Caregiver education in Parkinson's disease: formative evaluation of a standardized program in seven European countries.

PURPOSE: The formative evaluation of a standardized psychosocial education program for patients with Parkinson's disease (PD) and their caregivers. The results of the participation of the caregivers are presented next to the data of the patients. METHODS: Caregivers (n = 137) and patients with PD (n = 151) participated in the 8-week program in separate groups. Measurements were performed on psychosocial problems (BELA-P/A-k), health state (EQ-5D VAS), quality of life (PDQ-39) and depression (SDS) 1 week before and 1 week after the program. Participants rated their mood on a visual analogue scale before and after each session, and they filled in an evaluation questionnaire after the last session. RESULTS: Scores on the BELA-P/A-k improved significantly on the 'bothered by scale' as well as the 'need for help scale'. No improvements were found on EQ-5D VAS, PDQ-39 and SDS. Mood ratings improved significantly after each session. Most participants evaluated the program as positive. Feedback led to improvements in the program, which are incorporated in a final manual. CONCLUSIONS: The program was feasible to run in the different countries. This exploratory study led to improvements in the program and recommendations for further research. A study on the effectiveness of the program is the next step.

Patterns of psychological problems in Parkinson's disease.

OBJECTIVE: To identify patterns of psychological problems in Parkinson's disease (PD). METHOD: A sample of 3075 patients was surveyed to determine frequencies of psychological problems and cross-validated cluster analyses were computed to identify patterns of these problems. RESULTS: An increase of symptoms during arousal was reported by 68%, sleep disturbances by 32% of the sample, and sexual problems by 57% of men and 22% of women. Less frequently reported were difficulties in communicating (27%), needing help of others (38%), and depressive moods (20%). Four patterns of psychological problems were identified: general low stress, general high stress, sexual and social problems, and non-social problems. CONCLUSION: The study confirms the clinical observation that PD patients differ not only in degree, but also in structure of psychological stress. Social and non-social stress constitute principal types of stress experienced in PD. This distinction should be taken into account for any approach to support people with PD.

Chocolate eating in healthy men during experimentally induced sadness and joy.

The study compared influences of qualitatively different emotions on eating. Motivation to eat, affective responses to chocolate and chewing of chocolate were investigated in healthy normal weight males during experimentally induced emotions. Subjects abstained from eating 2 h (n = 24) or 8 h (n = 24) before testing. They received pieces of chocolate after viewing film clips presented to induce anger, fear, sadness and joy. Motivation to eat and most affective responses to eating chocolate were higher after 8 h than after 2 h of deprivation. Sadness and joy affected motivation to eat in opposite directions: joy increased and sadness decreased appetite (p < 0.001). In joy, a higher tendency to eat more chocolate was reported (p < 0.001), and chocolate tasted more pleasant (p < 0.001) and was experienced as more "stimulating" than in sadness (p < 0.01). No effects of deprivation could be found for chewing time and number of chews. Results indicate that the quality of emotions can affect motivation to eat and affective responses to eating chocolate. Our findings on decreased eating responses to sadness in healthy males and the contradictory increased eating responses to sadness reported by others supports two types of emotion-induced changes of eating: emotion-congruent modulation of eating and eating to regulate emotions.

Molecular structure, processing, and tissue distribution of matrilin-4.

Matrilin-4 is the most recently identified member of the matrilin family of von Willebrand factor A-like domain containing extracellular matrix adapter proteins. Full-length matrilin-4 was expressed in 293-EBNA cells, purified using affinity tags, and subjected to biochemical characterization. The largest oligomeric form of recombinantly expressed full-length matrilin-4 is a trimer as shown by electron microscopy, SDS-polyacrylamide gel electrophoresis, and mass spectrometry. Proteolytically processed matrilin-4 species were also detected. The cleavage occurs in the short linker region between the second von Willebrand factor A-like domain and the coiled-coil domain leading to the release of large fragments and the formation of dimers and monomers of intact subunits still containing a trimeric coiled-coil. In immunoblots of calvaria extracts similar degradation products could be detected, indicating that a related proteolytic processing occurs in vivo. Matrilin-4 was first observed at day 7.5 post-coitum in mouse embryos. Affinity-purified antibodies detect a broad expression in dense and loose connective tissue, bone, cartilage, central and peripheral nervous systems and in association with basement membranes. In the matrix formed by cultured primary embryonic fibroblasts, matrilin-4 is found in a filamentous network connecting individual cells.

Mass spectrometric analysis of head-to-tail connected cyclic peptides.

Tandem mass spectrometry is an extremely useful tool for high sensitive sequence identification of peptides. In the case of cyclic peptides fragmentation can easily be performed for sequence analysis. However, analysis is usually tedious due to the lack of a defined beginning and end of the sequence. Since cyclic peptides are a highly interesting class of compounds especially for the pharmaceutical industry, ways have to be found to identify their strictures. In this work we demonstrate how software and dedicated analytical strategies can be used for detailed analysis of these substances.

Magnetic, microplate-format plasmid isolation protocol for high-yield, sequencing-grade DNA.

