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  • 11
    In: Movement Disorders, Wiley, Vol. 37, No. 6 ( 2022-06), p. 1202-1210
    Kurzfassung: To date, variants in the GBA gene represent the most frequent large‐effect genetic factor associated with Parkinson's disease (PD). However, the reason why individuals with the same GBA variant may or may not develop neurodegeneration and PD is still unclear. Objectives Therefore, we evaluated the contribution of rare variants in genes responsible for lysosomal storage disorders (LSDs) to GBA ‐PD risk, comparing the burden of deleterious variants in LSD genes in PD patients versus asymptomatic subjects, all carriers of deleterious variants in GBA . Methods We used a custom next‐generation sequencing panel, including 50 LSD genes, to screen 305 patients and 207 controls (discovery cohort). Replication and meta‐analysis were performed in two replication cohorts of GBA ‐variant carriers, of 250 patients and 287 controls, for whom exome or genome data were available. Results Statistical analysis in the discovery cohort revealed a significantly increased burden of deleterious variants in LSD genes in patients ( P  = 0.0029). Moreover, our analyses evidenced that the two strongest modifiers of GBA penetrance are a second variation in GBA (5.6% vs. 1.4%, P  = 0.023) and variants in genes causing mucopolysaccharidoses (6.9% vs. 1%, P  = 0.0020). These results were confirmed in the meta‐analysis, where we observed pooled odds ratios of 1.42 (95% confidence interval [CI] = 1.10–1.83, P  = 0.0063), 4.36 (95% CI = 2.02–9.45, P  = 0.00019), and 1.83 (95% CI = 1.04–3.22, P  = 0.038) for variants in LSD genes, GBA , and mucopolysaccharidosis genes, respectively. Conclusion The identification of genetic lesions in lysosomal genes increasing PD risk may have important implications in terms of patient stratification for future therapeutic trials. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson Movement Disorder Society.
    Materialart: Online-Ressource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    RVK:
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2022
    ZDB Id: 2041249-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 12
    In: Journal of Parkinson's Disease, IOS Press, Vol. 11, No. 1 ( 2021-02-02), p. 159-170
    Kurzfassung: Background: Although abnormalities in gut microbiota are hypothesized to influence the pathogenesis and clinical phenotype of Parkinson’s disease (PD), prospective studies on de novo patients are lacking. Objective: To preliminarily investigate whether gut microbiota in early untreated PD may predict motor and non-motor features progression over a 3-year period. Methods: 16S ribosomal RNA gene amplicons were sequenced on fecal samples of 39 de novo PD patients. Multiple confounders were taken into account, including dietary habits. Motor and non-motor symptoms were assessed using validated scales at baseline and followed-up yearly for 3 years. At last follow-up, a detailed neuropsychological assessment was additionally performed. A general linear model for repeated measurements— adjusted by dopaminergic therapy at follow-up— was used to investigate the relationship between bacterial taxa abundance at baseline (stratified by the median of distribution at baseline) and outcome variables. Results: Twenty-five patients were included (11 refused, 2 lost at follow-up, 1 died). Lower abundance of Roseburia (Firmicutes phylum) at baseline was associated with worse evolution of motor, non-motor and cognitive functions at 3-year follow-up. Similarly, lower abundance of Ruminococcaceae and Actinobacteria at baseline was associated with faster worsening of global cognitive functions. At follow-up, frontal lobe functions were the features most robustly associated with baseline microbial abnormalities. Conclusion: In the present exploratory study on de novo PD, we found an association between abnormal distribution of specific bacterial taxa and the progression of motor and non-motor features over a 3-year period. This proof-of-principle study supports the design of a larger observational study aiming to determine whether these differences survive multiple-comparison correction and define microbiota-specific subgroups suitable for therapeutic targeting.
