scholarly journals Occupational exposure to chronic ionizing radiation increases risk of Parkinson's disease incidence in Russian Mayak workers

2019 ◽  
Vol 49 (2) ◽  
pp. 435-447 ◽  
Author(s):  
Tamara V Azizova ◽  
Maria V Bannikova ◽  
Evgeniya S Grigoryeva ◽  
Valentina L Rybkina ◽  
Nobuyuki Hamada

Abstract Background Patients receiving radiotherapy demonstrate cognitive deficits, impairment of neurogenesis and neurovascular damage developing as late side effects of radiation exposure to the head. In light of the increasing use of diagnostic radiological procedures, epidemiological data raise concerns about possible harmful effects of low-level radiation on the human brain. A series of studies of chronically exposed Russian nuclear workers have provided information on risks of cancer and non-cancer diseases. Methods This study aimed to assess the risk of Parkinson’s-disease (PD) incidence in a cohort of workers occupationally exposed to chronic radiation. The cohort comprised workers of a Russian nuclear production facility who were first employed in 1948–1982 and followed up until the end of 2013 (22 377 individuals; 25% female). Using the AMFIT module of EPICURE software, relative risk and excess relative risk per unit dose (ERR/Gy) were calculated based on maximum likelihood. Results A linear association was found between PD incidence and cumulative γ-dose after adjusting for sex and attained age [ERR/Gy = 1.02 (95% confidence interval, 0.59 to 1.63, p = 5.44 × 10–5)]. The ERR/Gy of external radiation for PD incidence was stable after adjusting for neutron dose (ERR/Gy = 1.03; 95% confidence interval: 0.59 to 1.67, p = 6.86 × 10–5). The risk increased with increasing lag period and decreased notably after adjusting for body mass index, smoking and alcohol consumption. Additional adjustments for hypertension, gout, gastric ulcer, head injuries with loss of awareness and diabetes mellitus did not affect the risk estimate. Conclusions This study is the first to suggest that PD is associated with prolonged occupational external γ-ray exposure.

2021 ◽  
pp. 1-10
Author(s):  
Keran Wang ◽  
Zhehui Luo ◽  
Chenxi Li ◽  
Xuemei Huang ◽  
Eric J. Shiroma ◽  
...  

Background: Literature shows an inverse association of circulating cholesterol level with the risk of Parkinson’s disease (PD); this finding has important ramifications, but its interpretation has been debated. Objective: To longitudinally examine how blood total cholesterol changes during the development of PD. Methods: In the Health, Aging and Body Composition study (n = 3,075, 73.6±2.9 years), blood total cholesterol was measured at clinic visit years 1, 2, 4, 6, 8, 10, and 11. We first examined baseline cholesterol in relation to PD risk, adjusting for potential confounders and competing risk of death. Then, by contrasting the observed with expected cholesterol levels, we examined the trajectory of changes in total cholesterol before and after disease diagnosis. Results: Compared to the lowest tertile of baseline total cholesterol, the cumulative incident ratio of PD and 95%confidence interval was 0.41 (0.20, 0.86) for the second tertile, and 0.69 (0.35, 1.35) for the third tertile. In the analysis that examined change of total cholesterol level before and after PD diagnosis, we found that its level began to decrease in the prodromal stage of PD and became statistically lower than the expected values∼4 years before disease diagnosis (observed-expected difference, –6.68 mg/dL (95%confidence interval: –13.14, –0.22)). The decreasing trend persisted thereafter; by year-6 post-diagnosis, the difference increased to –13.59 mg/dL (95%confidence interval: –22.12, –5.06), although the linear trend did not reach statistical significance (p = 0.10). Conclusion: Circulating total cholesterol began to decrease in the prodromal stage of PD, which may in part explain its reported inverse association with PD.


2018 ◽  
Vol 66 ◽  
pp. S264-S265
Author(s):  
F. Moisan ◽  
T. Vlaar ◽  
E. Moutengou ◽  
M. Boussac-Zarebska ◽  
L. Carcaillon-Bentata ◽  
...  

