-2255. [PMID: 28911086 DOI: 10.1093/annonc/mdx288] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background In a significant percentage of advanced non-small-cell lung cancer (NSCLC) patients, tumor tissue is unavailable or insufficient for genetic analyses. We prospectively analyzed if circulating-free DNA (cfDNA) purified from blood can be used as a surrogate in this setting to select patients for treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). Patients and methods Blood samples were collected in 119 hospitals from 1138 advanced NSCLC patients at presentation (n = 1033) or at progression to EGFR-TKIs (n = 105) with no biopsy or insufficient tumor tissue. Serum and plasma were sent to a central laboratory, cfDNA purified and EGFR mutations analyzed and quantified using a real-time PCR assay. Response data from a subset of patients (n = 18) were retrospectively collected. Results Of 1033 NSCLC patients at presentation, 1026 were assessable; with a prevalence of males and former or current smokers. Sensitizing mutations were found in the cfDNA of 113 patients (11%); with a majority of females, never smokers and exon 19 deletions. Thirty-one patients were positive only in plasma and 11 in serum alone and mutation load was higher in plasma and in cases with exon 19 deletions. More than 50% of samples had <10 pg mutated genomes/µl with allelic fractions below 0.25%. Patients treated first line with TKIs based exclusively on EGFR positivity in blood had an ORR of 72% and a median PFS of 11 months. Of 105 patients screened after progression to EGFR-TKIs, sensitizing mutations were found in 56.2% and the p.T790M resistance mutation in 35.2%. Conclusions Large-scale EGFR testing in the blood of unselected advanced NSCLC patients is feasible and can be used to select patients for targeted therapy when testing cannot be done in tissue. The characteristics and clinical outcomes to TKI treatment of the EGFR-mutated patients identified are undistinguishable from those positive in tumor.
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Affiliation(s)
- C Mayo-de-Las-Casas
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - N Jordana-Ariza
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - M Garzón-Ibañez
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - A Balada-Bel
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - J Bertrán-Alamillo
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - S Viteri-Ramírez
- Dr Rosell Oncology Institute, Quirón Dexeus University Hospital, Barcelona
| | - N Reguart
- Department of Medical Oncology, Hospital Clínic, Barcelona
| | - M A Muñoz-Quintana
- Department of Medical Oncology, Valencia Institute of Oncology, Valencia
| | | | - C Camps
- Molecular Oncology Laboratory, Fundación Investigación, Valencia General University Hospital, Valencia.,CIBERONC, Valencia.,Medical Oncology Department, Valencia General University Hospital, Valencia.,Department of Medicine, Universitat de València
| | - E Jantús
- Molecular Oncology Laboratory, Fundación Investigación, Valencia General University Hospital, Valencia.,CIBERONC, Valencia.,Department of Biotechnology, Universitat Politècnica de València
| | | | - S Calabuig
- Molecular Oncology Laboratory, Fundación Investigación, Valencia General University Hospital, Valencia.,CIBERONC, Valencia.,Department of Biotechnology, Universitat Politècnica de València
| | - D Aguiar
- Department of Medical Oncology, Hospital Dr Negrín of Gran Canaria, Las Palmas
| | - M L Gil
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - N Viñolas
- Department of Medical Oncology, Hospital Clínic, Barcelona
| | | | - M Majem
- Medical Oncology Service, Hospital de Sant Pau, Barcelona
| | - B García-Peláez
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - S Villatoro
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - A Pérez-Rosado
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - J C Monasterio
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - E Ovalle
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - M J Catalán
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - R Campos
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
| | - D Morales-Espinosa
- Dr Rosell Oncology Institute, Quirón Dexeus University Hospital, Barcelona
| | - A Martínez-Bueno
- Dr Rosell Oncology Institute, Quirón Dexeus University Hospital, Barcelona
| | - M González-Cao
- Dr Rosell Oncology Institute, Quirón Dexeus University Hospital, Barcelona
| | - X González
- Dr Rosell Oncology Institute, General Hospital of Catalonia, Sant Cugat del Vallés
| | - I Moya-Horno
- Dr Rosell Oncology Institute, General Hospital of Catalonia, Sant Cugat del Vallés
| | - A E Sosa
- Dr Rosell Oncology Institute, University Hospital Sagrat Cor, Barcelona
| | - N Karachaliou
- Dr Rosell Oncology Institute, University Hospital Sagrat Cor, Barcelona
| | - R Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Germans Trias i Pujol Health Sciences Institute and Hospital, Badalona, Spain
| | - M A Molina-Vila
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, Barcelona
