scholarly journals Parkinson’s disease and occupational exposures: a systematic literature review and meta-analyses

2017 ◽  
Vol 43 (3) ◽  
pp. 197-209 ◽  
Author(s):  
Lars-Gunnar Gunnarsson ◽  
Lennart Bodin
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Occupational Exposures ◽  
Meta Analyses

scholarly journals Occupational Exposures and Neurodegenerative Diseases—A Systematic Literature Review and Meta-Analyses

2019 ◽  
Vol 16 (3) ◽  
pp. 337 ◽  
Author(s):  
Lars-Gunnar Gunnarsson ◽  
Lennart Bodin
Keyword(s):  
Alzheimer’S Disease ◽  
Parkinson’S Disease ◽  
Alzheimer's Disease ◽  
Parkinson's Disease ◽  
Occupational Exposure ◽  
Neurodegenerative Diseases ◽  
Meta Analysis ◽  
Occupational Exposures ◽  
Increased Risk ◽  
Meta Analyses

Objectives: To carry out an integrated and stratified meta-analysis on occupational exposure to electromagnetic fields (EMFs), metals and pesticides and its effects on amyotrophic lateral sclerosis (ALS) and Parkinson’s and Alzheimer’s disease, and investigate the possibility of publication bias. Methods: In the current study, we updated our recently published meta-analyses on occupational exposures in relation to ALS, Alzheimer’s and Parkinson’s disease. Based on 66 original publications of good scientific epidemiological standard, according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines, we analysed subgroups by carrying out stratified meta-analyses on publication year, statistical precision of the relative risk (RR) estimates, inspection of the funnel plots and test of bias. Results: Based on 19 studies the weighted RR for occupational exposure to EMFs was 1.26 (95% confidence interval (CI) 1.07–1.50) for ALS, 1.33 (95% CI 1.07–1.64) for Alzheimer’s disease and 1.02 (95% CI 0.83–1.26) for Parkinson’s disease. Thirty-one studies concerned occupational exposure to pesticides and the weighted RR was 1.35 (95% CI 1.02–1.79) for ALS, 1.50 (95% CI 0.98–2.29) for Alzheimer’s disease and 1.66 (95% CI 1.42–1.94) for Parkinson’s disease. Finally, 14 studies concerned occupational exposure to metals and only exposure to lead (five studies) involved an elevated risk for ALS or Parkinson’s disease and the weighted RR was 1.57 (95% CI 1.11–2.20). The weighted RR for all the non-lead exposures was 0.97 (95% CI 0.88–1.06). Conclusions: Exposure to pesticides increased the risk of getting the mentioned neurodegenerative diseases by at least 50%. Exposure to lead was only studied for ALS and Parkinson’s disease and involved 50% increased risk. Occupational exposure to EMFs seemed to involve some 10% increase in risk for ALS and Alzheimer’s disease only.

scholarly journals PND6 PARKINSON'S DISEASE PROGRESSION: A SYSTEMATIC LITERATURE REVIEW

2019 ◽  
Vol 22 ◽  
pp. S270-S271
Author(s):  
S. Wu ◽  
P. Alvarez ◽  
H. Folse ◽  
C. Chandler ◽  
A. Ward
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Disease Progression ◽  
Systematic Literature Review

scholarly journals Amyotrophic Lateral Sclerosis and Occupational Exposures: A Systematic Literature Review and Meta-Analyses

2018 ◽  
Vol 15 (11) ◽  
pp. 2371 ◽  
Author(s):  
Lars-Gunnar Gunnarsson ◽  
Lennart Bodin
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Literature Review ◽  
Electromagnetic Fields ◽  
Systematic Literature Review ◽  
Occupational Exposures ◽  
Physical Work ◽  
Scientific Quality ◽  
Occupational Risk Factors ◽  
Meta Analyses ◽  
Lateral Sclerosis

Objectives: We conducted a systematic literature review to identify studies fulfilling good scientific epidemiological standards for use in meta-analyses of occupational risk factors for amyotrophic lateral sclerosis (ALS). Methods: We identified 79 original publications on associations between work and ALS. The MOOSE (Meta-analysis Of Observational Studies in Epidemiology) and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) guidelines were used to ensure high scientific quality, and reliable protocols were applied to classify the articles. Thirty-seven articles fulfilled good scientific standards, while 42 were methodologically deficient and thus were excluded from our meta-analyses. Results: The weighted relative risks for the various occupational exposures were respectively; 1.29 (95% confidence interval (CI): 0.97–1.72; six articles) for heavy physical work, 3.98 (95% CI: 2.04–7.77; three articles) for professional sports, 1.45 (95% CI: 1.07–1.96; six articles) for metals, 1.19 (95% CI: 1.07–1.33; 10 articles) for chemicals, 1.18 (95% CI: 1.07–1.31; 16 articles) for electromagnetic fields or working with electricity, and 1.18 (95% CI: 1.05–1.34; four articles) for working as a nurse or physician. Conclusions: Meta-analyses based only on epidemiologic publications of good scientific quality show that the risk of ALS is statistically significantly elevated for occupational exposures to excessive physical work, chemicals (especially pesticides), metals (especially lead), and possibly also to electromagnetic fields and health care work. These results are not explained by publication bias.

