Eleonora Dzoljic

Prevalence of menstrually related migraine and nonmigraine primary headache in female students of Belgrade University.

Objectives.—To determine prevalence and characteristics of menstrually related migraine and nonmigraine headache in female students of Belgrade University.

Environmental Factors and Parkinson's Disease: A Case-Control Study in Belgrade, Serbia

ABSTRACT A case-control study was performed in Belgrade in order to investigate the association between Parkinsons disease (PD) and some environmental factors. During the period 2001–2005, 110 new PD cases and 220 hospital controls were interviewed. Cases and controls were matched by sex, age (±2 years), and place of residence (urban/rural). According to multivariate conditional logistic regression analysis, PD was positively asssociated with exposure to insecticides (odds ratio (OR) 3.22, 95% confidence interval (95% CI) 1.32–7.87), dyes (OR 25.33; 95% CI, 2.89–222.0), and naphtha and its derivates (OR 9.53; 95% CI, 1.04–86.96), and with gardening (OR 5.51; 95% CI, 3.04–10.01), well water drinking (OR 2.62; 95% CI, 1.40–4.90), and spring water drinking (OR 2.19; 95% CI, 1.15–4.16). Negative association was found for service-sector working (OR 0.15; 95% CI, 0.04–0.59). The results obtained did not changed after adjustment for smoking. The findings of the present study support the role of environmental factors in the occurence of PD.

Infections as a risk factor for Parkinson's disease: a case-control study.

Objectives: The etiology of Parkinsons disease (PD) is unknown. The aim of the study was to test the hypothesis that some infectious diseases are related to the occurrence of PD. Methods: The case–control study, conducted in Belgrade during the period 2001–2005, comprised 110 subjects diagnosed for the first time as PD cases, and 220 controls chosen among patients with degenerative joint disease and some diseases of the digestive tract. Results: According to logistic regression analysis, PD was significantly related to mumps [odds ratio adjusted on occupation and family history of PD (aOR) = 7.86, 95% confidence interval (CI) = 3.77–16.36], scarlet fever (aOR = 12.18, 95% CI = 1.97–75.19), influenza (aOR = 8.01, 95% CI = 4.61–13.92), whooping cough (aOR = 19.90, 95% CI = 2.07–190.66) and herpes simplex infections (aOR = 11.52, 95% CI = 2.25–58.89). Tuberculosis, measles and chicken pox were not associated with PD. Other infectious diseases we asked for were not reported (12 diseases), or were too rare (four diseases) to be analysed. Conclusion: The results obtained are in line with the suggestion that some infectious diseases may play a role in the development of PD.

A survey of female students with migraine: what is the influence of family history and lifestyle?

Objectives: To compare characteristics of migraine and some lifestyle habits in migraineurs with and without a positive family history for migraine. Method: The prevalence study was combined with a case-control study and comprised 245 female students with migraine. Results: Out of 245 female students with migraine, 132 (53.9%) had a positive family history for migraine. In comparison with migraineurs who had not, those with a positive family history were younger at the onset of migraine and significantly more frequently reported menstrual migraine (p < 0.001), unilateral pain ( p < 0.05) and pulsate pain ( p < 0.05) as well as severe headache ( p < 0.01). In comparison to migraineurs with a positive family history for migraine, those who did not report a significantly higher frequency of average number of meals per day of <3 ( p < 0.001), missed meals ( p < 0.05) and an average sleep duration of ≤6 h ( p < 0.05). Conclusions: The results of the present study are in line with literature showing a high frequency of positive family history for migraine among migraineurs. They also suggest that subjects with a positive family history have a lower “migrainous threshold” for the development of migraine and that environmental factors are more important for the occurrence of migraine in subjects without a positive family history. Accordingly, the conclusions of this study are limited to reproductive aged women.

The Stressful Life Events and Parkinson's Disease: A Case–Control Study

A case-control study was conducted in order to investigate the possible link between stressful life events and Parkinsons disease (PD). A group of 110 consecutive newly diagnosed PD cases treated at the Institute of Neurology, Faculty of Medicine, Belgrade University, was compared with a control group comprising 220 subjects with degenerative joint disease and some diseases of the digestive tract. The case and control subjects were matched by sex, age (±2 years) and place of residence (urban/rural). According to conditional multivariate logistic regression analysis, PD was found to be significantly related to retirement (odds ratio--OR 18.73, 95% confidence interval--95%CI 1.9-175.4), birth of own child (OR 66.22, 95%CI 8.3-526.3) and air raids (OR 5.66, 95%CI 2.4-13.5). The risk of PD significantly increased with the number of stressful events. The results of the present study support the hypothesis that stress may play a role in the development of PD.

