The Role of Vitamin D in Basal Ganglia Diseases

Homann, Carl Nikolaus; Homann, B

doi:10.31083/j.jin2106155

Cited by 3 publications

(3 citation statements)

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“…Becerra et al describe that two (40%) of their patient’s falls required hospitalization but do not give details about the sustained injuries [ 39 ]. Unfortunately, neither of the authors provided data on bone mineralization or vitamin D levels frequently found diminished in RLS [ 40 41 ], which could have been a possible explanation for the seriousness of the injuries [ 42 43 44 ].…”

Section: Resultsmentioning

confidence: 99%

Accidental Falls in Patients with Hyperkinetic Movement Disorders: A Systematic Review

Homann¹,

Homann²,

Ivanic³

et al. 2022

Tremor and Other Hyperkinetic Movements

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Background:The significance of falls and their repercussions in Parkinson's disease has been extensively researched. However, despite potentially serious effects on health and quality of life and negative impact on the healthcare system, there is not a sufficient understanding of the role of falls in hyperkinetic movement disorders (HKMDs). This review aims to provide an overview of the prevalence of falls, injuries, and preventive measures in the most common HKMDs.Methods: Studies up to May 1, 2022 were searched in PubMed using Medical Subjects Headings of relatively prevalent HKMDs associated with the terms "accidental falls", "injuries", "fractures", and "accident prevention".Results: In our review of 37 studies out of 155, we found evidence that for several HKMDs, such as spinocerebellar ataxia, essential tremor, Huntington's disease, and dystonia, fall risk is increased. Falls were reported in up to 84% of spinocerebellar ataxia patients, 59% of essential tremor patients, and 79% of Huntington's patients, with 65% of the latter falling frequently. Injuries occurred in up to 73% in Huntington and 74% in ataxia patients. Most of the common diseases characterized by HKMDs were investigated for both fall causes and consequences, but prevention studies were limited to spinocerebellar ataxia and Huntington's disease. Discussion:The limited available data suggest that patients with several HKMDs can be considered to be at increased risk of falling and that the consequences can be serious. As a result, physicians should be advised to include fall exploration in their routine workup and provide advice for safer mobility. In general, more research into fall-related concerns in HKMDs is necessary. Highlights:In contrast to Parkinson's disease, the prevalence of accidental falls, their repercussions, and preventive strategies are under-investigated in hyperkinetic movement disorders (HKMDs). Several HKMDs such as essential tremor, ataxia, and Huntington's disease have reported fall rates of up to 84% and fall-related injury rates of up to 74%. Therefore, routine examinations of HKMD patients should include a fall exploration and provide advice on safe mobility.

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Section: Resultsmentioning

confidence: 99%

Accidental Falls in Patients with Hyperkinetic Movement Disorders: A Systematic Review

Homann¹,

Homann²,

Ivanic³

et al. 2022

Tremor and Other Hyperkinetic Movements

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“…Studies have provided encouraging data that VitD3 and Res could be beneficial for restoring normal movement and reducing postural and action tremor of the upper limbs, as well as tremor in the legs and trunk 48 – 53 . However, to the best of our knowledge, there have been no investigations of the effect of the combination of VitD3 and Res on ET.…”

Section: Discussionmentioning

confidence: 99%

Resveratrol and 1,25-dihydroxyvitamin D decrease Lingo-1 levels, and improve behavior in harmaline-induced Essential tremor, suggesting potential therapeutic benefits

