RESUMEN
Recent evidence has supported a pathogenic role for neuroinflammation in Parkinson's disease (PD). Inflammatory response has been associated with symptoms and subtypes of PD. However, it is unclear whether immune changes are involved in the initial pathogenesis of PD, leading to the non-motor symptoms (NMS) observed in its prodromal stage. The current study aimed to characterize the behavioral and cognitive changes in a toxin-induced model of prodromal PD-like syndrome. We also sought to investigate the role of neuroinflammation in prodromal PD-related NMS. Male mice were subjected to bilateral intranasal infusion with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) or saline (control group), followed by comprehensive behavioral, pathological and neurochemical analysis. Intranasal MPTP infusion was able to cause the loss of dopaminergic neurons in the substantia nigra (SN). In parallel, it induced impairment in olfactory discrimination and social memory consolidation, compulsive and anxiety-like behaviors, but did not influence motor performance. Iba-1 and GFAP expressions were increased in the SN, suggesting an activated state of microglia and astrocytes. Consistent with this, MPTP mice had increased levels of IL-10 and IL-17A, and decreased levels of BDNF and TrkA mRNA in the SN. The striatum showed increased IL-17A, BDNF, and NFG levels compared to control mice. In conclusion, neuroinflammation may play an important role in the early stage of experimental PD-like syndrome, leading to cognitive and behavioral changes. Our results also indicate that intranasal administration of MPTP may represent a valuable mouse model for prodromal PD.
Asunto(s)
Modelos Animales de Enfermedad , Ratones Endogámicos C57BL , Síntomas Prodrómicos , Sustancia Negra , Animales , Masculino , Sustancia Negra/metabolismo , Sustancia Negra/patología , Sustancia Negra/efectos de los fármacos , Neuronas Dopaminérgicas/patología , Neuronas Dopaminérgicas/metabolismo , Neuronas Dopaminérgicas/efectos de los fármacos , Enfermedades Neuroinflamatorias/patología , Cuerpo Estriado/metabolismo , Cuerpo Estriado/efectos de los fármacos , Cuerpo Estriado/patología , Ratones , Microglía/metabolismo , Microglía/patología , Inflamación/inducido químicamente , Inflamación/metabolismo , Inflamación/patología , Factor Neurotrófico Derivado del Encéfalo/metabolismo , Ansiedad/etiología , 1-Metil-4-fenil-1,2,3,6-Tetrahidropiridina/farmacologíaRESUMEN
BACKGROUND: Due to its multiple benefits in Parkinson's Disease, Dance has been a widely recommended activity in rehabilitation. However, there is a gap in the literature on the use of Brazilian sytles in rehabilitation protocols. This study aimed to compare the effect of 2 different protocols of Brazilian dance, samba and forró, and samba on motor aspects and quality of life of individuals with Parkinson's disease. METHODS: In a nonrandomized clinical trial lasting 12 weeks, 69 individuals with Parkinson's disease participated in the study: forró and samba group (FSG = 23), samba group (SG = 23), and control group (CG = 23). RESULTS: Significant improvements were found after SG intervention in the UPDRSIII and in the subitem quality of life mobility. In intra-group comparisons of FSG, significant differences were found in the subtype of quality of life discomfort. In the intergroup analysis, significant differences were found between CG, SG, and FSG in the communication sub-item, showing a greater increase in the scores of the groups that participated in the SG and FSG. CONCLUSIONS: The findings of this study suggest that Brazilian dance practice is capable of improving the perception of some aspects of quality of life and motor symptoms in relation to controls in people with Parkinson's disease.
