| 1. |
- Ahmadi, Ahmad, 1964-, et al.
(författare)
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GSTM1 and mEPHX polymorphisms in Parkinson's disease and age of onset
- 2000
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Ingår i: Biochemical and Biophysical Research Communications - BBRC. - : Elsevier BV. - 0006-291X .- 1090-2104. ; 269:3, s. 676-680
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Tidskriftsartikel (refereegranskat)abstract
- Both environmental and genetic factors are involved in the development of PD and biotransformation of exogenous and endogenous compounds and may play a role in inter-individual susceptibility. Therefore, we investigated the presence of null genotypes of GSTM1, GSTT1, and two polymorphisms of mEPHX in subjects with Parkinson's disease and in a reference population. The study included 35 male PD patients and a male control group including 283 subjects. Homozygosity of the histidine (H) 113 isoform of mEPHX was significantly increased in PD patients (odds ratio = 3.8 CI 95% 1.2–11.8) and analysis of allele frequencies displayed an increased frequency of the H-allele among PD patients (odds ratio = 1.9 CI 95% 1.1–3.3). However, a significantly elevated median age for the onset of PD was found among GSTM1 gene carriers (median age = 68 years) compared to PD patients being GSTM1 null genotypes (median age = 57 years). Our observations suggest that (H) 113 isoform of mEPHX, which has been suggested as a low activity isoform, is overrepresented in PD patients and that inherited carriers of the GSTM1 gene postpone the onset of PD. These detoxification pathways may represent important protective mechanisms against reactive intermediates modifying the susceptibility and onset of PD.
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| 2. |
- Fall, Per-Arne, et al.
(författare)
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Age standardised incidence and prevalence of Parkinson´s disease in a Swedish community
- 1996
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Ingår i: Journal of Clinical Epidemiology. - : Elsevier BV. - 0895-4356. ; 49:6, s. 637-641
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Tidskriftsartikel (refereegranskat)abstract
- Parkinson's disease (PD) shows a geographical variation. All prescriptions for anti-parkinsonian drugs were recorded for a half-year in a region with low -dopa consumption. Hospital and outpatient records were studied and physicians were asked to supply details of PD patients in the region, with 147,777 inhabitants. The crude prevalence was 115 PD per 100,000 inhabitants, based on 170 cases. In contrast to other studies we report an age-standardized prevalence, which was 76 per 100,000, using the European Standard Population as reference. The corresponding approximate incidences were 11.0 (crude) and 7.9 (age-standardized) per 100,000 person-years. Male preponderance appeared in all age groups. Mean age at onset was 65.6 years, the highest figure reported. Variation between studies for age at onset, differences in prevalence, and male preponderance suggest environmental risk factors to be of importance for PD.
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| 3. |
- Fall, Per-Arne, 1943-
(författare)
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Aspects of Parkinson's disease. Epidemiology, risk factors and ECT in advanced disease
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose was to investigate some aspects of epidemiology, risk factors and treatment with ECT in advanced Parkinson’s disease (PD).In study I, we performed a descriptive epidemiologic population-based survey in the Central Health Care District in Östergötland in south-east Sweden, with a population of almost 150,000 inhabitants 1989. The case finding was accomplished in three ways: 1. Collection of all prescriptions for Parkinson’s disease. 2. Search in medical files. 3. Checking with all nursing homes in the area. The crude prevalence was found to be 115 per 100,000 inhabitants. When we used the European Standard Population as a tool for easy comparisons of PD prevalence between different areas and time periods 76 PD-cases per 100,000 inhabitants were found. The corresponding incidences were 11.0 (crude) and 7.9 (age standardised) per 100,000 person-years. Mean age at onset was 65.6. A low prevalence and a high age at onset suggested that e.g. environmental factors could influence the occurrence of PD, and the results implies that only few such factors were present in the investigated area.The findings led to study II, a case-control study which investigated the possible impact of nutritional and environmental risk factors for idiopathic Parkinson’s disease (IP), including 113 cases and 263 control subjects. Dietary, drinking, and smoking habits, as well as previous occupation, were requested in a structured questionnaire. No increased risk was found for any of the nutrients. A reduced risk was found for coffee, wine, and spirits but also for broiled meat, smoked ham or meat, eggs, French loaf or white bread, and