Pirmoradi,

Nakhaie,

Ranjbar

et al. 2024

Sci Rep

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Essential tremor (ET) is a neurological disease that impairs motor and cognitive functioning. A variant of the Lingo-1 genetic locus is associated with a heightened ET risk, and increased expression of cerebellar Lingo-1. Lingo-1 has been associated with neurodegenerative processes; however, neuroprotection from ET-associated degeneration can be conferred by the protein Sirt1. Sirt1 activity can be promoted by Resveratrol (Res) and 1,25-dihydroxyvitamin D3 (VitD3), and thus these factors may exert neuroprotective properties through a Sirt1 mechanism. As Res and VitD3 are linked to Sirt1, enhancing Sirt1 could counteract the negative effects of increased Lingo-1. Therefore, we hypothesized that a combination of Res-VitD3 in a harmaline injection model of ET would modulate Sirt1 and Lingo-1 levels. As expected, harmaline exposure (10 mg/kg/every other day; i.p.) impaired motor coordination, enhanced tremors, rearing, and cognitive dysfunction. When Res (5 mg/kg/day; i.p.) and VitD3 (0.1 mg/kg/day; i.p.) were given to adult rats (n = 8 per group) an hour before harmaline, tremor severity, rearing, and memory impairment were reduced. Individual treatment with Res and VitD3 decreased Lingo-1 gene expression levels in qPCR assays. Co-treatment with Res and VitD3 increased and decreased Sirt1 and Lingo-1 gene expression levels, respectively, and in some cases, beneficial effects on behavior were noted, which were not seen when Res or VitD3 were individually applied. Taken together, our study found that Res and VitD3 improved locomotor and cognitive deficits, modulated Sirt1 and Lingo-1. Therefore, we would recommend co-treatment of VitD3 and Res to leverage complementary effects for the management of ET symptoms.

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“…Currently, despite these promising indications, scientific data is insufficient to recommend vitamin D as a therapy choice in rehabilitations. Yet, considering the significant frequency of hypovitaminosis D in senior patients with MDs (Homann and Homann, 2022), as well as the demonstrated overall benefit and potential specific impact, Vitamin D management and assessment should become part of standard care for elderly patients with MDs. In this regard, replacement should be sufficient but not excessive, adhering to recommended limits (Rosen et al, 2012;Bouillon, 2017).…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Vitamin D supplementation in later life: a systematic review of efficacy and safety in movement disorders

Homann,

Ivanic

et al. 2024

Front. Aging Neurosci.

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IntroductionNutrition plays a pivotal role in the multidisciplinary approach to rehabilitating middle to old-aged patients with neurological diseases including movement disorders (MDs). Despite the prevalence of vitamin D deficiency in many patients with MDs, data supporting supplementation’s effectiveness and safety is sparse and conflicting, therefore, our explicit objective was to provide an all-encompassing review of the subject.MethodsA comprehensive search of PubMed, Embase, and other scientific databases was conducted up to November 1 2023. The searches included RCTs in all languages with human participants aged 35 and above and not meeting these requirements led to exclusion.ResultsFour studies on Parkinson’s disease (PD) and one on restless legs syndrome (RLS) including 369 MD patients, however, none in a rehabilitation context, were found. Although three of the four PD studies showed better outcomes, such as decreasing levodopa-induced dyskinesia or enhancing physical performance in some or all domains, the RLS study did not identify symptom improvement. The one serious adverse effect observed, cerebral infarction, aroused safety concerns, however its relationship to vitamin D consumption is questionable. Structurally the studies can be characterized by large variations in patient populations, in primary outcomes, and disease severity, but typically a relatively short duration of therapy in most cases. With other limitations such as the small number of studies, major trial design heterogeneity, limited sample sizes, and a greatly variable Cochrane risk of bias (RoB) evaluation, only a qualitative synthesis was feasible.DiscussionTwo main implications can be inferred from these results, which we interpret as cautiously promising but overall insufficient for firm recommendations. First, there is an urgent need for more research on the role of vitamin D in MDs in the middle- to older-aged population, particularly during rehabilitation. Second, given the benefits of vitamin D supplementation for those who are deficient, we recommend routine screening and supplementation for MD patients.

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The Role of Vitamin D in Basal Ganglia Diseases

Cited by 3 publications

References 100 publications

Accidental Falls in Patients with Hyperkinetic Movement Disorders: A Systematic Review

Accidental Falls in Patients with Hyperkinetic Movement Disorders: A Systematic Review

Resveratrol and 1,25-dihydroxyvitamin D decrease Lingo-1 levels, and improve behavior in harmaline-induced Essential tremor, suggesting potential therapeutic benefits

Vitamin D supplementation in later life: a systematic review of efficacy and safety in movement disorders

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