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See detailGBA variants in Parkinson’s disease: clinical, metabolomic and multimodal neuroimaging phenotypes
Greuel, Andrea; Trezzi, Jean-Pierre UL; Glaab, Enrico UL et al

in Movement Disorders (in press)

Background: Alterations in the GBA gene (NM_000157.3) are the most important genetic risk factor for Parkinson’s disease. Biallelic GBA mutations cause the lysosomal storage disorder Gaucher´s disease ... [more ▼]

Background: Alterations in the GBA gene (NM_000157.3) are the most important genetic risk factor for Parkinson’s disease. Biallelic GBA mutations cause the lysosomal storage disorder Gaucher´s disease. The GBA variants p.E365K and p.T408M are associated with Parkinson’s but not with Gaucher´s disease. The pathophysiological role of these variants needs to be further explored. Objective: This study analyzed the clinical, neuropsychological, metabolic and neuroimaging phenotypes of Parkinson’s disease patients carrying the GBA variants p.E365K and p.T408M. Methods: GBA was sequenced in 56 mid-stage Parkinson’s disease patients. Carriers of GBA variants were compared to non-carriers regarding clinical history and symptoms, neuropsychological features, metabolomics and multimodal neuroimaging. Blood plasma gas chromatography coupled to mass spectrometry, [18F]FDopa PET, [18F]FDG PET, and resting-state fMRI were performed. Results: Sequence analysis detected 13 heterozygous GBA variant carriers (seven with p.E365K, six with p.T408M). One patient carried a GBA mutation (p.N409S) and was excluded. Clinical history and symptoms were not significantly different between groups. Global cognitive performance was lower in variant carriers. Metabolomic group differences were suggestive of more severe Parkinson’s disease-related alterations in carriers versus non-carriers. [18F]FDopa and [18F]FDG PET showed signs of a more advanced disease; [18F]FDG PET and fMRI showed similarities with Lewy body dementia and Parkinson’s disease dementia in carriers. Conclusions: This is the first study to comprehensively assess (neuro-)biological phenotypes of GBA variants in Parkinson’s disease. Metabolomics and neuroimaging detected more significant group differences than clinical and behavioral evaluation. These alterations could be promising to monitor effects of disease-modifying treatments targeting glucocerebrosidase metabolism. [less ▲]

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See detailDeep Brain Stimulation for Freezing of Gait in Parkinson’s Disease With Early Motor Complications
Krüger, Rejko UL; EARLYSTIM study group; Barbe, Michael

in Movement Disorders (2019)

Background: Effects of DBS on freezing of gait and other axial signs in PD patients are unclear. Objective: Secondary analysis to assess whether DBS affects these symptoms within a large randomized ... [more ▼]

Background: Effects of DBS on freezing of gait and other axial signs in PD patients are unclear. Objective: Secondary analysis to assess whether DBS affects these symptoms within a large randomized controlled trial comparing DBS of the STN combined with best medical treatment and best medical treatment alone in patients with early motor complications (EARLYSTIMtrial). [less ▲]

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See detailGenotype-phenotype relations for the Parkinson’s disease genes SNCA, LRRK2, VPS35: MDSGene Review.
Trinh, Joanne; Zeldenrust, Florentine M. J.; Huang, Jana et al

in Movement Disorders (2018), 33(12), 1857-1870

This comprehensive MDSGene review is devoted to the three autosomal-dominant PD forms: PARK-SNCA, PARK-LRRK2, and PARK-VPS35. It follows MDSGene's standardized data extraction protocol, screened a total ... [more ▼]

This comprehensive MDSGene review is devoted to the three autosomal-dominant PD forms: PARK-SNCA, PARK-LRRK2, and PARK-VPS35. It follows MDSGene's standardized data extraction protocol, screened a total of 2,972 citations, and is based on fully curated phenotypic and genotypic data on 937 patients with dominantly inherited PD attributed to 44 different mutations in SNCA, LRRK2, or VPS35. All of these data are also available in an easily searchable online database (www.mdsgene.org), which additionally provides descriptive summary statistics on phenotypic and genetic data. Despite the high degree of missingness of phenotypic features and unsystematic reporting of genotype data in the original literature, the present review recapitulates many of the previously described findings including later onset of disease (median age at onset: ∼49 years) compared to recessive forms of PD of an overall excellent treatment response. Our systematic review validates previous reports showing that SNCA mutation carriers have a younger age at onset compared to LRRK2 and VPS35 (P < 0.001). SNCA mutation carriers often have additional psychiatric symptoms, and although not exclusive to only LRRK2 or VPS35 mutation carriers, LRRK2 mutation carriers have a typical form of PD, and, lastly, VPS35 mutation carriers have good response to l-dopa. [less ▲]

