Prevalence of Parkinson’s disease in a rural village of coastal Ecuador. A two-phase door-to-door survey

Occupational exposure to toxic solvents increases the odds for having Parkinson’s disease (PD). We performed a door-to-door survey to assess PD prevalence in Atahualpa, a rural village of coastal Ecuador where more than 50 % of men work as carpenters, being in contact with toxic solvents under poor safety settings. During Phase I, rural doctors screened all Atahualpa residents aged ≥40 years with a questionnaire directed to identify those with PD. In Phase II, neurologists evaluated individuals who screened as suspected cases of PD, as well as a random sample of negative individuals to assess possible false negative cases. As a result, the census yielded 642 Atahualpa residents aged ≥40 years. An affirmative response to the questionnaire was obtained in seven persons. Neurological examination confirmed the diagnosis of PD in two of them (both carpenters). Examination of 14 non-suspected individuals disclosed no further PD patients. Prevalence of PD in Atahualpa residents aged ≥40 years was 312 per 100,000 which increased to 671 per 100,000 when only people aged ≥60 years was considered. Job-specific prevalence was 1,470 per 100,000 in carpenters. In conclusions, PD prevalence in Atahualpa is similar to that reported from other regions. However, we noted an increase in PD prevalence when only carpenters were considered. Unsafe occupational exposure to toxic substances may counterbalance the apparently lower risk of PD in the non-industrialized world.     

Promise of Pharmacogenomics for Drug Discovery, Treatment and Prevention of Parkinson’s Disease. A Perspective

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by a heterogeneous array of motor and non-motor features. Anti-PD drugs that are in use target only the motor symptoms, may lose efficacy over time, and can cause serious adverse effects such as dyskinesia and psychosis. There are currently no preventative or disease modifying treatments. All attempts to develop disease modifying drugs have failed. Pharmacogenomics (PGx) has the potential to change the way new drugs are developed and the way drugs are prescribed. By using genetic markers that correlate with, and can therefore predict drug response, clinical trials can be designed to be enriched with individuals who are most likely to benefit from the drug, maximizing drug’s efficacy, minimizing its adverse effects, and boosting the odds of successful drug discovery. Clinical application of PGx will help physicians to quickly and accurately determine the right drugs and the right doses for individuals, avoiding the lengthy trial and error approaches and adverse effects. In combination with known protective factors such as nicotine and caffeine, PGx may enable development of personalized methods for PD prevention and, by extension, care.     

The use of EEG in Alzheimer’s disease,with and without scopolamine – A pilot study

ObjectiveTo use multivariate statistical analysis of EEG data in order to separate EEGs of patients with Alzheimer’s disease (AD) from controls. A group of individuals with mild cognitive impairment (MCI) was evaluated using the same methodology. Additionally, the effects of scopolamine on this separation are studied.MethodsStatistical pattern recognition (SPR) is used in conjunction with information extracted from EEGs before and after administration of scopolamine.ResultsThere was complete separation of the AD group and controls before administration of scopolamine. The separation increased after scopolamine had been given. Of the 10 MCI individuals, five seemed to belong to the AD group. Three of those progressed to AD within 1 year and one after 3 years.ConclusionsUsing SPR on EEG recordings it is possible to separate AD from controls. This separation can be increased by the use of scopolamine but the medication is not a prerequisite for classification. The results indicate that SPR is useful for predicting progress of MCI to AD.SignificanceEEG registration is a simple and noninvasive method. If these results are confirmed in other studies, this method could be more widely applied than the highly specialized methods used today in detection of early AD.     

A systematic review of autistic children’s prosocial behaviour

BackgroundProsocial behaviour (e.g., comforting, helping, sharing) is associated with important positive life outcomes. Historical and recent theory, evidence and personal accounts within the autism community present a mixed picture regarding Autistic children’s prosocial engagement. This systematic review consolidates, for the first time, how empirical studies have been measuring Autistic children’s prosocial behaviour to date (objective one). This review clarifies what knowledge the evidence provides, specifically how the type (e.g., comforting, helping, sharing), target (e.g., parent, experimenter, Autistic or neurotypical peer) and timing (e.g., young, middle, and late childhood) affect Autistic children’s prosocial behaviour (objective two).MethodsRelevant published records were identified through systematic searches of three electronic databases: PsychINFO, PubMED and Embase. Thirty studies presented in 29 articles met eligibility criteria and were included for data-extraction, quality assessment and narrative synthesis.ResultsThe most common methodologies used were found to be: in-person paradigms, games, informant reports, and self-reports. Reliability and validity efforts were inconsistent. It is hoped these findings will act as a benchmark for development of future research in the area. Outcomes were found to be much more positive about Autistic children’s engagement in prosocial behaviour than diagnostic criteria and historical theory suggests, with Autistic children often engaging in prosocial behaviour to the same frequency as comparison groups despite unfamiliar and neurotypical targets. Narrative synthesis revealed moderating variables and differing patterns and styles of Autistic children’s prosocial behaviour.ConclusionsFindings encourage Autistic strengths-based approaches and caution is expressed regarding findings possibly linked to Autistic masking.     