We have developed a rapid, microplate-format plasmid isolation procedure to purify sequencing-grade DNA templates for high-throughput DNA sequencing operations. A modified lysozyme/boiling method is used to produce a plasmid-containing supernatant that is then purified by iron bead capture. After binding, the beads are pelleted in a magnetic field, washed and the DNA eluted in water. The method yields up to 10 micrograms plasmid DNA from a 1-mL overnight culture in a deep-well microplate. The procedure is suitable for large-scale experiments, amenable to automation and does not require expensive reagents or equipment. The entire protocol can be completed in as little as 2 h, and one technician with a 96-well pipetting station can process up to 48 plates per day. This protocol is ideal for any high-throughput operation in which template quantity, quality and reproducibility are of primary importance.

Emotions and eating in everyday life.

This field study assessed emotional states experienced in everyday life and examined the subjective motivation to eat associated with these emotional states. Twenty-three female subjects rated their momentary emotional state and motivation to eat on 6 consecutive days at 11:00a.m., 2:00p.m., 5:00p.m., 8:00p.m. and 11:00p.m. A cluster analysis of the resulting 634 emotion profiles revealed three types of emotional states characterized by the labels "Anger-dominance", "Tension/Fear" and "Relaxation/Joy". A fourth cluster showing generally low levels of emotions was labelled "Unemotional state". Most of the self-rated motivations to eat were increased during periods of negative emotions. During negative emotions a heightened tendency to cope with these emotions through eating and more intense bodily symptoms of hunger were also reported. No differences in motivations to eat were found between the two negative emotion clusters or between relaxation/joy and the unemotional state. Results indicate the presence of "emotionally instrumental eating" in a non-clinical population under real life conditions. Physiological correlates of negative emotional states may be involved in emotionally instrumental eating.

Characteristics of eating in anger, fear, sadness and joy.

The influences of emotions on eating were investigated. One-hundred and seven female and 103 male subjects were asked to report how various characteristics of eating could change during the emotions of anger, fear, sadness and joy. Subjects completed a questionnaire of 33 items for each emotion and a food deprivation condition. A factor analysis of the items answered with respect to food deprivation yielded four factors which were labelled hunger, impulsive eating, sensory eating and hedonic eating. ANCOVAs showed main effects of emotions upon each factor. Single comparisons showed that: (1) subjects reported to experience higher levels of hunger during anger and joy than during fear and sadness; (2) impulsive eating and sensory eating were rated higher during anger than during the other emotions; and (3) hedonic eating was rated higher during joy than during the other emotions. Results did not indicate any differential influences upon eating between fear and sadness. Women reported to experience higher tendencies of impulsive eating and sensory eating than men during anger and sadness. Eating scores of negative emotions correlated low and positive with body mass index, low and negative with dietary restraint. The differential effects of emotions on characteristics of eating may be due to differences of the examined emotions in frequency of occurrence, physiological correlates and motivational properties.

Behavioral analysis of the freezing phenomenon in Parkinson's disease: a case study.

The "freezing" phenomenon was examined in a 77 yr old male patient suffering from Parkinsons's disease (PD). Motor blocks occurred several times a day, mainly affected walking, and lasted mostly between 2 and 5 min. Behavioral analysis showed that freezing was elicited and intensified not only by external factors (limited space and room to move), but also by negative cognitions, negative emotions and tension. The most effective behavior to overcome freezing was a combination of relaxation and loud rhythmic counting. Effectiveness in overcoming freezing correlated positively with self-rated mobility before trials. Relaxation training improved self-rated mobility. It is suggested that relaxation training and cognitive techniques should be used to reduce tension, negative thoughts and negative emotions contributing to freezing and to improve the ability to cope with freezing.

Correlation between chlamydial infection and autoimmune response: molecular mimicry between RNA polymerase major sigma subunit from Chlamydia trachomatis and human L7.

L7 is one of the ribosomal proteins frequently targeted by autoantibodies in rheumatic autoimmune diseases. A computer search revealed a region within the immunodominant epitope of L7 (peptide II) that is highly homologous to amino acid sequence 264-286 of the RNA polymerase major sigma factor of the eubacterium Chlamydia trachomatis. Anti-L7 autoantibodies affinity purified from the immunodominant epitope were able to recognize this sequence as they reacted with purified recombinant sigma factor. Immunofluorescence labeling experiments on C. trachomatis lysates revealed a punctate staining pattern of numerous spots when incubated with the affinity-purified anti-peptide II autoantibodies. Binding of autoantibodies to peptide II was inhibited by the homologous sigma peptide. This is the first demonstration of epitope mimicry between a human and a chlamydial protein on the level of B cells. Antibody screening revealed a significant correlation between the presence of anti-L7 autoantibodies and C. trachomatis infection in patients with systemic lupus erythematosus and mixed connective tissue disease. Our results suggest that molecular mimicry is involved in the initiation of anti-L7 autoantibody response and may represent a first glance into the immunopathology of Chlamydia with respect to systemic rheumatic diseases.