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See detailUnderstanding the role of genetic variability in LRRK2 in Indian population
Krüger, Rejko UL; Kishore, Asha; Comprehensive Unbiased Risk Factor Assessment for Genetics and Environment in Parkinson's Disease (COURAGE-PD) et al

in Movement Disorders (2018)

Background: Genetic variability in LRRK2 has been unequivocally established as a major risk factor for familial and sporadic forms of PD in ethnically diverse populations. Objectives: To resolve the role ... [more ▼]

Background: Genetic variability in LRRK2 has been unequivocally established as a major risk factor for familial and sporadic forms of PD in ethnically diverse populations. Objectives: To resolve the role of LRRK2 in the Indian population. Methods: We performed targeted resequencing of the LRRK2 locus in 288 cases and 298 controls and resolved the haplotypic structure of LRRK2 in a combined cohort of 800 cases and 402 controls in the Indian population. We assessed the frequency of novel missense variants in the white and East Asian population by leveraging exome sequencing and densely genotype data, respectively. We did computational modeling and biochemical approach to infer the potential role of novel variants impacting the LRRK2 protein function. Finally, we assessed the phosphorylation activity of identified novel coding variants in the LRRK2 gene. Results: We identified four novel missense variants with frequency ranging from 0.0008% to 0.002% specific for the Indian population, encompassing armadillo and kinase domains of the LRRK2 protein. A common genetic variability within LRRK2 may contribute to increased risk, but it was nonsignificant after correcting for multiple testing, because of small cohort size. The computational modeling showed destabilizing effect on the LRRK2 function. In comparison to the wild-type, the kinase domain variant showed 4-fold increase in the kinase activity. Conclusions: Our study, for the first time, identified novel missense variants for LRRK2, specific for the Indian population, and showed that a novel missense variant in the kinase domain modifies kinase activity in vitro. [less ▲]

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See detailFDG-PET and metabolomics in PD-associated GBA variants
Greuel, Andrea; Trezzi, Jean-Pierre; Glaab, Enrico UL et al

in Movement Disorders (2018), 33(2), 599

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See detailDistinct metabolomic signature in cerebrospinal fluid in early parkinson's disease: Early Parkinson'S CSF Metabolic Signature
Trezzi, Jean-Pierre UL; Galozzi, Sara; Jäger, Christian UL et al

in Movement Disorders (2017)

Objective: The purpose of this study was to profile cerebrospinal fluid (CSF) from early-stage PD patients for disease-related metabolic changes and to determine a robust biomarker signature for early ... [more ▼]

Objective: The purpose of this study was to profile cerebrospinal fluid (CSF) from early-stage PD patients for disease-related metabolic changes and to determine a robust biomarker signature for early-stage PD diagnosis. Methods: By applying a non-targeted and mass spectrometry-driven approach, we investigated the CSF metabolome of 44 early-stage sporadic PD patients yet without treatment (DeNoPa cohort). We compared all detected metabolite levels with those measured in CSF of 43 age- and gender-matched healthy controls. After this analysis, we validated the results in an independent PD study cohort (T€ubingen cohort). Results: We identified that dehydroascorbic acid levels were significantly lower and fructose, mannose, and threonic acid levels were significantly higher (P <.05) in PD patients when compared with healthy controls. These changes reflect pathological oxidative stress responses, as well as protein glycation/glycosylation reactions in PD. Using a machine learning approach based on logistic regression, we successfully predicted the origin (PD patients vs healthy controls) in a second (n518) as well as in a third and completely independent validation set (n536). The biomarker signature is composed of the three markers—mannose, threonic acid, and fructose—and allows for sample classification with a sensitivity of 0.790 and a specificity of 0.800. Conclusion: We identified PD-specific metabolic changes in CSF that were associated with antioxidative stress response, glycation, and inflammation. Our results disentangle the complexity of the CSF metabolome to unravel metabolome changes related to earlystage PD. The detected biomarkers help understanding PD pathogenesis and can be applied as biomarkers to increase clinical diagnosis accuracy and patient care in early-stage PD. [less ▲]

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See detailExploring therapeutic viability of a non-dopaminergic target for Parkinson’s disease
Ashrafi, Amer; Buttini, Manuel UL; Garcia, Pierre UL et al

in Movement Disorders (2016), 31(2), 630

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See detailGut microbiota are related to Parkinson's disease and clinical phenotype
Scheperjans, F.; Aho, Velma UL; Pereira, P. A. B. et al

in Movement Disorders (2015), 30(3), 350-358

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