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Baile , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/rehabilitación , Calidad de Vida , Brasil , Terapia por Ejercicio/métodosRESUMEN
BACKGROUND: Dystonia is associated with disabling nonmotor symptoms like chronic pain (CP), which is prevalent in dystonia and significantly impacts the quality of life (QoL). There is no validated tool for assessing CP in dystonia, which substantially hampers pain management. OBJECTIVE: The aim was to develop a CP classification and scoring system for dystonia. METHODS: A multidisciplinary group was established to develop the Dystonia-Pain Classification System (Dystonia-PCS). The classification of CP as related or unrelated to dystonia was followed by the assessment of pain severity score, encompassing pain intensity, frequency, and impact on daily living. Then, consecutive patients with inherited/idiopathic dystonia of different spatial distribution were recruited in a cross-sectional multicenter validation study. Dystonia-PCS was compared to validated pain, mood, QoL, and dystonia scales (Brief Pain Inventory, Douleur Neuropathique-4 questionnaire, European QoL-5 Dimensions-3 Level Version, and Burke-Fahn-Marsden Dystonia Rating Scale). RESULTS: CP was present in 81 of 123 recruited patients, being directly related to dystonia in 82.7%, aggravated by dystonia in 8.8%, and nonrelated to dystonia in 7.5%. Dystonia-PCS had excellent intra-rater (Intraclass Correlation Coefficient - ICC: 0.941) and inter-rater (ICC: 0.867) reliability. In addition, pain severity score correlated with European QoL-5 Dimensions-3 Level Version's pain subscore (r = 0.635, P < 0.001) and the Brief Pain Inventory's severity and interference scores (r = 0.553, P < 0.001 and r = 0.609, P < 0.001, respectively). CONCLUSIONS: Dystonia-PCS is a reliable tool to categorize and quantify CP impact in dystonia and will help improve clinical trial design and management of CP in patients affected by this disorder. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Distonía , Trastornos Distónicos , Trastornos del Movimiento , Humanos , Distonía/diagnóstico , Distonía/complicaciones , Calidad de Vida , Estudios Transversales , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Trastornos Distónicos/complicaciones , Trastornos Distónicos/diagnóstico , Trastornos del Movimiento/complicaciones , DolorRESUMEN
Parkinson's disease is a neurodegenerative disease understood as a complex syndrome with motor and non-motor symptoms, including sleep-related conditions, such as periodic limb movements in sleep (PLMS). This paper presents issues regarding Parkinson's disease, motor and non-motor symptoms, sleep physiology, and PLMS. In conclusion, both conditions seem to be correlated through impairment of the dopaminergic system.
A doença de Parkinson é uma doença neurodegenerativa entendida como uma síndrome complexa com sintomas motores e não motores, incluindo condições relacionadas ao sono, como movimentos periódicos dos membros durante o sono (MPMS). Este artigo apresenta questões relacionadas à doença de Parkinson, sintomas motores e não motores, fisiologia do sono e MPMS. Em conclusão, ambas as condições parecem estar correlacionadas por comprometimento do sistema dopaminérgico.
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Humanos , Anciano , Anciano de 80 o más Años , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico , Síndrome de las Piernas Inquietas , Trastornos del Sueño-Vigilia/etiología , Neuroimagen/métodos , Disfunción Cognitiva/etiología , Trastornos de Somnolencia ExcesivaRESUMEN
OBJECTIVE: To assess the frequency of somatization and its association with motor, nonmotor symptoms, and quality of life in persons with Parkinson disease (PD). METHODS: A cross-sectional case-control study was carried out. Assessments included the List of 90 Symptoms somatic factor (SCL-90-R SOM), Movement Disorder Society Unified Parkinson's Ratings Scale (MDS-UPDRS), Non-Motor Symptom Scale (NMSS), Montreal Cognitive Assessment (MoCA), and Parkinson Questionnaire-8 (PDQ-8). RESULTS: A total 93 persons with PD and 93 controls were included. Somatization within the PD group was 2 times more frequent compared to the control group (43% vs 21.5%, P = .003). Persons with PD had higher NMSS total scores (48.6 ± 42.6 vs 28.3 ± 30.4, P = .001). Patients with PD with somatization had worst MDS-UPDRS, NMSS, MoCA, and PDQ-8 (all P < .05). CONCLUSION: Somatization is more frequent in persons with PD compared to healthy controls. Somatization in PD is associated with nonmotor symptoms and worst quality of life.
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Actividades Cotidianas , Enfermedad de Parkinson/diagnóstico , Calidad de Vida/psicología , Trastornos Somatomorfos/psicología , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Estudios Transversales , Evaluación de la Discapacidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/psicología , Psicometría , Índice de Severidad de la Enfermedad , Trastornos Somatomorfos/diagnóstico , Encuestas y CuestionariosRESUMEN
BACKGROUND AND PURPOSE: Excessive daytime sleepiness (EDS) is a common complaint among patients with Parkinson's disease (PD). Several factors have been associated with EDS in PD, especially neuropsychiatric symptoms. This study aimed to determine the relationships between neuropsychiatric symptoms, sociodemographic and clinical parameters, and EDS in PD. METHODS: This cross-sectional study analyzed 85 patients with PD. All patients underwent socioeconomic and clinical data evaluations followed by a psychiatric interview and a neurological examination, including the assessment of sleep features. Patients were divided into two groups according to the presence or absence of EDS, which was defined as a score higher than 10 on the Epworth Sleepiness Scale. Binary logistic regression was performed in order to describe the predictors of EDS. RESULTS: We found that EDS affects 40% of PD patients and is associated with older age, restless legs syndrome, depressive and anxious symptoms, and worse sleep quality. In the multivariate analysis, older age, levodopa use, and worse sleep quality remained as significant predictors of EDS in PD. CONCLUSIONS: Nighttime sleep problems, older age, and levodopa use are significantly associated with EDS in PD. A careful assessment and the management of sleep problems in PD patients might help to improve their quality of life.
