Clinical significance of serum lncRNA H19, GAS5, HAR1B and linc01783 levels in Parkinson's disease.

Background and purpose:

Long noncoding RNAs (lncRNAs) are highly expressed in the brain and alterations in their levels have been shown in many neurodegenerative disorders. Evidence has shown that lncRNAs play role in the onset and progression of Parkinson’s disease (PD) and it can be used as a potential therapeutic target. Our purpose was to detect whether the serum levels of four candidate lncRNAs H19, GAS5, HAR1B and LINC01783 are related with the clinical findings and treatment of PD or not. 

83 patients and 50 healthy controls were included in this study. We assessed how severe the disease is, by using Hoehn Yahr (HY) staging and Unified PD rating scale (UPDRS). Venous blood samples were taken from the participants. Serum samples were centrifuged and stored at -80°C until analysis. Expression levels of these lncRNAs were analyzed by a real-time PCR instrument after RNA isolation and complementary DNA synthesis in the laboratory.

There was no significant difference between PD patients and healthy controls in these lncRNAs’ serum levels. Just as sociodemographic characteristics, also onset type and right or left predominance of the disease, its duration and treatment did not differ in lncRNA levels. Solely, there was a significant negative correlation between GAS5 and HY and UPDRS scores. Patients with family history of PD had significantly higher levels of LINC01783.

Serum lncRNA GAS5 level may be a possible biomarker for disease severity in PD patients. 

Soluble LRP-1 in Parkinson's disease: clues for paradoxical effects.

Background: Low density lipoprotein receptor-related protein-1 (LRP-1) is highly expressed in the central nervous system and plays a role in neurodegenerative disorders. The available data on this subject-matter seem to support the presence of a correlation between LRP-1 levels and abnormal aggregation of a plurality of proteins, including tau, amyloid, and α­synuclein. Understanding the molecular mechanisms underlying Parkinson's disease (PD) is critical for development of new therapies.Aim: To investigate serum soluble LRP-1 (sLRP-1) concentrations in patients with PD and explored their potential role as a biomarker in diagnosis and prognosis of disease.Methods: Based on well-defined inclusion and exclusion criteria, we have included 133 PD patients and 45 healthy controls. The clinical severity was assessed using Hoehn Yahr and Unified PD Rating Scale (UPDRS). Following a fasting period, venous blood samples were taken, and centrifuged. Serum samples were stored until analysis. sLRP-1 was measured by ELISA assay.Results: The median of serum sLRP-1 levels was higher in PD patients compared to that in healthy controls, but without reaching a statistical significance. There was a positive, but statistically insignificant, correlation between sLRP-1 levels and duration of disease. sLRP-1 levels had a significant correlation with UPDRS Parts I and IV. Patients with hypertension showed lower levels of sLRP-1.Conclusion: The present study suggests that serum sLRP-1 concentrations are associated with the factors influencing prognosis of PD and disease severity. Further studies are needed to definitively determine whether or not sLRP-1 can be utilized as a diagnostic and prognostic biomarker for PD.

Serum microRNA expression levels in Turkish patients with Parkinson's disease.

OBJECTIVES: To determine the serum expression levels of seven candidate microRNAs (miRNA); miR-19a, miR-19b, miR-29a, miR-29c, miR-181, miR-195 and miR-221 in Turkish patients with Parkinson's disease (PD) and explored their potential role in the diagnosis of PD. We further described the relationship between these miRNAs with the clinical findings and treatment of PD. MATERIALS AND METHODS: The study included 51 PD patients and 20 healthy controls. The clinical severity of disease was assessed using the Hoehn Yahr staging scale and the Unified Parkinson's Disease Rating Scale (UPDRS). Venous blood samples were taken after fasting for 12 h, then centrifuged. Obtained serum samples were stored until analysis of miRNA. In the laboratory, expression levels of these miRNAs were analyzed using a real-time PCR instrument. Receiver-operating characteristic analysis and area-under the-curve (AUC) was used to evaluate these miRNA levels as potential diagnostic biomarkers for PD. RESULTS: miR-29c expression levels were increased significantly for PD patients compared to healthy controls. There were no significant differences in levels of other miRNAs between PD patients and controls. The AUC of miR-29c was 0.689. The sensitivity and specificity of this diagnostic test was 54.9% and 80.0%, respectively. miR-195 level was found to have a significant positive correlation only with age. Significant negative correlation was found between miR-29a level and UPDRS total score. miR-19b was found higher in ropinirole drug used group than that of pramipexole group. CONCLUSION: This study suggests that serum miR-29c expression level might be potential biomarker in the diagnosis of Turkish Parkinson patients.

