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Journal of Parkinson's Disease 2022Ankylosing spondylitis (AS) is an immune-mediated, chronic inflammatory rheumatic disorder. The etiology of Parkinson's disease (PD) is multifactorial; however,...
BACKGROUND
Ankylosing spondylitis (AS) is an immune-mediated, chronic inflammatory rheumatic disorder. The etiology of Parkinson's disease (PD) is multifactorial; however, inflammation is receiving an increasing amount of attention as an underlying cause of the neurodegenerative process of PD.
OBJECTIVE
We performed a nationwide longitudinal, population-based matched cohort study to assess the association with the later development of parkinsonism in Korea.
METHODS
This study was conducted using records from the Health Insurance Review and Assessment Service database. The cumulative incidence rate of PD was estimated. Fine-Gray subdistribution hazard models were used to identify hazards associated with PD development based on the presence of AS. Exposure to anti-inflammatory drugs was measured and analyzed to determine the protective effect of these medications. Additionally, the hazard ratio (HR) for atypical parkinsonism was estimated.
RESULTS
The results of the Fine-Gray subdistribution hazard model revealed that the HR for PD development in the AS group was 1.82 (95%confidence interval [CI], 1.38-2.39, p < 0.001). A significant decrease in PD development was observed in patients with AS taking non-steroidal anti-inflammatory drugs (NSAIDs). The HR for atypical parkinsonism in the AS group was 3.86 (95%CI, 1.08-13.78, p < 0.05).
CONCLUSION
We found that AS was associated with an increased risk of PD and atypical parkinsonism. NSAIDs used for AS control have some protective effects against PD. Further studies assessing whether biological treatment mitigates PD risk in patients with high activity are warranted.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Cohort Studies; Humans; Incidence; Parkinson Disease; Parkinsonian Disorders; Retrospective Studies; Risk Factors; Spondylitis, Ankylosing
PubMed: 34602503
DOI: 10.3233/JPD-212878 -
Neurotoxicology Sep 2010It is widely recognized that both genetic and environmental factors are likely to contribute to the pathogenesis of human parkinsonism. While the identification of... (Review)
Review
It is widely recognized that both genetic and environmental factors are likely to contribute to the pathogenesis of human parkinsonism. While the identification of specific predisposing conditions and mechanisms of disease development remain elusive, new discoveries coupled with technological advances over the past decade have provided important clues. From the genetic standpoint, both causal and susceptibility genes have been identified, with some of these genes pointing to gene-environment interactions. The application of emerging genomic technologies, such as Genome Wide Association Studies (GWAS), will certainly further our knowledge of Parkinson's disease (PD)-related genes. From the environmental perspective, toxicant-induced models of parkinsonian syndromes, such as those associated with exposure to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) or beta-N-methylamino-l-alanine (BMAA), have revealed potential mechanisms of increased susceptibility based on genetic predisposition. Finally, new hypotheses on mechanisms of disease development include the possibility that exposure to neurotoxicants triggers an upregulation and pathological modifications of alpha-synuclein. Mutations in the alpha-synuclein gene are responsible for rare familial cases of parkinsonism, and polymorphisms in the promoter region of this gene confer a higher susceptibility to idiopathic PD. Thus, toxicant-alpha-synuclein interactions could have deleterious consequences and play a role in pathogenetic processes in human parkinsonism.
Topics: Animals; Disease Models, Animal; Environment; Gene Expression Regulation; Genetic Predisposition to Disease; Genome-Wide Association Study; Humans; Mutation; Nerve Tissue Proteins; Neurotoxins; Parkinson Disease; Parkinsonian Disorders
PubMed: 20430055
DOI: 10.1016/j.neuro.2010.04.007 -
Parkinsonism & Related Disorders Feb 2015Accurate diagnosis of Parkinson disease (PD) and other degenerative parkinsonian syndromes is important for management and prognostic purposes. Diagnosis can be... (Review)
Review
BACKGROUND
Accurate diagnosis of Parkinson disease (PD) and other degenerative parkinsonian syndromes is important for management and prognostic purposes. Diagnosis can be challenging in early disease and in atypical cases.
METHODS
We reviewed the literature on the application of dopamine transporter single-photon emission computed tomography (DAT-SPECT) in degenerative parkinsonism and related disorders as a diagnostic tool.
RESULTS
The use of DAT-SPECT shows some utility in the early diagnosis of PD and differentiation from other non-degenerative parkinsonian disorders (i.e. essential tremor, dystonic tremor, drug-induced and in most cases of psychogenic parkinsonism), since it can accurately detect the presynaptic dopaminergic deficit. The test has been shown to have high sensitivity/specificity by multiple studies. DAT imaging may also have some prognostic value for disease progression. However, it has limited value in differentiating among degenerative causes of parkinsonism. DAT imaging has some limitations. In most studies, true test accuracy is unknown since the gold standard is clinical diagnosis by a movement disorders neurologist. Therefore, the sensitivity of the test cannot exceed that of the clinical diagnosis. In addition, false negative scans occur and highlight the need for clinical follow-up.