tomatoes. These findings could indicate an antioxidant effect. Frequency of preceding and present smoking was reduced in IP patients. Possible mechanisms are discussed. Various occupational groups and exposures were analysed and increased risks of IP in men were found for agricultural work, pesticide exposure, male carpenters, and in female cleaners.In advanced PD there is a need for further therapeutic improvements, and electroconvulsive therapy (ECT) is one insufficiently explored and evaluated method. In study III ECT 16 non-depressed, nondemented PD patients with advanced disease were treated with ECT. In all patients an antiparkinsonian effect of ECT was seen, lasting between a few days and 18 months. Five patients, all with signs of blood brain barrier damage, developed transitory mental confusion after ECT. The results indicated that ECT could cause increased dopaminergic activity, which led us to study IV. Single photon emission computed tomography (SPECT) with the cocaine analogue [123I]-β-CIT was used in order to visualise dopaminergic neurones in the brain. Six patients with PD were examined before and after a series of ECT, and in three cases SPECT was also repeated after one year. The side-to-side difference in the radiotracer uptake was found to be significantly lower in striatum located contralaterally to the part of the body with most pronounced symptomatology. No significant change in uptake of [123I]-β-CIT was seen after ECT, although all patients improved and the most pronounced improvement was seen in patients with less advanced PD.Study V points at two new positive observations with maintenance ECT (MECT). i.e. repeated ECT treatment of PD. One patient had either severe mental side effects on higher L-dopa doses or intolerable parkinsonian symptoms on lower doses. MECT implied marked improvement in parkinsonian symptoms without mental side effects. Another PD patient, who also had a mental depression, showed slight improvement of motor symptoms on a series of ECT. When treated with MECT further antiparkinsonian effects were seen.
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| 4. |
- Fall, Per-Arne, et al.
(författare)
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ECT in Parkinson's disease : Changes in motor symptoms, monoamine metabolites and neuropeptides
- 1995
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Ingår i: Journal of Neural Transmission. Parkinson's disease and dementia section.. - 0936-3076. ; 10:2-3, s. 129-140
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Tidskriftsartikel (refereegranskat)abstract
- Electroconvulsive therapy (ECT) was given to 16 non-depressed, non-demented patients with advanced Parkinson's disease (PD). In all the patients an antiparkinsonian effect was seen, lasting for 18 months in one patient, 3-5 months in seven patients, and a few days to four weeks in eight patients. After ECT the levels of homovanillic acid and neuropeptide Y in cerebrospinal fluid (CSF) were significantly increased. The eight patients with long lasting motor improvement after ECT had significantly lower CSF-3-methoxy-4-hydroxyphenylglycol compared to the group with short lasting improvement. Five patients developed transitory mental confusion after ECT. In these patients, and in no others, a high albumin-ratio was found already before ECT was given - an indication of blood CSF barrier damage. Our results suggest that ECT is valuable in patients with drug refractory PD or PD with intolerance to antiparkinsonian drugs.
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| 5. |
- Fall, Per-Arne, et al.
(författare)
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ECT in Parkinson's disease-dopamine transporter visualised by [123I]-beta-CIT SPECT
- 2000
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Ingår i: Journal of Neural Transmission. - : Springer Science and Business Media LLC. - 0300-9564 .- 1435-1463. ; 107:8-9, s. 997-1008
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Tidskriftsartikel (refereegranskat)abstract
- Parkinson's disease (PD) is characterised by a loss of dopaminergic neurones in the basal ganglia. These neurones may be visualised by single photon emission computed tomography (SPECT) with the cocaine analogue 2β-carboxymethyl-3-β-(4-iodophenyl)tropane ([123I]β-CIT), which labels the dopamine reuptake sites in the nerve terminals. In order to evaluate the possibility to predict the outcome of ECT a prospective study was per-formed with six PD patients in whom the [123I]β-CIT uptake was measured before and after an electroconvulsive therapy (ECT) series. The side-to-side difference in the radiotracer uptake was found to be significantly lower in striatum located contralaterally to the part of the body with the most pronounced symptomathology. No significant change in uptake of the radioligand was seen after ECT. Patients with best uptake and thus with less advanced PD improved most after ECT. The possibility to use the [123I]β-CIT uptake to predict the outcome of ECT treatment has to be further evaluated.