Determining mercury levels in anchovy and in individuals with different fish consumption habits, together with their neurological effects.

An increase in enviromental pollution may lead to mercury toxicity of fish origin due to the accumulative nature of methylmercury in fish. The main sources of human exposure to organic mercury compounds are contaminated fish and other seafoods. This descriptive study was planned to determine mercury levels in anchovy and in hair samples from individuals with different fish consumption habits, and to evaluate those individuals in terms of toxic effects. For that purpose, we analyzed 100 anchovies from the Black Sea and 100 anchovies from the Sea of Marmara, and assessed 25 wholesale workers in fish markets and 25 cleaning firm employees from both Ankara and Istanbul. Mercury levels in samples were measured using a cold vapor atomic absorption spectrophotometer. Participants were examined neurologically and mini mental state examination was applied to evaluate their cognitive functions. Mercury levels in fish were found to be below the national and international permitted levels. There was no statistically significant relation between mercury levels and the sea from which fish were caught. Hair mercury levels for all participants were within permitted ranges. However, hair mercury levels in both cities increased significantly with amount and frequency of fish consumption. A significant correlation was determined at correlation analysis between levels of fish consumption and hair mercury levels in the fishmongers and in the entire group (r = 0.32, p = 0.025; r = 0.23, p = 0.023, respectively). Neurological examination results were normal, except for a decrease in deep tendon reflexes in some participants in both cities. There was no correlation between Standardized Mini Mental State Examination results and hair mercury levels. We conclude that establishing a monitoring system for mercury levels in fish and humans will be useful in terms of evaluating potential neurotoxic effects.

Serum Leptin Levels and Cognition in Parkinson's Disease Patients.

INTRODUCTION: To investigate the relationship between serum leptin levels and cognition in Parkinson's disease (PD) patients. METHODS: Thirty patients with idiopathic PD and 30 healthy controls were enrolled. At baseline, all patients had their standing height, weight, and waist circumference measurements taken using a standard scale. Their body mass index was then calculated. A fasting blood of 5 ml was obtained from each patient in the morning. ELISA was used to analyze leptin concentrations. The severity of PD was evaluated using the Hoehn and Yahr scale, and the clinical status of patients was evaluated using the Unified Parkinson's Disease Rating Scale. The cognitive status of whole patients was evaluated using a validated form of the Montreal Cognitive Assessment Scale in Turkey (MoCA-TR). RESULTS: The mean ages of the patients and controls were 59.37±9.22 and 58.50±9.85 years, while the mean leptin levels were 4.13±3.61 and 3.12±2.43 ng/mL, respectively. Leptin levels did not differ between PD patients and the controls. PD patients had significantly lower MoCA-TR scores than the controls (p=0.028). MoCA-TR scores were not correlated to leptin levels in PD patients. CONCLUSION: In this study, we could not find a relationship between blood leptin levels of PD patients and cognition as assessed by MoCA-TR. Larger longitudinal studies are needed.

Neurosyphilis: a case report.

Syphilis is a multisystem chronic infection caused by treponema pallidum. It can cause psychiatric disorders including depression, mania, psychosis, personality changes, delirium and dementia. With the introduction of penicillin into practice, the number of cases with syphilis decreased and its incidence increased with AIDS and HIV seropositivity. In this article, we present a case of neurosyphilis that manifested itself with neuropsychiatric symptoms.

Social phobia in Parkinson's disease: Prevalence and risk factors.

