Philipp Mahlknecht1, Stefan Kiechl2, Heike Stockner3, Johann Willeit4, Arno Gasperi5, Werner Poewe6, Klaus Seppi7. 1. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria; Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK. Electronic address: Philipp.Mahlknecht@i-med.ac.at. 2. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria. Electronic address: Stefan.Kiechl@i-med.ac.at. 3. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria. Electronic address: Heike.Stockner@i-med.ac.at. 4. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria. Electronic address: Johann.Willeit@i-med.ac.at. 5. Department of Neurology, Hospital of Bruneck, Bruneck, Italy. Electronic address: Arno.Gasperi@sb-bruneck.it. 6. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria. Electronic address: Werner.Poewe@i-med.ac.at. 7. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria. Electronic address: Klaus.Seppi@uki.at.
Abstract
OBJECTIVE: Mild parkinsonian signs (MPS) are common in the elderly population and are associated with a wide range of adverse health outcomes, including incident Parkinson's disease (PD). We aimed to prospectively evaluate potential risk factors for incident MPS. METHODS: Participants of the population-based Bruneck Study representative for the general elderly community underwent a baseline assessment of substantia nigra (SN)-echogenicity with transcranial sonography, olfactory function with the Sniffin' Sticks identification test and vascular risk according to the Framingham risk score as well as a baseline and 5-year follow-up neurological examination. MPS were defined according to established criteria based on the entire motor section of the Unified PD Rating Scale. Participants with PD at baseline or follow-up and subjects with MPS at baseline were excluded. A logistic regression analysis adjusted for age and sex was used to detect risk factors for incident MPS in the remaining 393 participants. RESULTS: SN-hyperechogenicity and hyposmia were related to the development of MPS with odds ratios of 2.0 (95%CI, 1.1-3.7) and 1.6 (95%CI, 1.0-2.7), respectively, while increased vascular risk was not. Having both, SN-hyperechogenicity and hyposmia, was associated with an odds ratio of 3.0 (95%CI, 1.2-7.7) for incident MPS. Among the various motor domains, increased SN-echogenicity predicted the development of bradykinesia and rigidity, whereas diminished olfactory function predicted the development of impaired axial motor function. CONCLUSIONS: In addition to their established roles as risk factors for PD, SN-hyperechogenicity and hyposmia are associated with an increased risk for MPS in the general elderly community.
OBJECTIVE: Mild parkinsonian signs (MPS) are common in the elderly population and are associated with a wide range of adverse health outcomes, including incident Parkinson's disease (PD). We aimed to prospectively evaluate potential risk factors for incident MPS. METHODS:Participants of the population-based Bruneck Study representative for the general elderly community underwent a baseline assessment of substantia nigra (SN)-echogenicity with transcranial sonography, olfactory function with the Sniffin' Sticks identification test and vascular risk according to the Framingham risk score as well as a baseline and 5-year follow-up neurological examination. MPS were defined according to established criteria based on the entire motor section of the Unified PD Rating Scale. Participants with PD at baseline or follow-up and subjects with MPS at baseline were excluded. A logistic regression analysis adjusted for age and sex was used to detect risk factors for incident MPS in the remaining 393 participants. RESULTS:SN-hyperechogenicity and hyposmia were related to the development of MPS with odds ratios of 2.0 (95%CI, 1.1-3.7) and 1.6 (95%CI, 1.0-2.7), respectively, while increased vascular risk was not. Having both, SN-hyperechogenicity and hyposmia, was associated with an odds ratio of 3.0 (95%CI, 1.2-7.7) for incident MPS. Among the various motor domains, increased SN-echogenicity predicted the development of bradykinesia and rigidity, whereas diminished olfactory function predicted the development of impaired axial motor function. CONCLUSIONS: In addition to their established roles as risk factors for PD, SN-hyperechogenicity and hyposmia are associated with an increased risk for MPS in the general elderly community.
Authors: Horacio Kaufmann; Lucy Norcliffe-Kaufmann; Jose-Alberto Palma; Italo Biaggioni; Phillip A Low; Wolfgang Singer; David S Goldstein; Amanda C Peltier; Cyndia A Shibao; Christopher H Gibbons; Roy Freeman; David Robertson Journal: Ann Neurol Date: 2017-02 Impact factor: 10.422
Authors: Philipp Mahlknecht; Raimund Pechlaner; Sanne Boesveldt; Dieter Volc; Bernardette Pinter; Eva Reiter; Christoph Müller; Florian Krismer; Henk W Berendse; Jacobus J van Hilten; Albert Wuschitz; Wolfgang Schimetta; Birgit Högl; Atbin Djamshidian; Michael Nocker; Georg Göbel; Arno Gasperi; Stefan Kiechl; Johann Willeit; Werner Poewe; Klaus Seppi Journal: Mov Disord Date: 2016-05-09 Impact factor: 10.338
Authors: Stefanie Lerche; Kathrin Brockmann; Andrea Pilotto; Isabel Wurster; Ulrike Sünkel; Markus A Hobert; Anna-Katharina von Thaler; Claudia Schulte; Erik Stoops; Hugo Vanderstichele; Victor Herbst; Britta Brix; Gerhard W Eschweiler; Florian G Metzger; Walter Maetzler; Daniela Berg Journal: Alzheimers Res Ther Date: 2016-10-10 Impact factor: 6.982