2017 ◽  
Vol 32 (5) ◽  
pp. 607-618 ◽  
Author(s):  
Michelle N McDonnell ◽  
Briony Rischbieth ◽  
Tenille T Schammer ◽  
Chantel Seaforth ◽  
Alex J Shaw ◽  
...  

Objective: The technique called Lee Silverman Voice Treatment (LSVT)-LOUD has previously been used to improve voice quality in people with Parkinson’s disease. The objective of this study was to assess the effectiveness of an alternate intervention, LSVT-BIG (signifying big movements), to improve functional mobility. Design: Systematic review with meta-analysis of randomized trials. Data sources: Medline, Embase, CINAHL, AgeLine, Scopus and Cochrane Library were searched from inception to September 2017 using multiple search terms related to Parkinson’s disease and LSVT-BIG. Review method: Two researchers searched the literature for studies of the LSVT-BIG intervention of 16 sessions, delivered by a certified instructor over four weeks, to any other intervention. Outcomes related to functional ability were included. Study quality was appraised using the Cochrane Risk of Bias tool. Results: Four studies were included, reporting on three randomized trials of 84 participants with mild Parkinson’s disease. Compared to physiotherapy exercises, or a shorter training protocol, there was a significant improvement in motor function assessed with the Unified Parkinson’s Disease Rating Scale part III (mean difference = −3.20, 95% confidence interval = −5.18 to −1.23) and a trend towards faster Timed Up and Go performance (mean difference = −0.47, 95% confidence interval = −0.99 to 0.06) and 10-metre walk test (mean difference = −0.53, 95% confidence interval = −1.07 to 0.01). Conclusion: Compared to shorter format LSVT-BIG or general exercise, LSVT-BIG was more effective at improving motor function. This provides preliminary, moderate quality evidence that amplitude-oriented training is effective in reducing motor impairments for people with mild Parkinson’s disease.


Author(s):  
Arvid Rongve ◽  
Dag Aarsland

Dementia with Lewy bodies and Parkinson’s disease dementia belong to the α-synucleinopathies, a family of diseases pathologically characterized by aggregation of α-synuclein in Lewy bodies in the brain. In this chapter we present the epidemiological data for both conditions including new data on MCI. Clinical diagnostic criteria are reviewed and the different neuropathology staging systems for DLB and PDD and the most important genetic findings are considered. Biomarkers in DLB and PDD with particular focus on imaging techniques like CIT-SPECT and MRI are described. Important clinical symptoms in both conditions are presented in detail and the most important clinical differential diagnoses are discussed. Pharmacological and non- pharmacological treatment of different symptoms in both conditions are discussed with particular emphasis on the choline esterase inhibitors and antipsychotic medications.New data on memantine are presented.


2019 ◽  
Vol 116 (15) ◽  
pp. 7419-7424 ◽  
Author(s):  
Jill A. Hollenbach ◽  
Paul J. Norman ◽  
Lisa E. Creary ◽  
Vincent Damotte ◽  
Gonzalo Montero-Martin ◽  
...  

Parkinson’s disease (PD) is a neurodegenerative disease in which genetic risk has been mapped to HLA, but precise allelic associations have been difficult to infer due to limitations in genotyping methodology. Mapping PD risk at highest possible resolution, we performed sequencing of 11 HLA genes in 1,597 PD cases and 1,606 controls. We found that susceptibility to PD can be explained by a specific combination of amino acids at positions 70–74 on the HLA-DRB1 molecule. Previously identified as the primary risk factor in rheumatoid arthritis and referred to as the “shared epitope” (SE), the residues Q/R-K/R-R-A-A at positions 70–74 in combination with valine at position 11 (11-V) is highly protective in PD, while risk is attributable to the identical epitope in the absence of 11-V. Notably, these effects are modified by history of cigarette smoking, with a strong protective effect mediated by a positive history of smoking in combination with the SE and 11-V (P = 10−4; odds ratio, 0.51; 95% confidence interval, 0.36–0.72) and risk attributable to never smoking in combination with the SE without 11-V (P = 0.01; odds ratio, 1.51; 95% confidence interval, 1.08–2.12). The association of specific combinations of amino acids that participate in critical peptide-binding pockets of the HLA class II molecule implicates antigen presentation in PD pathogenesis and provides further support for genetic control of neuroinflammation in disease. The interaction of HLA-DRB1 with smoking history in disease predisposition, along with predicted patterns of peptide binding to HLA, provide a molecular model that explains the unique epidemiology of smoking in PD.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ovidijus Laucius ◽  
Renata Balnytė ◽  
Kęstutis Petrikonis ◽  
Vaidas Matijošaitis ◽  
Neringa Jucevičiūtė ◽  
...  