Possible therapies of Parkinson’s disease: A review

Parkinson's disease (PD) is a complex condition with a wide range of symptoms, like impaired movement, tremors, apathy and depression, and many other symptoms. The disease results from degeneration of dopaminergic neural cells. No cure at present but symptomatic some palliative treatments are available to slow down the disease progression. According to the Parkinson’s Foundation every year in U.S., approximately 60,000 Americans diagnosed with PD. Nearly one million will be living with PD in the U.S. by 2020, which is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Amyotrophic Lateral Sclerosis (ALS).There is no diagnostic test for PD, yet, but this article will review all kinds symptomatic and disease-modifying therapy.     

A review of possible therapies for Parkinson’s disease

Parkinson's disease (PD) is a complex condition with a wide range of symptoms, like impaired movement, tremors, apathy and depression, and many other symptoms. The disease results from degeneration of dopaminergic neural cells. No cure at present but symptomatic some palliative treatments are available to slow down the disease progression. According to the Parkinson’s Foundation every year in U.S., approximately 60,000 Americans diagnosed with PD. Nearly one million will be living with PD in the U.S. by 2020, which is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Amyotrophic Lateral Sclerosis (ALS).There is no diagnostic test for PD, yet, but this article will review all kinds symptomatic and disease-modifying therapy.     

A Case of Unilateral Neglect in Huntington’s Disease

Unilateral neglect, an attentional deficit in detecting and acting on information coming from one side of space, is a relatively common consequence of right hemisphere stroke. Although neglect has been observed following damage to a variety of brain structures, to date no reports exist of neglect phenomena arising from Huntington’s Disease (HD). However, reports in the animal and human literature suggest that neglect is possible following damage to a primary site for Huntington’s pathology, the basal ganglia. Here we present a patient (BG) with genetically proven HD who, in the context of the mild intellectual, executive and attentional impairments associated with the disorder, showed a remarkably severe and stable neglect for left space. MRI and electrophysiological results make it unlikely that the spatial bias could be accounted for by basic sensory loss. In addition, behavioural investigation indicated that, although BG’s neglect operated in a very striking manner along body-centred co-ordinates (missing almost all information presented to her left), more general limitations in visual attention were apparent to the left-side of information presented entirely to the right of the body midline. Further evidence is presented showing that the neglect was manifest on tactile and auditory tasks as well as those presented in the visual domain. The presence of neglect in HD in this case is novel and somewhat puzzling, particularly as flourodeoyglucose positron emission tomography revealed bilateral caudate hypoperfusion. Reducing the statistical threshold on this analysis revealed a potential frontal hypometabolism that was more marked in the right than left hemisphere. However, as this was only apparent at a threshold below that normally considered acceptable (due to the resulting number of false positives), this possible account of the neglect must be viewed very cautiously.     

Efficacy and safety of perampanel in Parkinson’s disease. A systematic review with meta-analysis

Background

L-Dopa represents the mainstay of therapy of Parkinson’s disease (PD), but its effectiveness is reduced with continued treatment and disease progression. Accordingly, there remains a need to explore novel treatment strategies to manage the signs and symptoms of the later disease stages. The aim of the study was to evaluate the efficacy and safety of adjunctive perampanel (PER) in patients with PD through a meta-analysis of existing trials.

Methods

Randomized, placebo-controlled, double- or single-blind, add-on studies of PER in patients with PD were identified through a systematic literature search. The following outcomes were assessed: changes from baseline to final efficacy visit in total daily OFF time, activities of daily living during OFF time and motor function during ON time, incidence of adverse events (AEs), and treatment withdrawal.

Results

Four trials were included involving 2266 participants, 1449 and 817 for PER and placebo treatment groups, respectively. Four PER daily doses were tested, namely 0.5, 1, 2 and 4 mg. There were no significant differences in any efficacy outcome between PER and placebo treated patients. The risk ratios (RRs) for AEs, severe AEs and treatment withdrawal were similar between placebo and PER at 0.5, 1 and 2 mg; the 4 mg daily dose was associated with an increased risk of AEs [RR 1.118 (1.047–1.193)], and withdrawal for AEs [RR 1.345 (1.034–1.749)] and for any reason [RR 1.197 (1.020–1.406)].

Conclusions

In PD patients experiencing motor fluctuations, adjunctive PER did not improve the motor state and was well-tolerated at the lower doses.