RESUMEN
Nonmotor symptoms (NMS) have been described in several neurodegenerative diseases but have not been systematically evaluated in spinocerebellar ataxia type 10 (SCA10). The objective of the study is to compare the frequency of NMS in patients with SCA10, Machado-Joseph disease (MJD), and healthy controls. Twenty-eight SCA10, 28 MJD, and 28 healthy subjects were prospectively assessed using validated screening tools for chronic pain, autonomic symptoms, fatigue, sleep disturbances, psychiatric disorders, and cognitive function. Chronic pain was present with similar prevalence among SCA10 patients and healthy controls but was more frequent in MJD. Similarly, autonomic symptoms were found in SCA10 in the same proportion of healthy individuals, while the MJD group had higher frequencies. Restless legs syndrome and REM sleep behavior disorder were uncommon in SCA10. The mean scores of excessive daytime sleepiness were worse in the SCA10 group. Scores of fatigue were higher in the SCA10 sample compared to healthy individuals, but better than in the MJD. Psychiatric disorders were generally more prevalent in both spinocerebellar ataxias than among healthy controls. The cognitive performance of healthy controls was better compared with SCA10 patients and MJD, which showed the worst scores. Although NMS were present among SCA10 patients in a higher proportion compared to healthy controls, they were more frequent and severe in MJD. In spite of these comparisons, we were able to identify NMS with significant functional impact in patients with SCA10, indicating the need for their systematic screening aiming at optimal treatment and improvement in quality of life.
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Ataxias Espinocerebelosas/fisiopatología , Ataxias Espinocerebelosas/psicología , Enfermedades del Sistema Nervioso Autónomo/epidemiología , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Dolor Crónico/epidemiología , Dolor Crónico/fisiopatología , Expansión de las Repeticiones de ADN , Fatiga/epidemiología , Fatiga/fisiopatología , Femenino , Humanos , Enfermedad de Machado-Joseph/epidemiología , Enfermedad de Machado-Joseph/fisiopatología , Enfermedad de Machado-Joseph/psicología , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/fisiopatología , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Trastorno de la Conducta del Sueño REM/epidemiología , Trastorno de la Conducta del Sueño REM/fisiopatología , Síndrome de las Piernas Inquietas/epidemiología , Síndrome de las Piernas Inquietas/fisiopatología , Ataxias Espinocerebelosas/epidemiologíaRESUMEN
BACKGROUND: Olfactory function assessment is an important screening tool for Parkinson's disease (PD) diagnosis. It is debated whether olfaction is affected by comorbid depression. We assessed the relationship between depression and olfaction in PD and determined whether depression may limit the usefulness of olfactory testing for PD diagnosis. METHODS: Olfaction was evaluated using the Sniffin' Sticks test and the Hyposmia Rating Scale in four groups of subjects: PD patients without depression (n = 30); PD patients with major depression (PDD; n = 30); major depressive disorder (MDD) patients (n = 29); and healthy controls (HCs; n = 30). RESULTS: No differences were found between PD and PDD patients for total Sniffin' Sticks test, threshold, discrimination or identification scores, or in Hyposmia Rating Scale, although both groups differed from HCs and MDD patients (P < 0.05), which, in turn, showed similar olfactory scores. CONCLUSIONS: Lack of differences in olfactory impairment between PD and PDD suggest that depression may not contribute to olfactory dysfunction in PD.
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Trastorno Depresivo Mayor , Trastornos del Olfato/diagnóstico , Trastornos del Olfato/etiología , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/epidemiología , Anciano , Análisis de Varianza , Trastorno Depresivo Mayor/complicaciones , Trastorno Depresivo Mayor/epidemiología , Trastorno Depresivo Mayor/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Reino UnidoRESUMEN
Spinocerebellar ataxia type 3 or Machado-Joseph disease is the most common spinocerebellar ataxia worldwide, and the high frequency of nonmotor manifestations in Machado-Joseph disease demonstrates how variable is the clinical expression of this single genetic entity. Anatomical, physiological, clinical, and functional neuroimaging data reinforce the idea of a degenerative process involving extracerebellar regions of the nervous system in Machado-Joseph disease. Brain imaging and neuropathologic studies have revealed atrophy of the pons, basal ganglia, midbrain, medulla oblongata, multiple cranial nerve nuclei, and thalamus and of the frontal, parietal, temporal, occipital, and limbic lobes. This review provides relevant information about nonmotor manifestations and extracerebellar symptoms in Machado-Joseph disease. The main nonmotor manifestations of Machado-Joseph disease described in previous data and discussed in this article are: sleep disorders, cognitive and affective disturbances, psychiatric symptoms, olfactory dysfunction, peripheral neuropathy, pain, cramps, fatigue, nutritional problems, and dysautonomia. In addition, we conducted a brief discussion of noncerebellar motor manifestations, highlighting movement disorders. © 2013 Movement Disorder Society.