L-Dopa response, choreic dyskinesia, and dystonia in Perry syndrome.

INTRODUCTION: A marked response to L-Dopa and L-Dopa-induced dyskinesia (LID) make the diagnosis of Parkinson's disease (PD) highly likely. This paper evaluates response to L-Dopa in Perry syndrome (PS), parkinsonism with distinct molecular and neuropathologic characteristics. METHODS: Six patients with PS with a mean follow-up of 5 years (0.5-12) were assessed by movement disorder specialists and video recorded in states off and on. Additionally, DATSCAN-SPECT was performed in 3 subjects. RESULTS: Four patients displayed a marked and sustained response to L-Dopa and LID. Additionally, we observed a distinct pattern of off-state predominant craniocervical dystonia responsive to L-Dopa in 4 patients, truncal dystonia in one, and dystonic head tremor in another. DATSCAN-SPECT was abnormal in 3 patients. CONCLUSIONS: Patients with PS may present PD-like parkinsonism with a marked and sustained response to L-Dopa and LID. The characteristic pattern of craniocervical dystonia may be a helpful clue to the diagnosis of PS.

Serum levels of hepcidin and interleukin 6 in Parkinson's disease.

Neurodegeneration in Parkinson's disease (PD) includes processes of chronic inflammation and oxidative stress which are related to dysregulation in the homeostasis of iron metabolism. Hepcidin is a peptide hormone responsible for systemic iron homeostasis and simultaneously the inflammatory response protein, induced in response to interleukin 6 (IL­6). We assessed the serum concentration of hepcidin and IL­6 in the groups of patients with PD treated only pharmacologically with optimal individualized therapy (MT) and treated additionally with deep brain stimulation (DBS), compared to the control group. The serum concentrations of hepcidin and IL­6 in the group of all PD patients were significantly higher than in the control group. In the group of PD patients treated with DBS hepcidin and IL­6 concentrations were significantly higher compared to the control group. Additionally, the positive correlations between serum hepcidin and IL­6 were found in the PD (MT and DBS) and PD­DBS group. The obtained results may indicate the influence of immunological mechanisms on iron metabolism and oxidative stress, in particular when the inflammatory process is more active in the DBS­treated group. This effect can be protective as well as neurodegenerative.

Relationships between typical histopathological hallmarks and the ferritin in the hippocampus from patients with Alzheimer's disease.

Oxidative stress is one of the possible mechanisms of neurodegeneration. One of the elements of this mechanism are altered iron homeostasis and changes concerning of iron metabolism regulatory proteins. The primary iron storage protein in cells is ferritin, composed of heavy (H) and light (L) chains. In brain tissue neurons contain mainly ferritin H-chains, whereas glial cells are rich in L-chains. To the best of our knowledge, this is the first study that compares structure of ferritin and histopathological hallmarks in hippocampal tissue affected by the pathological process of Alzheimer's disease (AD). Our data indicate a statistically significant correlation between the concentration of L chains of ferritin, the H/L ratio and the amount of senile plaques in the subiculum, CA1 and CA4 sectors of the hippocampus (p<0.001, p=0.025, p=0.029). A significant correlation was also found between the concentration of L-ferritin and neuronal loss (p=0.0026). These findings indicate an important role of ferritin light chains in neurodegeneration, that is linked to chronic inflammation processes and the associated activation of the microglia rich of L chains.