Background. It is currently impossible to diagnose Parkinson’s disease (PD) in the premotor phase even though at the time of motor symptom onset the number of already degenerated dopaminergic substantia nigra neurons is considerable. Degeneration of the dorsal nucleus of the vagus nerve (VN) has been reported early in the disease course, and it could lead to impaired function of the VN, resulting in certain nonmotor symptoms of PD. Therefore, we raised a hypothesis that the loss of VN neurons could result in a smaller diameter of the VN among PD patients. Methods. 20 PD patients and 20 age- and gender-matched individuals without any neurodegenerative disease were enrolled in a pilot study. The diameters of the right and left VNs were measured using ultrasonography, their average was calculated, and the narrower VN diameter was noted separately. Results. No difference was found between the PD and control groups neither in the average VN diameter (mean 1.17; 95% confidence interval (CI) 1.10–1.24 vs. 1.13; 1.07–1.18, mm; p=0.353) nor in the narrower VN diameter (mean 1.11; 95% confidence interval (CI) 1.02–1.20 vs. 1.07; 1.02–1.13, mm; p=0.421). The narrower VN diameter and the average VN diameter were not able to distinguish between PD patients and controls (area under curve (AUC) = 0.588, 95% CI = 0.408–0.767, and p=0.344; and AUC = 0.578, 95% CI = 0.396–0.759, and p=0.402). Conclusions. To conclude, no differences were found in VN diameter between the PD and control groups. Therefore, our data do not support the hypothesis that PD could be associated with a smaller diameter of the VN.


Author(s):  
Qiangping Wang ◽  
Xing Huang ◽  
Yansen Bai ◽  
Xuan Wang ◽  
Haijun Wang ◽  
...  

ABSTRACTBackgroundThe novel coronavirus (SARS-CoV-2) has infected a large number of healthcare workers in Hubei province, China. In addition to infectious and respiratory disease physicians, many doctors in other medical fields have been infected.MethodsWe prospectively collected epidemiological data on medical staff members who are working in neurosurgery departments in 107 hospitals in Hubei province through self-reported questionnaires or telephone interviews. Data of medical staff members with laboratory-confirmed coronavirus disease 2019 (COVID-19) were analysed. The final follow-up date was 1 March 2020.FindingsA total of 5,442 neurosurgery department medical staff members were surveyed. One hundred and twenty cases, involving 54 doctors and 66 nurses, were found to have been infected with SARS-CoV-2. The overall incidence was 2.2%. These cases were concentrated in 26 centres, 16 of which had admitted a total of 59 patients with COVID-19 complicated by craniocerebral disease. Medical staff members in centres receiving COVID-19 patients had a higher risk of contracting infection than those in centres not receiving COVID-19 patients (relative risk: 19.6; 95% confidence interval: 12.6–30.6). Contact with either COVID-19 patients (62.5%, 75/120) or infected colleagues (30.8%, 37/120) was the most common mode of transmission. About 78.3% (94/120) of the infected cases wore surgical masks, whereas 20.8% (25/120) failed to use protection when exposed to the source of infection. Severe infections were observed in 11.7% (14/120) of the cases, with one death (0.8%, 1/120). All the infected medical staff members had been discharged from the hospital. A total of 1,287 medical staff members were dispatched to participate in the frontline response to COVID-19 under level 2 protection of whom one was infected. Medical staff members who took inadequate protection had a higher risk of contracting infection than those using level 2 protection (relative risk: 36.9; 95% confidence interval: 5.2–263.6).ConclusionsNeurosurgical staff members in Hubei province were seriously affected by COVID-19. Level 2 protection and strengthening of protective measures are likely to be effective in preventing medical workers from being infected.


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