    Materialart: Online-Ressource
    ISSN: 1877-7171 , 1877-718X
    Sprache: Unbekannt
    Verlag: IOS Press
    Publikationsdatum: 2021
    ZDB Id: 2599550-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 13
    Online-Ressource
    Online-Ressource
    Wiley ; 2021
    In:  Movement Disorders Clinical Practice Vol. 8, No. 6 ( 2021-08), p. 980-982
    In: Movement Disorders Clinical Practice, Wiley, Vol. 8, No. 6 ( 2021-08), p. 980-982
    Materialart: Online-Ressource
    ISSN: 2330-1619 , 2330-1619
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2772809-2
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 14
    In: Brain, Oxford University Press (OUP), Vol. 143, No. 8 ( 2020-08-01), p. 2490-2501
    Kurzfassung: The natural pattern of progression of Parkinson’s disease is largely unknown because patients are conventionally followed on treatment. As Parkinson’s disease progresses, the true magnitude of the long-duration response to levodopa remains unknown, because it can only be estimated indirectly in treated patients. We aimed to describe the natural course of motor symptoms by assessing the natural OFF in consecutive Parkinson’s disease patients never exposed to treatment (drug-naïve), and to investigate the effects of daily levodopa on the progression of motor disability in the OFF medication state over a 2-year period. In this prospective naturalistic study in sub-Saharan Africa, 30 Parkinson’s disease patients (age at onset 58 ± 14 years, disease duration 7 ± 4 years) began levodopa monotherapy and were prospectively assessed using the Unified Parkinson’s disease Rating Scale (UPDRS). Data were collected at baseline, at 1-year and 2-years follow-up. First-ever levodopa intake induced a significant improvement in motor symptoms (natural OFF versus ON state UPDRS-III 41.9 ± 15.9 versus 26.8 ± 15.1, respectively; P  & lt; 0.001). At 1-year follow-up, OFF state UPDRS-III score after overnight withdrawal of levodopa was considerably lower than natural OFF (26.5 ± 14.9; P  & lt; 0 .001). This effect was not modified by disease duration. At the 2-year follow-up, motor signs after overnight OFF (30.2 ± 14.2) were still 30% milder than natural OFF (P = 0.001). The ON state UPDRS-III at the first-ever levodopa challenge was similar to the overnight OFF score at 1-year follow-up and the two conditions were correlated (r = 0.72, P  & lt; 0.001). Compared to the natural progression of motor disability, levodopa treatment resulted in a 31% lower annual decline in UPDRS-III scores in the OFF state (3.33 versus 2.30 points/year) with a lower model’s variance explained by disease duration (67% versus 36%). Using the equation regressed on pretreatment data, we predicted the natural OFF at 1-year and 2-year follow-up visits and estimated that the magnitude of the long-duration response to levodopa ranged between 60% and 65% of total motor benefit provided by levodopa, independently of disease duration (P = 0.13). Although levodopa therapy was associated with motor fluctuations, overnight OFF disability during levodopa was invariably less severe than the natural course of the disease, independently of disease duration. The same applies to the yearly decline in UPDRS-III scores in the OFF state. Further research is needed to clarify the mechanisms underlying the long-duration response to levodopa in Parkinson’s disease. Understanding the natural course of Parkinson’s disease and the long-duration response to levodopa may help to develop therapeutic strategies increasing its magnitude to improve patient quality of life and to better interpret the outcome of randomized clinical trials on disease-modifying therapies that still rely on the overnight OFF to define Parkinson’s disease progression.
    Materialart: Online-Ressource
    ISSN: 0006-8950 , 1460-2156
    RVK:
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2020
    ZDB Id: 1474117-9
    SSG: 12
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 15
    In: Neurology Genetics, Ovid Technologies (Wolters Kluwer Health), Vol. 6, No. 6 ( 2020-12), p. e523-
    Kurzfassung: To provide a variant-specific estimate of incidence, penetrance, sex distribution, and association with dementia of the 4 most common Parkinson disease (PD)-associated GBA variants, we analyzed a large cohort of 4,923 Italian unrelated patients with primary degenerative parkinsonism (including 3,832 PD) enrolled in a single tertiary care center and 7,757 ethnically matched controls. Methods The p.E326K, p.T369M, p.N370S, and p.L444P variants were screened using an allele-specific multiplexed PCR approach. All statistical procedures were performed using R or Plink v1.07. Results Among the 4 analyzed variants, the p.L444P confirmed to be the most strongly associated with disease risk for PD, PD dementia (PDD), and dementia with Lewy bodies (DLB) (odds ratio [OR] for PD 15.63, 95% confidence interval [CI] = 8.04–30.37, p = 4.97*10 −16 ; OR for PDD 29.57, 95% CI = 14.07–62.13, p = 3.86*10 −19 ; OR for DLB 102.7, 95% CI = 31.38–336.1, p = 1.91*10 −14 ). However, an unexpectedly high risk for dementia was conferred by p.E326K (OR for PDD 4.80, 95% CI = 2.87–8.02, p = 2.12*10 −9 ; OR for DLB 12.24, 95% CI = 4.95–30.24, p = 5.71*10 −8 ), which, on the basis of the impact on glucocerebrosidase activity, would be expected to be mild. The 1.5–2:1 male sex bias described in sporadic PD was lost in p.T369M carriers. We also showed that PD penetrance for p.L444P could reach the 15% at age 75 years. Conclusions We report a large monocentric study on GBA -PD assessing mutation-specific data on the sex distribution, penetrance, incidence, and association with dementia of the 4 most frequent deleterious variants in GBA .
    Materialart: Online-Ressource
    ISSN: 2376-7839
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2020
    ZDB Id: 2818607-2
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 16
    In: SSRN Electronic Journal, Elsevier BV
    Materialart: Online-Ressource
    ISSN: 1556-5068
    Sprache: Englisch
    Verlag: Elsevier BV
    Publikationsdatum: 2020
    Standort Signatur Einschränkungen Verfügbarkeit
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