Increased cerebral activity in Parkinson's disease patients carrying the DRD2 TaqIA A1 allele during a demanding motor task: a compensatory mechanism?

Previous studies suggest that neuroimaging techniques are useful for detecting the effects of functional genetic polymorphisms on brain function in healthy subjects or in patients presenting with psychiatric or neurodegenerative conditions. Former evidence showed that individuals carrying risk alleles displayed broader patterns of brain activity during behavioural and cognitive tasks, despite being clinically comparable to non-carriers. This suggests the presence of compensatory brain mechanisms. In the present study, we investigated this effect in Parkinson's disease (PD) patients carrying the DRD2 TaqIA A1 allelic variant. This variant may confer an increased risk of developing the disease and/or influence the clinical presentation. During a complex sequential motor task, we evidenced by functional magnetic resonance imaging that A1 allele carriers activated a larger network of bilateral cerebral areas than non-carriers, including cerebellar and premotor regions. Both groups had similar clinical and demographic measures. In addition, their motor performance during the functional magnetic resonance experiment was comparable. Therefore, our conclusions, pending replication in a larger sample, seem to reflect the recruitment of compensatory cerebral resources during motor processing in PD patients carrying the A1 allele.

Posibilidades y limitaciones de un seguro de cuidados de larga duración para mayores dependientes en España / The possibilities and constrains of long term care insurance in Spain

En este articulo se examina la problemática de la financiaciónde la dependencia en España. Se revisa la evidencia empíricarelevante con en fin de evaluar los instrumentos de financiaciónal alcance, y en especial un seguro de dependencia comomecanismo de cobertura de los gastos asociados a cuidados delarga duración. Se argumenta que el riesgo de dependencia esun riesgo asegurable, si bien la existencia de fallos de mercadoapunta a la necesidad de instrumentalizar un seguro obligatorio.El rol del seguro privado un papel complementario o suplementario.La evidencia empírica apunta a que la opción preferidapor la población española es una financiación pública

This paper examines the financial policy constrains andpossibilities of funding long term care in Spain. To this end, werevise the existing empirical evidence to evaluate the financingtools available , and specially the applicability of a long term careinsurance as a means to insure the costs of long term care. Weargue that the dependency risks are insurable risks subjected tomarket failures that justify the need for a compulsory insurance.The role of the private long-term care insurance in that caseis restricted to a complementary or a supplementary role. Evidencefrom Spanish social attitudes suggests that the public prefersa publicly funded system to private alternatives

Polimorfismo T102C del receptor 5HT2A y rendimiento cognitivo en la alteración cognitiva leve / T102C polymorphism in the 5HT2A gene and cognition in mild cognitive impairment

La Alteración Cognitiva Leve es un estado de transición entreel envejecimiento normal y la enfermedad de Alzheimer y espor ello una condición de riesgo para la demencia. La serotoninay sus receptores tienen un papel importante en los procesosde aprendizaje y memoria. El receptor 5HT2A está localizadopredominantemente en áreas frontales e hipocampales. En esteestudio hemos valorado la influencia del genotipo del polimorfismoT102C del gen 5HT2A en el rendimiento cognitivo de unamuestra de 59 sujetos con Alteración Cognitiva Leve. Los sujetosheterocigotos (T102/C102) para este polimorfismo puntuabansignificativamente menos en el Mini-Mental, pruebas dememoria visual y verbal y en funciones premotoras, sugiriendoque este genotipo sería un nuevo marcador genético de riesgoen la alteración cognitiva

Mild Cognitive Impairment (MCI) is a transitional statebetween normal aging and Alzheimer’s disease and thus, it is ahigh-risk condition for dementia. Serotonin and its receptorsare associated with memory and learning processes. The5HT2A receptor is expressed in prefrontal cortex and hippocampus,above all. We have studied the role of the polymorphismT102C in the 5HT2A gene in cognition in a sample of 59MCI subjects. Those individuals carrying the heterozygous variant(T102/C102) performed significantly worse in the Mini-Mental State Examination, visual and verbal memory tests aswell as premotor functions. These results suggest that this genotypecould be a new genetic risk factor for cognitive impairmentin the elderly

Apolipoproteins E and C1 and brain morphology in memory impaired elders.

Previous research has shown that polymorphisms of the apolipoproteins E ( APOE) and APOC1 represent genetic risk factors for dementia and for cognitive impairment in the elderly. The brain mechanisms by which these genetic variations affect behavior or clinical severity are poorly understood. We studied the effect of APOE and APOC1 genes on magnetic resonance imaging measures in a sample of 50 subjects with age-associated memory impairment. The APOE E4 allele was associated with reduced left hippocampal volumes and APOE*E3 status was associated with greater frontal lobe white matter volumes. However, no APOE effects were observed when analyses accounted for other potential confounding variables. The effects of APOC1 on hippocampal volumes appeared to be more robust than those of the APOE polymorphism. However, no modulatory effects on brain morphology outside the medial temporal lobe region were observed when demographic variables, clinical status, and other anatomical brain measurements were taken into consideration. Our results suggest that the role of the APOC1 polymorphism in brain morphology of the cognitively impaired elderly should be examined in further studies.