OBJECTIVE: We aimed to investigate the frequency of social phobia in patients with Parkinson's disease (PD). In addition, we explored the relationship between social phobia and the clinical characteristics of PD, and the frequency of comorbid psychiatric disorders in PD patients. METHODS: This study included 80 consecutive patients with PD admitted to the Parkinson's disease and Movement Disorders Clinic at the Erenkoy Research and Training Hospital for Neurologic and Psychiatric Disorders, Istanbul, Turkey and used demographic and clinical data. The PD patients were evaluated during the "on state", using the Hoehn and Yahr scale, the Unified Parkinson's Disease Rating Scale, and the Schwab England Activities of Daily Living Scale. Psychiatric evaluations were conducted using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition structured clinical interview, the Liebowitz Social Anxiety Scale (LSAS), and the Hamilton Depression Rating Scale. RESULTS: Social phobia was diagnosed in 42.5% of PD patients. Social phobia was comorbid with depression in 20 patients (58.8%), generalized anxiety disorder in 18 patients (52.9%), and panic disorder in six patients (17.6%). Social phobia was more frequent in males, early-onset PD, patients with a long duration of disease, the presence of postural instability, and with the use of a high Levodopa equivalent daily dose. A logistic regression analysis revealed the predictive factors of social phobia to be the sex of the patient (more frequent in males) and the presence of postural instability. There was a statistically significantly negative correlation between the LSAS score and the age of disease onset (r=-0.503; P=0.002) and a positive correlation between LSAS score and the duration of disease (r=0.374; P=0.023). CONCLUSION: Social phobia is frequently observed in PD patients. Therefore, the assessment of PD patients should always include psychiatric evaluations, particularly for social phobia. The early detection and treatment of social phobia in PD patients is very important for the quality of life of patients as well as caregivers.

Serum leptin concentrations in Turkish Parkinson's disease population.

Objectives. To investigate leptin levels and their relationship to body composition and demographic and clinical characteristics of Turkish patients with Parkinson's disease (PD). Patients and Methods. Forty eligible PD patients and 25 healthy controls were included in the study. Body composition measurements (height, weight, waist circumference (WC), and body mass index (BMI)) of the whole sample and clinical findings of PD patients were evaluated in the on-state. A single 5 mL fasting blood sample was obtained from each participant in the morning. Severity of PD was evaluated using the Hoehn and Yahr scale and the Unified Parkinson's Disease Rating Scale. Results. The mean age of the patients and controls was 60.8 ± 9.4 and 61.8 ± 5.8 years, while the mean BMI was 30.17 ± 5.10 and 28.03 ± 3.23 and the mean leptin levels were 6.8 ± 6.9 and 3.9 ± 3.8 ng/mL, respectively. Only age and gender were correlated with leptin levels. There was a significant difference (P < 0.001) in leptin levels between male (3.6 ± 3.1 ng/mL) and female (14.3 ± 7.7 ng/mL) PD patients. Among the male PD patients, older age and higher BMI and WC values were associated with higher mean leptin levels. There was not any significant relationship between leptin levels and clinical findings in PD patients. Conclusion. These results may suggest that leptin levels have no determinative role in the follow-up of PD patients with regard to the severity and clinical prognosis of PD.

Suicidal behavior among Turkish patients with Parkinson's disease.

OBJECTIVE: To investigate the predictors of suicidal ideation and attempts among Turkish Parkinson's disease (PD) patients. MATERIALS AND METHODS: The study comprised 120 patients with PD. Clinical findings were obtained by using the Unified Parkinson's Disease Rating Scale. Disease severity was measured by the Hoehn and Yahr staging scale, and the Schwab and England Activities of Daily Living scale was used for patient disability. Psychiatric evaluation was performed by the same psychiatrist using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Axis I Disorders. Severity of depression was measured with the Hamilton Depression Rating Scale. Suicidal ideation and attempts were considered positive if experienced during the patient's lifetime. The Suicide Probability Scale was used to assess the risk of suicide. Data were analyzed by logistic regression models to identify variables associated with suicidal ideation and attempts. RESULTS: Based on logistic regression analysis, education level, age of disease onset, disease duration, depression, and history of impulse-control disorder (ICD) behaviors were significant predictors of suicidal ideation. The risk rate in the presence of depression and history of ICD behaviors was increased by 5.92 and 4.97, respectively. Additionally, lifetime prevalence of suicidal ideation was found in 11.6% (14 of 120) of PD patients, although no patient had ever attempted suicide. CONCLUSION: Turkish patients with PD who exhibit a high risk for suicidal ideation also experience disease starting at an earlier age, longer disease duration, presence of depression, and ICD behaviors, and should be monitored carefully.

