Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease

Hughes, Andrew; Daniel, Susan E.; Lees, Andrew J.

doi:10.1212/wnl.57.8.1497

Cited by 708 publications

(465 citation statements)

References 8 publications

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“…Asymmetrical onset, no atypical clinical features and no other cause of parkinsonian syndrome were the best predictors of histopathological confirmation of PD [12]. In a more recent sample of 100 cases with clinically diagnosed PD, 90 cases fulfilled neuropathological criteria for PD, leading the authors to suggest greater awareness among clinicians regarding diagnosis of PD [13]. A study based on cases diagnosed at a movement disorder clinic reported that 72 of 73 clinically diagnosed PD cases had a neuropathological diagnosis of PD.…”

Section: Diagnosis Of Pdmentioning

confidence: 99%

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

et al. 2011

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Section: Diagnosis Of Pdmentioning

confidence: 99%

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

et al. 2011

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“…Inclusion criteria were: a diagnosis of PD (using UK Brain Bank criteria) [17]; age > 40 years; and on a stable dopaminergic medication regimen ! 2 weeks.…”

Section: Patient Populationmentioning

confidence: 99%

Cerebrospinal fluid concentrations of N-acetylcysteine after oral administration in Parkinson's disease

Katz

Won

Park

et al. 2015

Parkinsonism & Related Disorders

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a b s t r a c tIntroduction: Depletion of neuronal glutathione may contribute to the pathogenesis of Parkinson's disease (PD). N-acetylcysteine (NAC) can restore neuronal glutathione levels, but it has not been established whether NAC can cross the bloodebrain barrier in humans. Methods: Twelve patients with PD were given oral NAC twice daily for 2 days. Three doses were compared: 7 mg/kg, 35 mg/kg, and 70 mg/kg. NAC, cysteine, and glutathione were measured in the cerebrospinal fluid (CSF) at baseline and 90 min after the last dose. Cognitive and motor functions were assessed pre-and post-NAC administration using the Montreal Cognitive Assessment (MoCA) and the Unified Parkinson's Disease Rating Scale part III motor subscore (UPDRS-III). Results: Oral NAC produced a dose-dependent increase in CSF NAC concentrations (p < 0.001), with the highest dose producing a CSF concentration of 9.26 ± 1.62 mM. There were no significant adverse events.NAC had no acute effect on motor or cognitive function. Conclusion: Orally administered NAC produces biologically relevant CSF NAC concentrations at doses that are well tolerated. The findings support the feasibility of NAC as a potential disease-modifying therapy for PD.

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“…PD is characterized clinically by resting tremor, rigidity, bradykinesia, and postural instability (Calne, 2005;Hughes et al, 2001). The pathological characteristics of this disease are a progressive loss of dopaminergic neurons, primarily in the substantia nigra pars compacta, and the presence of eosinophilic cytoplasmic inclusions, called Lewy bodies, throughout the brain (Braak et al, 2003;Gibb and Lees, 1988;Jellinger, 2001).…”

Section: Introductionmentioning

confidence: 99%

Sepiapterin reductase expression is increased in Parkinson's disease brain tissue

et al. 2007

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The PARK3 locus on chromosome 2p13 has shown linkage to both the development and age of onset of Parkinson's disease (PD). One candidate gene at this locus is sepiapterin reductase (SPR). Sepiapterin reductase catalyzes the final step in the biosynthetic pathway of tetrahydrobiopterin (BH 4 ), an essential cofactor for aromatic amino acid hydrolases including tyrosine hydroxylase, the rate-limiting enzyme in dopamine synthesis. The expression of SPR was assayed using semiquantitative real-time RT-PCR in human post-mortem cerebellar tissue from neuropathologically confirmed PD cases and neurologically normal controls. The expression of other enzymes involved in BH 4 biosynthesis, including aldose reductase (AKR1B1), carbonyl reductase (CBR1 and CBR3), GTP-cyclohydrolase I (GCH1), and 6-pyruvoyltetrahydrobiopterin (PTS), was also examined. Single-nucleotide polymorphisms around the SPR gene that have been previously reported to show association to PD affection and onset age were genotyped in these samples. Expression of SPR showed a significant 4-fold increase in PD cases relative to controls, while the expression of AKR1B1 and PTS was significantly decreased in PD cases. No difference in expression was detected for CBR1, CBR3, and GCH1. Genetic variants did not show a significant effect on SPR expression, however, this is likely due to the low frequency of rare genotypes in the sample. While the association of SPR to PD is not strong enough to support that this is the PARK3 gene, this study further implicates a role for SPR in idiopathic PD.

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Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease

Cited by 708 publications

References 8 publications

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

Cerebrospinal fluid concentrations of N-acetylcysteine after oral administration in Parkinson's disease

Sepiapterin reductase expression is increased in Parkinson's disease brain tissue

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