scholarly journals 1148 Conceiving A Connected, Preventative Treatment Stance Across The Brain-gut-microbiota Axis In Prodromal Parkinson’s Disease: The Power Of Preventative Sleep Health

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A437-A438
Author(s):  
J F Chandler ◽  
M M Bullock ◽  
N G Chandler ◽  
S M Nelson ◽  
S P Hoyle ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Gut Microbiota ◽  
Systematic Literature Review ◽  
Alpha Synuclein ◽  
Current Treatment ◽  
Reciprocal Relationship ◽  
Treatment Research ◽  
The Brain

Abstract Introduction Early non-motor symptoms of Parkinson’s Disease (PD) include sleep and digestive disturbances that share a common pathology via alpha-synuclein (AS) deposition in the central nervous system (CNS) and formation in the enteric (ENS). The concept of prodromal PD as expressed by the brain-gut-microbiota axis continues to gain credibility across multiple literatures; yet, no unified treatment plan has been suggested. Disconnected, symptomatic treatment of prodromal PD may unintentionally hasten its development via compromise of REM sleep quality and reciprocal gut health. A more connected, comprehensive approach is needed. We conducted a systematic literature review to hypothesize next steps in treatment research for prodromal PD. Methods A systematic literature review using the Boolean combinations of “ALPHA-SYNUCLEIN” & - “SLEEP”, “GUT MICROBIOME”, and “EXERCISE” in all fields, restricted to the last 5 years, focusing on specification of prodromal PD, was conducted. Results were combined with an examination of current treatment practices in PD. Results 38 articles met inclusion criteria. Results were categorized through a presupposed primacy of sleep. Conclusion Due to the emerging nature of the prodromal PD idea, current treatment practice is myopic and may contribute to the progression of PD. Specifically, 1) sedative-hypnotic sleep interventions suppress REM, where clearing of CNS alpha-synuclein occurs, and 2) proton-pump inhibitors (PPI) cause significant gut dysbiosis, which may contribute to initial AS misfolding in the gut. Early identification of prodromal PD symptoms via cross-referenced clinical interview may allow for early behavioral interventions that underlie healthy brain-gut-microbiota axis functioning. Results outline specific measures that may slow PD-related synucleinopothies. The highest impact practices in this regard are REM-focused sleep hygiene and cardiovascular conditioning in a reciprocal relationship, highlighting the necessity of an early-intervention, preventative health model for conquering PD. Support This work was made possible in part by a donation from Drs. Shane Pitts and Michelle Hilgeman in support of Birmingham-Southern College’s Southern Sleep Laboratory.

scholarly journals Patterns and Determinants of Prescribing for Parkinson’s Disease: A Systematic Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-40 ◽  
Author(s):  
Khalid Orayj ◽  
Emma Lane
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Common Factor ◽  
Safety Data ◽  
Prescribing Patterns ◽  
Efficacy And Safety ◽  
Ovid Medline ◽  
Number Of Patients

Since the discovery of levodopa (L-dopa) in 1967, the range of medications available to treat Parkinson’s disease has increased significantly and guidance on the use, efficacy, and safety of these medications has evolved. To assess levels of adherence to national prescribing guidelines and awareness of changes in the efficacy and safety data published in the profiles of medications for the treatment of PD, we have reviewed studies on patterns and determinants of prescribing PD medications conducted in the last 50 years (since the discovery of L-dopa). A systematic literature review was conducted using EMBASE (1967 to March, 2018), Ovid MEDLINE(R) ALL (1967 to March 16, 2018), PsycINFO (1967 to the 2nd week of March, 2018), and PubMed to identify all studies measuring prescribing patterns of PD medication between 1967 and 2017. Study design, source of data, country, year of study, number of patients and/or prescriptions, unit of analysis, prescribing determinants, and percentage utilisation of PD medications were extracted where possible. 44 studies examining prescribing patterns and/or prescribing determinants across 17 countries were identified. Unsurprisingly, L-dopa was the most commonly prescribed medication in all studies, accounting for 46.50% to 100% of all prescriptions for PD. In several studies, the prescribing rate of ergot-derived dopamine agonists (DAs) decreased over time in concordance with guidance. In contrast, the prescribing rates of non-ergot DAs increased over the last ten years in most of the included studies. In examining prescribing factors, two major categories were exemplified, patients’ factors and prescribers’ factors, with patients’ age being the most common factor that affected the prescription in most studies. In conclusion, L-dopa is now the most commonly prescribed medication for cases of PD but there is large variation in the prescribing rates of catechol-O-methyltransferase (COMT) inhibitors, monoamine oxidase B (MAO-B) inhibitors, amantadine, and anticholinergics between countries. New studies examining the effects of recent clinical trials and measuring the prescribing rates of newly approved medications are warranted.

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