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Linazasoro G, Sesar A, Valldeoriola F, Compta Y, Herrero MT, Martínez Castrillo JC, López Lozano JJ, Bergaretxe A, Vela L, Fernández JM, Castro A, Kulisevski J, Lezcano E, Vaamonde J, López Del Val J, Chacón J, Vivancos F, Luquin R, Aguilar M, Burguera JA, Salvador C, Menéndez Guisasola L, Catalán MJ, Mir P, Campos V, Grandas F, Mínguez A, Balaguer E, Yáñez R, Leiva C, García Ruiz P, Cubo E. [Neuroprotection in Parkinson's disease: analysis though group of experts' methodology]. Neurologia 2009; 24:113-124. [PMID: 19322690] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Currently used antiparkinsonian drugs neither stop nor slow-down the progressive nature of the disease. The final phase of PD is characterized by the presence of symptoms and signs resistant to dopaminergic agents, such as depression, dementia, freezing and falls. Therefore, it is urgent to develop therapies able to positively modify this outcome. Despite neuroprotection is a research priority in PD, no effective strategies have been found so far. METHOD A key informants study was conducted. A group of experts in PD fulfilled a questionnaire of 10 questions to explore the most important topics related to neuroprotection. Afterwards a consensus about the current situation of neuroprotection in PD was established and future directions of development were suggested. RESULTS Most of the answers emphasized the need of new concepts, the limitations of animal models and the difficulties in the difficulties in demonstrating a neuroprotective effects in humans owing to a lack of biomarkers. Some of the experts believe that we are already exerting a disease modifying effect. CONCLUSIONS The concept of neuroprotection should be widened. Animal models should be improved. A reliable biomarker to start neuroprotective therapies long before the appearance of motor symptoms and to evaluate the neuroprotective effect of any therapy should be urgently developed.
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Affiliation(s)
- G Linazasoro
- Centro de Investigación Parkinson, Policlínica Guipuzkoa, San Sebastián.
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8
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García MEG, García AMG, Catalán MJ. [Primary cerebral lymphoma in an immunocompetent patient]. Neurologia 2008; 23:122-125. [PMID: 18322833] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Primary lymphoma of the central nervous system PLCNS) was a very uncommon disease until a few decades ago. However, its incidence has increased in recent years, mainly in immunocompetent patients. Thus, some authors suggest that PLCNS may become the most frequent tumor. The final diagnosis is based on the pathology study of the samples obtained with stereotaxic biopsy or with surgery, but X-ray studies may be very useful in the orientation of this disease. The typical finding in immunocompetent subjects is the appearance of single supratentorial lesions with homogeneous uptake of contrast and scarce edema, without edema, necrosis nor bleeding. Survival has increased thanks to the new treatments applied, although there is still controversy regarding frequency, dose and administration form of many of them. We present the case of an immunocompetent male patient with progressive dyplopia and vertigo caused by a primary lymphoma of the central nervous system and a review the literature.
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9
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Catalán MJ, Fernández JM, Vazquez A, Varela de Seijas E, Suárez A, Bernaldo de Quirós JC. Failure of cefotaxime in the treatment of meningitis due to relatively resistant Streptococcus pneumoniae. Clin Infect Dis 1994; 18:766-9. [PMID: 8075268 DOI: 10.1093/clinids/18.5.766] [Citation(s) in RCA: 80] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
To our knowledge, we report the first failure of cefotaxime in the treatment of meningitis due to relatively resistant Streptococcus pneumoniae (MICs of penicillin and cefotaxime, 1 microgram/mL). Cure was achieved with a 14-day course of intravenous and intrathecal vancomycin. We recommend that in cases of meningitis caused by strains of S. pneumoniae for which MICs are > or = 1 microgram/mL, cefotaxime should be used with caution; however, if therapeutic failure is suspected therapy should be changed to intravenous and intrathecal vancomycin.
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Affiliation(s)
- M J Catalán
- Servico de Neurología, Hospital Universitario San Carlos, Madrid, Spain
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10
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Jiménez-Jiménez FJ, Molina JA, Fernández-Calle P, Vázquez A, Cabrera-Valdivia F, Catalán MJ, García-Albea E, Bermejo F, Codoceo R. Serum levels of beta-carotene and other carotenoids in Parkinson's disease. Neurosci Lett 1993; 157:103-6. [PMID: 8233018 DOI: 10.1016/0304-3940(93)90653-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
To elucidate the possible role of carotenoids in the risk for developing Parkinson's disease (PD), we compared serum levels of beta-carotene, alpha-carotene and lycopene, measured by high performance liquid chromatography, of 61 PD patients using their spouses as the control group. The serum levels of these 3 carotenoids did not differ significantly between PD patients and control groups. There was no influence of antiparkinsonian therapy on serum carotenoids levels, and these did not correlate with age, age at onset, scores of the Unified Parkinson Disease Rating Scale or the Hoehn and Yahr staging in the PD group. These results show that serum carotenoids concentrations are apparently unrelated to the risk for developing PD.
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Affiliation(s)
- F J Jiménez-Jiménez
- Department of Neurology, Hospital Universitario, Príncipe de Asturias-Alcalá de Henares, Spain
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