Manganese (Mn) poisoning, a well-known hazard in miners and industrial workers, shares many features with Parkinson's disease. Two young agricultural workers with a parkinsonian syndrome, who mentioned exposure to the fungicide maneb (manganese ethylene-bis-dithiocarbamate), led us to investigate a new possible source of Mn intoxication. Fifty male rural workers with occupational exposure to maneb were compared with 19 rural workers without fungicide exposure. We noted significantly higher prevalence of plastic rigidity with cogwheel phenomenon, headache, fatigue, nervousness, memory complaints, and sleepiness in the exposed group. In addition, we saw other neurologic signs, such as postural tremor, cerebellar signs, and bradykinesia, although without statistical significance. The data suggest that occupational exposure to pesticides containing Mn is a possible source of Mn intoxication of the CNS.
-Huntington disease (HD) is associated with expansions of a CAG trinucleotide repeat in the HD gene. Accurate measurement of a specific CAG repeat sequence in the HD gene in 92 Brazilian controls without HD, 44 Brazilian subjects with clinical findings suggestive of HD and 40 individuals from 6 putative HD families, showed a range from 7 to 33 repeats in normal subjects and 39 to 88 repeats in affected subjects. A trend between early age at onset of first symptoms and increasing number of repeats was seen. Major increase of repeat size through paternal inheritance than through maternal inheritance was observed. Data generated from this study may have significant implications for the etiology, knowledge of the incidence, diagnosis, prognosis, genetic counseling and treatment of HD Brazilian patients.KEY WORDS: Huntington disease, CAG repeats, Brazil, DNA, PCR.
Doença de Huntington: análise de DNA na população brasileiraRESUMO -A doença de Huntington (DH) está associada a expansões da seqüência repetitiva de trinucleotídeos CAG no gene HD. Através de análise do número de repetições CAG em indivíduos brasileiros, amostras de 92 indivíduos-controle não afetados pela DH, 44 pacientes com DH e 40 indivíduos de 6 famílias com a DH, demonstrou-se a presença de repetições de 7 até 33 trinucleotídeos CAG nos indivíduos-controle e de 39 até 88 nos alelos mutados dos indivíduos afetados. Foi constatada relação inversa entre a idade de manifestação dos primeiros sintomas da doença e o tamanho do fragmento encontrado. Também foi observado que o número de casos em que ocorrem expansões do trinucleotídeo foi maior quando o pai transmite o alelo mutado do que quando a mãe o transmite. Os dados gerados com este estudo têm importância significativa para a compreensão da etiologia, incidência, diagnóstico, prognóstico e tratamento dos pacientes com DH na população brasileira. O conhecimento da base genética desta doença na população brasileira permitirá um aconselhamento genético mais eficiente às famílias em risco.
Early-onset Parkinson's disease (EOPD) is distinct from the classic late-onset PD (LOPD) because of its slower disease progression. The aim of this study was to compare dopamine neuronal loss in EOPD with that of LOPD with the same disease duration, through dopamine transporter (DAT) estimation. Fourteen patients, seven EOPD (<50 years) and seven LOPD, matched for disease duration were scanned with [(99m)Tc]-TRODAT-1-SPECT (INER-Taiwan), and were assessed with standard PD scales. EOPD patients had 34% lower striatal DAT binding potential (BP) compared with that of LOPD patients (BP = 0.29 +/- 0.12, BP = 0.44 +/- 0.12, P < 0.02) with similar PD severity. These results suggest that EOPD patients have greater dopamine density loss than LOPD patients without motor-symptom worsening.
Our results suggest that in vivo DAT density is increased in dPD patients as compared to ndPD, suggesting that DAT is implicated in the pathophysiology of PD depression.
Parkinson’s disease (PD) is a common neurodegenerative disorder that is mainly caused by dopaminergic neuron loss in the substantia nigra. Several nuclear medicine radiotracers have been developed to evaluate PD diagnoses and disease evolution in vivo in PD patients. Positron emission tomography (PET) and single photon computerized emission tomography (SPECT) radiotracers for the dopamine transporter (DAT) provide good markers for the integrity of the presynaptic dopaminergic system affected in PD. Over the last decade, radiotracers suitable for imaging the DAT have been the subject of most efforts. In this review, we provide a critical discussion on the utility of DAT imaging for Parkinson’s disease diagnosis (sensitivity and specificity).
Konstantin Tretiakoff's doctoral dissertation "Contribution a l'Etude de L'Anatomie pathologique du Locus Niger de Soemmering avec quelques déductions relatives à la pathogénie des troubles du tonus musculaire et De La Maladie de Parkinson" (A Study of the Pathological anatomy of the locus niger of Soemerring and its relevance to the pathogenesis of changes in muscular tone in Parkinson's disease) published in 1919 earned him a silver medal awarded by the University of Paris but failed to gain him the recognition its importance deserved. Despite belated acknowledgment of the importance of his findings Tretiakoff received little acclaim during his life and there have been no biographical accounts written in English or French. Fifty years after his death it seems appropriate to relate some aspects of his interesting peripatetic life and recognize the continuing relevance of his pioneering research on "the black stuff" to our understanding of Parkinson's disease.
Voice and speech disorders are common in Parkinson's disease patients and may lead to social isolation. We employed routine clinical voice therapy measures to evaluate the effect of voice rehabilitation. Twenty patients with a stable drug regimen participated in this study. The patients were assessed before and after a program of voice rehabilitation consisting of 13 group therapy sessions during 1 month, with emphasis on the increase in laryngeal sphincteric activity. Voice rehabilitation produced an increase in maximal phonation times, decrease in the values of s/z ratio and air flow, increase in vocal intensity, decrease in the complaints of weak and strained‐strangled voice and monotonous and unintelligible speech and elimination of complaints of swallowing alterations. These data indicate a greater glottic efficiency after voice rehabilitation reflecting a more functional oral communication.
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