CONCLUSION
Clinical assessment remains the most important aspect in evaluating these patients. DAT-SPECT is a sensitive modality to detect nigrostriatal degeneration. In spite of increasing data using this technique, however, more long-term clinical studies are required to determine how DAT-SPECT scan can guide decision-making.
Topics: Clinical Trials as Topic; Diagnosis, Differential; Diagnostic Imaging; Dopamine Plasma Membrane Transport Proteins; Humans; Molecular Imaging; Parkinson Disease; Parkinsonian Disorders
PubMed: 25487733
DOI: 10.1016/j.parkreldis.2014.11.007 -
Journal of Neurological Surgery. Part... May 2022Parkinson's disease (PD) is the most common cause of parkinsonism, a clinical syndrome that includes bradykinesia, tremor, and postural instability. Secondary causes of...
Parkinson's disease (PD) is the most common cause of parkinsonism, a clinical syndrome that includes bradykinesia, tremor, and postural instability. Secondary causes of parkinsonism include chronic traumatic encephalopathy. However, clear physiopathologic association between spinal cord injury (SCI) and PD has not been well described yet. We describe a rare/unusual case of a patient with C7-D1 fracture/listhesis who, 12 days after the trauma, developed a progressive cognitive impairment together with mandibular tremor. Seven days after the onset of symptoms, because of the persistence of mandibular tremor and Glasgow Coma Scale (GCS) score of 4, therapy with L-DOPA/benserazide was started, which resulted in gradual reduction of symptoms and complete recovery of consciousness. This could be the first report of PD appearing only 12 days after an SCI in the acute stage. Early differential diagnosis on the first manifestations of this kind of symptoms should be considered in patients with SCI to set up the right therapy essential for improving the outcome and preventing devastating consequences. This might also provide insights into the potential pathophysiologic responses of the brain after primary (immediate) and secondary (delayed) damages.
Topics: Glasgow Coma Scale; Humans; Parkinson Disease; Parkinsonian Disorders; Spinal Cord Injuries; Tremor
PubMed: 34788867
DOI: 10.1055/s-0041-1724108 -
Brain Research Jun 2020Apathy and impulsivity constitute opposite poles of a behavioral motivation spectrum often disrupted by both the symptoms and therapies for Parkinson's Disease (PD)....
BACKGROUND
Apathy and impulsivity constitute opposite poles of a behavioral motivation spectrum often disrupted by both the symptoms and therapies for Parkinson's Disease (PD). Upwards of 70% of PD patients experience symptoms of apathy, frequently unresolved or worsened by deep brain stimulation (DBS) of the subthalamic nucleus (STN). Worse, more than half of patients receiving DBS for PD experience new-onset impulse control disorders of varying severity following therapy initiation. While these symptoms and side-effects have been widely reported in clinical studies, they are largely unexplored in animal models.
METHODS
We applied high-frequency DBS in a 6-OHDA hemiparkinsonian rat model. We trained rats on a series of go/stop and go/no-go behavioral paradigms and examined how parkinsonism and DBS modulated task responses.
RESULTS
STN DBS in healthy rodents drove impulsive behavior in the form of stop and no-go task failure, impulsive reward seeking, and noninstructed task attempts. While trained rats without DBS only tended to fail stop and no-go cues very shortly after the cue, DBS led to failures at significantly later time points. Hemiparkinsonism slowed response times and reduced response rates, not alleviated by effective DBS.
INTERPRETATIONS
PD interrupts neural signaling responsible for healthy action selection, not restored by DBS. PD may be associated with a dearth of action commands, manifesting as apathy. Conversely, effective DBS may bias the system toward the impulsive end of the behavioral motivation spectrum without restoring behaviorally reasonable actions, mis-weighting reward-based action selection and manifesting as impulsivity, aided by DBS interfering with stop signaling.
Topics: Animals; Cognition; Deep Brain Stimulation; Female; Impulsive Behavior; Male; Motivation; Parkinson Disease; Parkinsonian Disorders; Rats; Rats, Long-Evans; Reaction Time; Reward; Subthalamic Nucleus
PubMed: 32171706
DOI: 10.1016/j.brainres.2020.146776 -
Presse Medicale (Paris, France : 1983) Mar 2017
Topics: Diagnostic Imaging; Diagnostic Techniques, Neurological; Disease Progression; Humans; Parkinson Disease; Parkinsonian Disorders
PubMed: 28325375
DOI: 10.1016/j.lpm.2017.02.001 -
Movement Disorders Clinical Practice Jun 2024As the diagnosis of Parkinson's disease (PD) is fundamentally clinical, the usefulness of ioflupane (I) single-photon emission computed tomography (SPECT) or DaTSCAN as... (Review)
Review
BACKGROUND
As the diagnosis of Parkinson's disease (PD) is fundamentally clinical, the usefulness of ioflupane (I) single-photon emission computed tomography (SPECT) or DaTSCAN as a diagnostic tool has been a matter of debate for years. The performance of DaTSCAN is generally recommended in the follow-up of patients with a clinically uncertain diagnosis, especially in those with a suspected essential tremor, drug-induced parkinsonism, or vascular parkinsonism. However, there is a dearth of DaTSCAN findings regarding neurodegenerative parkinsonisms besides PD and atypical parkinsonisms. To date, a specific nigrostriatal dopamine uptake pattern that would help differentiate PD from the most frequent atypical parkinsonisms is yet to be described. This fact is further complicated by the possible visualization of abnormalities in the uptake pattern in patients with rarer neurodegenerative parkinsonisms.