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| 6. |
- Fall, Per-Arne, et al.
(författare)
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Maintenance ECT in Parkinson's disease
- 1999
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Ingår i: Journal of Neural Transmission. - : Springer Science and Business Media LLC. - 0300-9564 .- 1435-1463. ; 106:7-8, s. 737-741
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Tidskriftsartikel (refereegranskat)abstract
- Electroconvulsive therapy (ECT) has an anti-Parkinsonian effect. In two cases repeated single ECT, i.e. maintenance ECT (MECT), caused different, hitherto unreported positive effects. One patient had either severe mental side effects from higher L-dopa doses or intolerable parkinsonian symptoms on lower doses. MECT entailed a marked improvement in parkinsonian symptoms without mental side effects. Another patient with depression as well as Parkinson's disease who showed a slight improvement of motor symptoms after a series of ECT presented further anti-parkinsonian effects on MECT.
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| 7. |
- Fall, Per-Arne, et al.
(författare)
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Nutritional and occupational factors influencing the risk of Parkinson's disease : a case-control study in southeastern Sweden
- 1999
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Ingår i: Movement Disorders. - 0885-3185. ; 14:1, s. 28-37
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE AND METHODS: To investigate the possible impact of nutritional and environmental risk factors for idiopathic Parkinson's disease (IP), a case-control study was performed in the county of Ostergötland in southeastern Sweden. The study involved 113 cases of IP and 263 control subjects. Dietary, drinking, and smoking habits, as well as previous occupation, were requested in a structured questionnaire. RESULTS: No increased risk was found for any of the nutritional items in which information was requested. A reduced risk was found for coffee, wine, and liquor at various consumption levels but also for fried or broiled meat, smoked ham or meat, eggs, French loaf or white bread, and tomatoes. All these food and drink items contain niacin. As in many studies, the frequency of preceding and present smoking was reduced in IP patients. Various occupational groups and exposures were analyzed and increased risks of IP in men were found for agricultural work along with pesticide exposure; this was also the case for male carpenters and female cleaners. CONCLUSIONS: The findings indicate that nutritional factors and occupational exposures, especially to pesticides, could be of etiologic importance in IP.
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| 8. |
- Fall, Per-Arne, 1943-, et al.
(författare)
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Survival time, mortality, and cause of death in elderly patients with Parkinson's disease : A 9-year follow-up
- 2003
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Ingår i: Movement Disorders. - : Wiley. - 0885-3185 .- 1531-8257. ; 18:11, s. 1312-1316
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Tidskriftsartikel (refereegranskat)abstract
- This community-based study of Parkinson's disease (PD) investigated age at death and cause of death in a cohort of 170 previously studied patients. The current study is a 9-year follow-up, and the results are compared to 510 sex- and age-matched controls from the same area. A total of 170 patients were diagnosed with PD on August 31, 1989, within a defined area of Sweden. A control group of 510 persons from the same area and with the same age and sex distribution was also examined regarding age at death and cause of death. After 9.4 years, 121 cases (71.1%) and 229 controls (44.9%) were no longer alive. Thus, the mortality rate ratio was 1.6 (95% confidence interval [CI], 1.3-1.8) when comparing PD patients with controls. The all-cause hazard ratio for cases compared to controls was 2.4 (95% CI, 1.9-3.0). The mean age at death for the cases was 81.9 (95% CI, 80.3-83.0) years and for the controls 82.9 (95% CI, 82.0-83.7) years. Survival analysis also showed a shorter survival time (P < 0.001) for PD patients. Only 53% of the death certificates for the deceased patients recorded PD as an underlying or contributory cause of death. Many PD patients reached a high age but had a shorter survival than the controls. There was a significant increase in deaths from pneumonia.