Validation of the Turkish Version of the Montreal Cognitive Assessment Scale (MoCA-TR) in patients with Parkinson's disease.

The study aimed to examine the reliability and validity of the Turkish version of the Montreal Cognitive Assessment Scale (MoCA-TR) as a screening tool for cognitive dysfunction in Parkinson's disease (PD). A total of 50 patients with PD and 50 healthy controls were included. The screening instruments-MoCA-TR followed by the Mini-Mental Status Examination (MMSE-TR) and MoCA-TR retest within 1 month-and detailed neuropsychological testing were administered to the PD patients. MoCA-TR and MMSE-TR were also administered to controls. The discriminant validities of the MoCA-TR and MMSE-TR as screening and diagnostic instruments were ascertained. The concurrent and criterion validity, test-retest reliability, and internal consistency of the MoCA-TR and MMSE-TR were examined. The Cronbach's alpha of the MoCA-TR as an index of internal consistency was 0.664, and the test-retest reliability of MoCA-TR was 0.742. With a cut-off score of < 21 points, the MoCA-TR showed sensitivity of 59% and specificity of 89% in the detection of cognitive dysfunction in PD. The area under the receiver-operating characteristics curve (95% confidence interval) for MoCA-TR was 0.794 (0.670-0.918), p<.001. The present results indicated that the MoCA-TR has acceptable psychometric properties and it should be used to assess mild cognitive impairment and early dementia in PD patients, whereas the MMSE-TR should remain the instrument of choice to assess cognitive impairment in PD dementia.

Episodes of status epilepticus in young adults: etiologic factors, subtypes, and outcomes.

The aim of this study was to evaluate the type, duration, etiology, treatment, and outcome of status epilepticus (SE) episodes, among patients aged 16-50 years. A total of 101 SE episodes in 88 young adult patients fulfilled our criteria. The mean age was 32 years. Status epilepticus episodes were most frequently observed in patients 21-30 years of age. A total of 53% of the patients were male, and 57% had pre-existing epilepsy. Seventy of the 101 episodes were convulsive SE. The most common etiology was withdrawal of or change in antiepileptic drugs (AEDs), seen in 31% of the SE episodes. This study included treatment of SE with traditional AEDs. Sixty-six episodes were treated successfully with intravenous infusion of 18-mg/kg phenytoin, and six episodes were treated with 10-mg/kg phenytoin. A total of 28% of the SE episodes remained refractory to first-line treatment, which was related to the duration of SE and mortality. The outcome was death in 14% of the patients due to underlying etiologies in the hospital.

Motor and non-motor symptoms in Turkish patients with Parkinson's disease affecting family caregiver burden and quality of life.

Parkinson's disease (PD) decreases the quality of life (QoL) of both caregivers and patients by increasing stress and burden, and it has a negative impact on their psychological state. In the present study, the authors examined the impact of PD-patient motor and non-motor clinical symptoms on the psychological health, burden, and QoL of Turkish caregivers. The study included 50 patients with PD and their caregivers. Patients' disease severity and disability, motor and non-motor symptoms, disease complications, sleep disturbances, anxiety, and depressive symptoms were assessed with various scales. Data were analyzed by multiple linear-regression models to identify variables associated with caregiver burden, psychological status, and QoL. Anxiety and depressive symptoms exhibited by the patients significantly affected the psychological state of the caregivers. Caregiver burden was increased by disease severity; the patient's degree of disability, anxiety, and depressive symptoms; and excessive daytime sleepiness. Caregiver QoL was significantly affected by the presence of dyskinesia, sialorrhea, and anxiety symptoms in patients with PD. These findings indicate that caregiving for patients with PD, particularly those in later stages, with psychiatric symptoms, affects caregiver psychological status, QoL, and caregiver burden. These results can be used to develop treatment approaches to improve caregivers' psychological status and QoL and decrease caregiver burden.