OBJECTIVES
We aimed to summarize the current literature regarding DaTSCAN findings in patients with rare neurodegenerative parkinsonisms.
METHODS
The PubMed database was systematically screened for studies in English or Spanish up to October 15, 2023, using search terms "DaTSCAN", "ioflupane", "DaT-SPECT", "123I-FP-CIT SPECT", "dopamine transporter imaging", and "[123I] FP-CIT SPECT". Duplicated publications and studies regarding PD, atypical parkinsonisms, dystonia-parkinsonism, essential tremor, and parkinsonism due to non-degenerative causes were excluded.
RESULTS
The obtained results were reviewed and summarized, including DaTSCAN findings in fragile X-associated tremor/ataxia syndrome, prion diseases, Huntington's disease, spinocerebellar ataxia, hereditary spastic paraparesis, metabolic disorders, and other diseases (anti-IgLON5 disease, ring chromosome 20 syndrome, chorea-acanthocytosis, and neuronal ceroid lipofuscinosis).
CONCLUSIONS
This review highlights the need to determine in the future the utility and cost-effectiveness of DaTSCAN, both as a diagnostic and a prognostic tool, in patients with parkinsonian symptoms in rare neurodegenerative diseases.
Topics: Humans; Tomography, Emission-Computed, Single-Photon; Parkinsonian Disorders; Tropanes; Parkinson Disease
PubMed: 38693679
DOI: 10.1002/mdc3.14055 -
Movement Disorders : Official Journal... 2009The clinical differentiation of parkinsonian syndromes remains challenging not only for neurologists but also for movement disorder specialists. Conventional magnetic... (Review)
Review
The clinical differentiation of parkinsonian syndromes remains challenging not only for neurologists but also for movement disorder specialists. Conventional magnetic resonance imaging (cMRI) with the visual assessment of T2- and T1-weighted imaging as well as different advanced MRI techniques offer objective measures, which may be a useful tool in the diagnostic work-up of Parkinson's disease and atypical parkinsonian disorders (APDs). In clinical practice, cMRI is a well-established method for the exclusion of symptomatic parkinsonism due to other pathologies. Over the past two decades, abnormalities in the basal ganglia and infratentorial structures have been shown especially in APDs not only by cMRI but also by different advanced MRI techniques, including methods to assess regional cerebral atrophy quantitatively such as magnetic resonance volumetry, proton magnetic resonance spectroscopy, diffusion-weighted imaging, and magnetization transfer imaging. This article aims to review recent research findings on the role of advanced MRI techniques in the differential diagnosis of neurodegenerative parkinsonian disorders.
Topics: Atrophy; Brain; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Parkinson Disease; Protons
PubMed: 19877241
DOI: 10.1002/mds.22648 -
The Medical Clinics of North America Sep 1953
Topics: Humans; Parkinson Disease; Parkinsonian Disorders
PubMed: 13086035
DOI: 10.1016/s0025-7125(16)34965-3 -
Neuropathology : Official Journal of... Dec 2021Parkinson's disease (PD) is one of the most common neurodegenerative disorders. The cardinal neuropathological features of PD include selective and progressive loss of...
Parkinson's disease (PD) is one of the most common neurodegenerative disorders. The cardinal neuropathological features of PD include selective and progressive loss of pigmented neurons in the substantia nigra, deficiencies in dopaminergic signaling in the striatum, and occurrence of phosphorylated α-synuclein-identified Lewy bodies in the nervous system. Parkinsonism, the clinical presentation of movement disorders seen in PD, is a feature shared commonly by other pathologically distinct neurodegenerative diseases, such as progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and multiple system atrophy (MSA). Consequently, it is sometimes difficult to distinguish PD from such parkinsonism-related neurological disorders. In addition, parkinsonism is not always a feature of certain neurodegenerative diseases, and it can sometimes develop as a result of various forms of drug intoxication or cerebrovascular disease. Here, we describe the clinicopathological features of three patients (cases 1, 2, and 3) diagnosed as having PSP, MSA, and PD, respectively, in each of whom the postmortem histopathological diagnosis differed from the final clinical diagnosis. Neuropathologically, they had suffered from coexistent disorders: PD, MSA, and argyrophilic grain disease (case 1); PD (case 2); and vascular parkinsonism (case 3). The variety of patients showing features of parkinsonism underlines the importance of careful long-term follow up followed by postmortem neuropathological evaluation.
Topics: Corticobasal Degeneration; Diagnosis, Differential; Humans; Multiple System Atrophy; Parkinson Disease; Parkinsonian Disorders; Supranuclear Palsy, Progressive
PubMed: 34779072
DOI: 10.1111/neup.12777