RESUMO
BACKGROUND: Inflammation appears to play a role in the progression of neurodegenerative diseases. However, little is known about inflammation during early stages of cognitive decline or whether this differs in different disease groups. We sought to investigate this by assessing the inflammatory profile in patients with Parkinson disease with the early stages of cognitive impairment (PD-MCI), patients with prodromal Alzheimer disease (MCI-AD), prodromal Lewy body disease (MCI-LB), and controls. METHODS: We obtained venous blood samples from participants with PD-MCI (n = 44), PD-normal cognition (n = 112), MCI-LB (n = 38), MCI-AD (n = 21), and controls (n = 84). We measured 10 cytokines using Meso Scale Discovery V-Plex Plus including interferon gamma, interleukin (IL)-10, IL-12p70, IL-13, IL-1beta, IL-2, IL-4, IL-6, IL-8, and tumour necrosis factor alpha. High-sensitivity C-reactive protein was measured. RESULTS: There was a higher level of inflammation in patients with MCI-AD and MCI-LB compared with controls. PD noncognitively impaired had higher inflammatory markers than controls, but there was no difference between PD-MCI and controls. There was a decrease in inflammatory markers with increasing motor severity based on the Unified Parkinson's Disease Rating Scale. CONCLUSIONS: Inflammation may be involved in the onset of cognitive decline in patients with MCI-AD and MCI-LB but appears to be less prominent PD-MCI albeit in a small data set. This suggests that anti-inflammatory medications may have most benefit at the earliest stages of neurodegenerative diseases. For PD cases, this might be in advance of the development of MCI.
Assuntos
Doença de Alzheimer/patologia , Disfunção Cognitiva/patologia , Inflamação/patologia , Doença por Corpos de Lewy/patologia , Doença de Parkinson/patologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Biomarcadores/análise , Proteína C-Reativa/análise , Estudos de Casos e Controles , Disfunção Cognitiva/psicologia , Citocinas/análise , Progressão da Doença , Feminino , Humanos , Inflamação/sangue , Interleucina-1beta , Doença por Corpos de Lewy/psicologia , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Doença de Parkinson/psicologiaRESUMO
BACKGROUND: Mild cognitive impairment in Parkinson's disease (PD) is common and predicts those at risk of dementia. Cholinergic dysfunction may contribute to its pathophysiology and can be assessed using short latency afferent inhibition. METHODS: Twenty-two patients with PD (11 cognitively normal; 11 with mild cognitive impairment) and 22 controls participated. Short latency afferent inhibition was measured by conditioning motor evoked potentials, which were elicited by transcranial magnetic stimulation of the motor cortex with electrical stimuli delivered to the contralateral median nerve at varying interstimulus intervals. RESULTS: There was no significant difference between cognitively normal PD and controls for short latency afferent inhibition (62.8±30.3% vs. 55.7±21.7%; P=0.447). The PD-mild cognitive impairment group had significantly less inhibition (88.4±25.8%) than both cognitively normal PD (P=0.021) and controls (P=0.01). CONCLUSIONS: Cholinergic dysfunction occurs early in those with PD-mild cognitive impairment. Short latency afferent inhibition may be a useful biomarker of increased risk of dementia in PD patients. © 2013 Movement Disorder Society.