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Parkinson′s disease (PD) is the most common age-related neurodegenerative disease, which has the effects on the patients′ quality of life and brings a huge burden to the society and family. The pathological feature of PD is the abnormal accumulation of alpha-synuclein (α-syn) in the brain of substantia nigra-striatum, mediating the death of dopaminergic neurons. However, further studies have found that α-syn mediates the abnormal function of astrocytes leading to the destruction of the blood-brain barrier and the release of inflammatory factors caused by microglia, which are related to the pathogenesis of PD. Therefore, neurons, glial cells, and blood vessels as a whole named neurovascular unit can better reflect the pathophysiological environment of PD and reveal the PD pathogenesis. Studies have detected the ways of α-syn transmission, such as prion-like, tunneling nanotubes, exosomes, are connected with the pathogenesis and progression of PD. The Braak stage and the prospective cohort of early PD provide a view that the peripheral α-syn to the central nervous system may be an another important way to mediate the pathogenesis and progression of PD. The research about the abnormal aggregation and spread of α-syn can provide the new theory for the pathogenesis of PD and the new disease modifying therapy of PD. This article reviews the role of abnormal aggregation and transmission of α-syn in the pathogenesis of PD.
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Idiopathic rapid eye movement (REM) sleep behavior disorder is recognized as a prodromal stage of α-synucleinopathies such as Parkinson′s disease, Lewy body dementia and multiple system atrophy. It is important to timely identify early predictors that can predict early conversion into α-synucleinopathies. This review provided an update on classic and novel early predictors of α-synucleinopathies in patients with idiopathic REM sleep behavior disorder and provided a comprehensive understanding on the phenotypic transformation of the disease.
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@#Objective To investigate the effectiveness and safety of 8F guide catheter combined with other thrombectomy techniques in the thrombectomy treatment of patients with acute internal carotid artery occlusion. Methods From January 2016 to November 2019，we retrospectively analyzed 52 patients data from the Department of Neurology，Guangdong Provincial People’s Hospital，those patients were diagnosed as acute internal carotid artery occlusion results from cardiac cerebral embolism and treated with mechanical thrombectomy. They were divided into observation group and control group in according to whether suction treatment in combination with 8F guide catheter was conducted. Data collected and analyzed between the two groups included age，gender，hypertension，diabetes，Alberta Stroke Program Early CT（ASPECT） score，the United States National Institutes of Health Stroke Scale（NIHSS）score，bridging treatment，onset to puncture time （OTP），puncture to recanalization time （PTR），mechanical thrombectomy technique，number of thrombectomy maneuvers，vascular recanalization，asymptomatic intracranial hemorrhage （aSICH），symptomatic intracranial hemorrhage （SICH），mRS at 90 days after endovascular thrombectomy. Results （1）There were no statistically significant differences in baseline data between the two groups of patients （P>0.05）. （2）There were no statistically significant differences in bridging treatment，OTP，PTR，mechanical thrombectomy technique，aSICH and SICH between the two groups of patients （P>0.05）. The average times of thrombectomy in the observation group and the control group were 2.1 and 3.0 respectively，and the difference between the two groups was statistically significant （P=0.009）. In the observation group，23 cases had successful recanalization，17 cases had good mRS prognosis 90 days after operation，and 11 cases in the control group had successful recanalization，and 7 cases had a good prognosis at 90 days after operation. The difference between the two groups was statistically significant （P<0.05）. Conclusion For patients with acute internal carotid artery occlusion results from cardiac cerebral embolism，the application of 8F guided catheter suction combined with other thrombectomy techniques can improve the effect of thrombectomy. It is a method of mechanical thrombectomy with clinical value.
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Parkinson′s disease is a degenerative disease, in which cognitive impairment is main non-motor symptom. It can develop to dementia and seriously affect the quality of life and life expectancy of patients. Therefore, a correct understanding of the etiology and mechanism of cognitive impairment in Parkinson′s disease is helpful for the disease diagnosis and treatment. In recent years, the correlation between vascular factors and the development of Parkinson′s disease has become a research hot topic. This article reviewed the research progress of the correlation between vascular related factors and cognitive impairment in Parkinson′s disease.