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| 9. |
- Pereira, Maria J, 1981-, et al.
(författare)
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FKBP5 expression in human adipose tissue increases following dexamethasone exposure and is associated with insulin resistance
- 2014
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Ingår i: Metabolism: Clinical and Experimental. - : Elsevier BV. - 0026-0495 .- 1532-8600. ; 63:9, s. 1198-1208
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study effects of dexamethasone on gene expression in human adipose tissue aiming to identify potential novel mechanisms for glucocorticoid-induced insulin resistance. Materials/methods Subcutaneous and omental adipose tissue, obtained from non-diabetic donors (10 M/15 F; age: 28-60 years; BMI: 20.7-30.6 kg/m2), was incubated with or without dexamethasone (0.003-3 μmol/L) for 24 h. Gene expression was assessed by microarray and real time-PCR and protein expression by immunoblotting. Results FKBP5 (FK506-binding protein 5) and CNR1 (cannabinoid receptor 1) were the most responsive genes to dexamethasone in both subcutaneous and omental adipose tissue (~ 7-fold). Dexamethasone increased FKBP5 gene and protein expression in a dose-dependent manner in both depots. The gene product, FKBP51 protein, was 10-fold higher in the omental than in the subcutaneous depot, whereas the mRNA levels were similar. Higher FKBP5 gene expression in omental adipose tissue was associated with reduced insulin effects on glucose uptake in both depots. Furthermore, FKBP5 gene expression in subcutaneous adipose tissue was positively correlated with serum insulin, HOMA-IR and subcutaneous adipocyte diameter and negatively with plasma HDL-cholesterol. FKBP5 SNPs were found to be associated with type 2 diabetes and diabetes-related phenotypes in large population-based samples. Conclusions Dexamethasone exposure promotes expression of FKBP5 in adipose tissue, a gene that may be implicated in glucocorticoid-induced insulin resistance. © 2014 Elsevier Inc.
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| 10. |
- Skogar, O, et al.
(författare)
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"Effects of Tactile Touch on pain, sleep and health related quality of life in Parkinsons disease with chronic pain": A randomized, controlled and prospective study
- 2013
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Ingår i: European Journal of Integrative Medicine. - : Elsevier. - 1876-3820 .- 1876-3839. ; 5:2, s. 141-152
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Parkinsons disease (PD) is often associated with chronic PD related pain. Complementary medicine are widely used but randomized, controlled and prospective studies of the effects are sparse. less thanbrgreater than less thanbrgreater thanAims of the study: To compare the effects of Tactile Touch (TT) with Rest to Music (RTM) in PD patients with chronic pain and to describe effects within groups. less thanbrgreater than less thanbrgreater thanPatients and methods: A 34 week controlled randomized and prospective trial compared the effects of TT with RTM in 45 (29 TT and 16 RTM) patients with PD and chronic pain. The whole body tactile stimulation method was performed for each individual patient by the same therapist for 10 times during the first 8 weeks. The RTM group received the same therapy except for the tactile stimulation. Pharmacotherapy was kept unchanged. Participants were assessed at pre- and post-intervention for pain, sleep patterns and health related quality of life (HRQoL). less thanbrgreater than less thanbrgreater thanResults: Differences between TT and RTM groups were few. Total PDSS significantly improved within the TT but not in the RTM-group. No significant differences between groups were seen in pain parameters, although significant improvements were seen within the TT-group after the intervention period. There were significant improvements within both groups in HRQoL and between groups in the items physical role and social functioning 4 weeks after screening. less thanbrgreater than less thanbrgreater thanConclusions: No significant differences between the TT and RTM groups were seen. Only in single aspects did patients with PD and chronic pain have more benefit more from CAM therapy with TT in combination with RTM.
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