Clinical Study of 668 Indian Subjects with Juvenile, Young, and Early Onset Parkinson's Disease.

OBJECTIVE: To determine the demographic pattern of juvenile-onset parkinsonism (JP, <20 years), young-onset (YOPD, 20-40 years), and early onset (EOPD, 40-50 years) Parkinson's disease (PD) in India. MATERIALS AND METHODS: We conducted a 2-year, pan-India, multicenter collaborative study to analyze clinical patterns of JP, YOPD, and EOPD. All patients under follow-up of movement disorders specialists and meeting United Kingdom (UK) Brain Bank criteria for PD were included. RESULTS: A total of 668 subjects (M:F 455:213) were recruited with a mean age at onset of 38.7 ± 8.1 years. The mean duration of symptoms at the time of study was 8 ± 6 years. Fifteen percent had a family history of PD and 13% had consanguinity. JP had the highest consanguinity rate (53%). YOPD and JP cases had a higher prevalence of consanguinity, dystonia, and gait and balance issues compared to those with EOPD. In relation to nonmotor symptoms, panic attacks and depression were more common in YOPD and sleep-related issues more common in EOPD subjects. Overall, dyskinesias were documented in 32.8%. YOPD subjects had a higher frequency of dyskinesia than EOPD subjects (39.9% vs. 25.5%), but they were first noted later in the disease course (5.7 vs. 4.4 years). CONCLUSION: This large cohort shows differing clinical patterns in JP, YOPD, and EOPD cases. We propose that cutoffs of <20, <40, and <50 years should preferably be used to define JP, YOPD, and EOPD.

Association Serum S100B Protein in Alzheimer's Disease: A Case Control Study from South India.

BACKGROUND: Recent evidence points to a possible link between the inflammatory modulatory protein S100B protein and the pathogenesis of Alzheimer's disease (AD). OBJECTIVE: To investigate the elevated levels of serum S100B protein among AD in a South Indian cohort and its correlation with severity of cognitive impairment. METHODS: A cross-sectional study was conducted with 100 AD patients and 100 age and sex matched healthy controls. Diagnosis of AD was made by a qualified neurologist using NINCDS ADRDA criteria. Measurement of serum S100B protein was performed using solid phase sandwich ELISA method in both cases and controls. RESULTS: Significantly higher prevalence of elevated serum S100B protein 44(44%) (p<0.0001), hypertension 52(52%) (p=0.02), diabetes mellitus 58(58%) (p=0.002), thyroid dysfunction 28(28%) (p=0.009), positive CRP 46(46%) (p<0.0001) and lower mean Mini-Mental State Examination (MMSE) values 20.4±5.1 (p<0.0001) were seen in AD patients compared to controls. Elevated S100B protein levels were significantly associated with Clinical dementia rating (CDR) score 2(34%) (p=0,05) and score 3 (61.3%) (p=0.03) compared to normal levels. After multivariable logistic regression analysis positive C-Reactive Protein (odds: 3.2; 95%CI: 2.8-9.8)(p=0.001), elevated S100B protein (odds: 9.0;95%CI:2.2-35.8) and diabetes mellitus (odd:1.2;95%CI:1.0-4.9)(p<0.0001), were significantly associated with AD. CONCLUSION: In our study, we established an independent association of elevated serum S100B protein levels with AD. Elevated S100B protein levels higher in CDR score 3.