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Objective To establish an in vitro cell model of Parkinson disease with SHSY5Y cells over-expressing human A53T mutant alpha-synuclein and to examine the effects of Aβ1-42 oligomer on cell survival and autophagy function in the cell model Method The recombinant lentivirus containing the A53T mutant alpha-synuclein gene or empty vector were transfected to SHSY5Y cells. The expression of α-synuclein mRNA in SHSY5Y cells was detected by RT-qPCR. The effect of Aβ1-42 oligomer on cell proliferation was detected with CCK-8 after incubation with Aβ1-42 oligomer for 24 hours. The autophagy-related proteins were evaluated with Western Blot. Result The mRNA and protein levels of alpha-synuclein were significantly increased in SHSY5Y cells expressing alpha-synuclein. There were no significant difference in the cell proliferation between alpha-synuclein group and control group (P<0.001) . Incubation with Aβ1-42 oligomer significantly decreased the proliferation rate in alpha-synuclein group in a dose-dependent manner compared with the control group. The levels of autophagy related proteins including LC3-Ⅱ and Beclin-1 were significantly lower in alpha-synuclein group than in control group (P<0.05). Conclusion This work has constructed an in vitro cell model of Parkinson′s disease. The over-expression of A53T mutant alpha-synuclein do not affect the cell survival whereas the Aβ1-42 oligomer exhibits toxic effects on cells expressing alpha-synuclein possible through suppression of the autophagy activation.
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Parkinson's disease (PD) is a common neurodegenerative disease,pathogenesis of which is extremely complex.To explore the potential pathophysiological mechanism of PD and find effective treatment methods to improve symptoms,modify the disease and delay the progression are the major problems to be solved urgently.Studies have shown that transcranial magnetic stimulation (TMS) has a broad clinical application prospect,which might help clinicians to explore the pathophysiological mechanism of PD and provide new ideas for exploring new targets for diagnosis and treatment in the future.Meanwhile,TMS might play important roles in the treatment of PD motor and non-motor symptoms through enhancing synaptic plasticity,protecting monoamine neurons,increasing the monoamine neurotransmitter level in the brain,and adjusting the brain network with dysfunction.
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Objective To study the relationship between level of plasma glucose and cognitive function in patients with Parkinson's disease.Methods Two hundred PD patients were assessed cognitive function using Mini-Mental State Examination (MMSE),Montreal Cognitive Assessment (MoCA),Wechsler Intelligence Scale and Wechsler Memory Scale.The patients were divided into cognitive normal group (n=91) and cognitive impairment group (n=109).One hundred twenty-six normal subjects were enrolled as control group (n=126).The levels of fasting plasma glucose (FPG),postprandial plasma glucose (2hPPG),glycosylated hemoglobin (HbAlc) and the prevalence of diabetes mellitus were compared among the groups.The effect of blood glucose level on the cognitive function of PD patients was analyzed by Binary Logistic Regression.Results The levels of FPG,HbAlc and the prevalence of diabetes mellitus [5.19 (0.72),5.7％ (0.5％),14％] were significantly higher than those in the normal control group [4.85(0.79),5.6％ (0.5％),6％] (P＜0.05).The levels of FPG in PD patients with cognitive impairment [5.21 (1.32)] was significantly higher than that in PD patients with cognitive normal group [4.81 (0.95)] (P＜0.05).Although 2hPPG and HbAlc increased slightly in PD patients with cognitive impairment,the difference did not reach an significant level (P＞0.05).Binary Logistic Regression analysis showed that FPG(OR:1.764;95％ CI:0.06-3.244;P=0.068) was not associated with the impaired cognitive function in PD patients.Conclusion The present study has not revealed an association between the incidence of cognitive impairment in patients with PD and plasma glucose level although high plasma glucose may be a high risk factor for PD patients.