     

A Parental Report of Children’s Anxiety Symptoms in Japan

Using parental reports, the current study investigated anxiety symptoms among Japanese children as part of the process of developing the Japanese version of the Spence Children’s Anxiety Scale for Parents (SCAS-P). The participants were 677 parents and children aged 9–12 years. Confirmatory factor analysis on 568 parents and children supported that the SCAS-P had a 6-factor structure. The scale showed satisfactory internal consistency and good convergent validity. A MANOVA indicated no significant gender or age differences except for the obsessive–compulsive disorder subscale. Among Japanese children, the most prevalent symptoms within the parental report were items related to fear of the dark and of insects/spiders. Finally, we observed very low correlations between parental and child reports of anxiety symptoms; the relationships between child and parental reports were rather poor among Japanese children. We briefly discuss the utility of the SCAS-P as a screening instrument assessing parental reports of anxiety symptoms.     

Classification of Parkinson’s disease using a region-of-interest- and resting-state functional magnetic resonance imaging-based radiomics approach

Brain Imaging and Behavior - To investigate the value of combining amplitude of low-frequency fluctuations-based radiomics and the support vector machine classifier method in distinguishing...     

Parental Misperceptions of Children’s Underweight Status: A Meta-analysis

Background

Accurate parental perceptions of their children’s underweight status are needed to prevent overlooking potential disordered eating patterns or health conditions affecting growth.

Purpose

The aim of this study is to determine overall proportion of parents who misperceive children’s underweight status and correlates of such misperceptions.

Methods

Original studies published to January 2013 were chosen through a literature search in established databases. Studies included assessed parental perceptions of their children’s underweight and then compared perceptions to recognized standards for defining underweight based on anthropometric measures. Random- and mixed-effects models were used.

Results

Thirty-seven articles (representing 39 studies; N?=?4,039) were included. Pooled effect sizes indicated that 46.58 % (95 % CI 40.90–52.35 %) of parents misperceive their children’s underweight status, though the extent of misperceptions depended on a number of moderators.

Conclusions

Nearly half of parents perceive their underweight children as weighing more than they actually do. Health care professionals are well positioned to take steps to remedy misperceptions and encourage healthy behaviors.     

A comprehensive model of health-related quality of life in Parkinson’s disease

BACKGROUND : Insight in how impairments and disabilities related to Parkinson's disease (PD) influence health-related quality of life (HRQoL) is required to review adequacy of current management strategies. METHODS : The Scales for Outcomes in Parkinson's disease (SCOPA) evaluation was used to assess impairments and disabilities. HRQoL was assessed with the EuroQol-5D Visual Analogue Scale. 378 patients with PD who participated in the SCOPA/PROPARK cohort were assessed while on their usual treatment. Multiple linear regression analysis and structural equation modelling were used to construct a model of factors that influence HRQoL. RESULTS : A model with good fit was constructed that identified various impairments and disabilities as important contributors to HRQoL in PD. Of the disabilities, psychosocial well-being had a larger impact on HRQoL than physical functioning. Of the impairments, depression had the largest contribution to HRQoL, followed by axial motor symptoms, gastrointestinal symptoms, and urinary symptoms. In addition, pain, psychiatric and motor complications, and daytime sleepiness had small but significant influences on HRQoL. CONCLUSION : Multiple factors, including disabilities, nonmotor symptoms and axial motor symptoms, affect HRQoL in patients with PD. In patients who are on symptomatic treatment aiming to alleviate mainly motor symptoms, there is a large impact on HRQoL of nonmotor and nondopaminergic symptoms. Research is warranted to develop and evaluate management strategies for the aspects that currently impact on HRQoL as psychosocial well-being, depressive symptoms, axial motor symptoms, gastrointestinal symptoms, and urinary symptoms. These findings call for a multidisciplinary approach in the care of these features.     

Adenosine A2A Antagonists in Parkinson’s Disease: What’s Next?

Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder, affecting up to 10 million people worldwide. Current treatment primarily involves symptom management with dopaminergic replacement therapy. Levodopa remains the most effective oral treatment, although long-term use is associated with complications such as wearing off, dyskinesias, and on-off fluctuations. Non-dopaminergic medications that improve PD symptoms and motor fluctuations are in demand. Adenosine A2A receptors are abundantly expressed within the basal ganglia and offer a unique target to modify abnormal striatal signaling associated with PD. Preclinical animal models have shown the ability of adenosine A2A receptor antagonists to improve PD motor symptoms, reduce motor fluctuations and dyskinesia, as well as protect against toxin-induced neuronal degeneration. Both istradefylline and preladenant have demonstrated moderate efficacy in reducing off time in PD patients with motor fluctuations. The safety and efficacy of this class of compounds continues to be defined and future studies should focus on non-motor symptoms, dyskinesias, and neuroprotection.