Gennaro Pagano1, Sotirios Polychronis1, Heather Wilson1, Beniamino Giordano1, Nicola Ferrara1, Flavia Niccolini1, Marios Politis2. 1. From the Neurodegeneration Imaging Group (G.P., S.P., H.W., B.G., F.N., M.P.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Division of Geriatrics (B.G., N.F.), Department of Translational Medical Sciences, University of Naples Federico II, Italy. 2. From the Neurodegeneration Imaging Group (G.P., S.P., H.W., B.G., F.N., M.P.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Division of Geriatrics (B.G., N.F.), Department of Translational Medical Sciences, University of Naples Federico II, Italy. marios.politis@kcl.ac.uk.
Abstract
OBJECTIVE: To investigate whether diabetes mellitus is associated with Parkinson-like pathology in people without Parkinson disease and to evaluate the effect of diabetes mellitus on markers of Parkinson pathology and clinical progression in drug-naive patients with early-stage Parkinson disease. METHODS: We compared 25 patients with Parkinson disease and diabetes mellitus to 25 without diabetes mellitus, and 14 patients with diabetes mellitus and no Parkinson disease to 14 healthy controls (people with no diabetes mellitus or Parkinson disease). The clinical diagnosis of diabetes mellitus was confirmed by 2 consecutive fasting measurements of serum glucose levels >126 mL/dL. Over a 36-month follow-up period, we then investigated in the population with Parkinson disease whether the presence of diabetes mellitus was associated with faster motor progression or cognitive decline. RESULTS: The presence of diabetes mellitus was associated with higher motor scores (p < 0.01), lower striatal dopamine transporter binding (p < 0.05), and higher tau CSF levels (p < 0.05) in patients with Parkinson disease. In patients with diabetes but without Parkinson disease, the presence of diabetes mellitus was associated with lower striatal dopamine transporter binding (p < 0.05) and higher tau (p < 0.05) and α-synuclein (p < 0.05) CSF levels compared to healthy controls. At the Cox survival analysis in the population of patients with Parkinson disease, the presence of diabetes mellitus was associated with faster motor progression (hazard ratio = 4.521, 95% confidence interval = 1.468-13.926; p < 0.01) and cognitive decline (hazard ratio = 9.314, 95% confidence interval = 1.164-74.519; p < 0.05). CONCLUSIONS: Diabetes mellitus may predispose toward a Parkinson-like pathology, and when present in patients with Parkinson disease, can induce a more aggressive phenotype.
OBJECTIVE: To investigate whether diabetes mellitus is associated with Parkinson-like pathology in people without Parkinson disease and to evaluate the effect of diabetes mellitus on markers of Parkinson pathology and clinical progression in drug-naive patients with early-stage Parkinson disease. METHODS: We compared 25 patients with Parkinson disease and diabetes mellitus to 25 without diabetes mellitus, and 14 patients with diabetes mellitus and no Parkinson disease to 14 healthy controls (people with no diabetes mellitus or Parkinson disease). The clinical diagnosis of diabetes mellitus was confirmed by 2 consecutive fasting measurements of serum glucose levels >126 mL/dL. Over a 36-month follow-up period, we then investigated in the population with Parkinson disease whether the presence of diabetes mellitus was associated with faster motor progression or cognitive decline. RESULTS: The presence of diabetes mellitus was associated with higher motor scores (p < 0.01), lower striatal dopamine transporter binding (p < 0.05), and higher tauCSF levels (p < 0.05) in patients with Parkinson disease. In patients with diabetes but without Parkinson disease, the presence of diabetes mellitus was associated with lower striatal dopamine transporter binding (p < 0.05) and higher tau (p < 0.05) and α-synuclein (p < 0.05) CSF levels compared to healthy controls. At the Cox survival analysis in the population of patients with Parkinson disease, the presence of diabetes mellitus was associated with faster motor progression (hazard ratio = 4.521, 95% confidence interval = 1.468-13.926; p < 0.01) and cognitive decline (hazard ratio = 9.314, 95% confidence interval = 1.164-74.519; p < 0.05). CONCLUSIONS:Diabetes mellitus may predispose toward a Parkinson-like pathology, and when present in patients with Parkinson disease, can induce a more aggressive phenotype.
Authors: Zubeyir Elmazoglu; Marta Soltesova Prnova; Abel Santamaria; Milan Stefek; Cimen Karasu Journal: Neurotox Res Date: 2020-11-04 Impact factor: 3.911
Authors: Richard A Manfready; Phillip A Engen; Leo Verhagen Metman; Gabriella Sanzo; Christopher G Goetz; Deborah A Hall; Christopher B Forsyth; Shohreh Raeisi; Robin M Voigt; Ali Keshavarzian Journal: Front Neurosci Date: 2021-07-02 Impact factor: 4.677