Hereditary patterns of Belgrade university female students with migraine and nonmigraine primary headache

Abstract.Various studies have provided evidence that migraine is a multifactorial genetic disorder. The aim of the present study was to compare hereditary patterns of female students with migraine (245 subjects) and non–migraine primary headaches (1053 subjects). The prevalence study was performed combined with a case–control study. Migraineurs had significantly more frequently one or more first-degree and/or second–degree relatives with migraine. Students with menstrual migraine, in comparison with other subtypes of migraine (with the exception of premenstrual migraine),had significantly more frequently ≥ 2 relatives with migraine. Among students with non–migraine primary headaches, those with menstrually related headache had more frequently relatives with migraine in comparison with students suffering from menstrually unrelated nonmigraine headache. The results obtained are in line with the results of genetic epidemiologic studies suggesting that genetic factors play a role in the occurrence of migraine.

Cigarette smoking, coffee intake and alcohol consumption preceding Parkinson's disease: a case–control study

Objective: A case–control study was performed in Belgrade in order to investigate the association between Parkinsons disease (PD) and smoking, coffee and alcohol consumption. Methods: During the period 2001–2005, 110 new PD cases and 220 hospital controls were interviewed. Cases and controls were matched by sex, age and place of residence (urban/rural). For the analysis of data conditional univariate and multivariate logistic regression methods were used. Results: With PD were associated, independently from each other, current smoking [odds ratio (OR) = 0.44; 95% confidence interval (CI) = 0.23–0.82], alcohol consumption (OR = 4.78; 95% CI = 2.67–8.55) and coffee consumption (OR = 2.54; 95% CI = 1.36–4.75). In ever smokers the risk for PD significantly decreased with the increasing number of cigarettes smoked and with increasing duration of smoking. The risk for PD significantly increased with the increasing quantity of alcohol consumption. PD risk was significantly higher in subjects whose average daily consumption of coffee was 1 and 2–3 cups, and it was lower (but not significantly) in those whose daily coffee consumption was 4+ cups. Cases and controls did not differ in duration of alcohol and coffee consumption. The results of multivariate analyses did not substantially change after adjustment on family history positive on PD. Conclusion: The findings of this study support the hypotheses of inverse association of smoking with PD, but an inverse association with coffee was not confirmed. PD was found to be positively associated with coffee and alcohol consumption.

Dopa-responsive dystonia

BACKGROUND/AIM Dystonia is considered to be a prolonged involuntary contractions of the muscles leading to twisting, repetitive movements or irregular postures. Etiologically, it could be classified as primary and secondary dystonia. Dopa-responsive dystonia (DRD) belongs to a group of primary dystonia. The aim of this study was to detect the presence of gene GCH-I mutation in our population in patients with dopa-responsive dystonic dyskinesia and to analyse clinical specificity of the affected. METHODS Out of the group of patients with dystonia of different distribution four patients were separated whose clinical picture indicated the diagnosis of DRD. Two patients had a positive family anamnesis while the other two were sporadic. Genetic analysis was performed by the use of a standard protocol, which included PCR amplification and DNK sequencing according to the method of Senger and autoradiografy. RESULTS In the patients from the family DRD-1 new hetaerazygote point mutation 520G-->A in 4-m exson gene GCH-I was revealed. First symptoms of the disease showed in the age of seven by the torsion of the left foot, progressively advanced and got into the evolution of numbness in the legs, aggravated gait, tending to worsen in the evening, and the therapy with levodopa (500 mg) produced a dramatic effect. The second mutation in the female patient from the family DRD-2 was homozygote deletion in 1-m intron gene GCH-I (IVS1-85delA). Unwilling torsion of the foot, feeling of weakness in the lower extremities (that caused falling without loss of the consciousness) were clinical demonstrations of the disease. The application of levodopa (300 mg) caused regression of the symptoms of the disease. Hetaerazygote deletion of adenine in the position 209 in the first exon (209del A) was identificated in the patient DRD-3 with negative family anamnesis, in who in the age of ten the torsion of the foot inside occured for the first time following by trembling of both the left and right legs at rest; after a few years, tremor of hands also appeared, which became worse in stressful situations. The father of the patient was an asymptomatic bearer of mutation. The fourth mutation in gene GCH-I was found in I exon gene GCH-I, 208delA. The disease was started by torsion of the left foot, progressing easily, and worsening in the evenings, but at the age of 30, moving became harder, fatigue and pain in muscles, increased and at the age of 40 the patient recognised the change of speech. The application of levodopa (300 mg/daily) made the patient feel better and walk independently. CONCLUSION The study presented four patients with genetic confirmation of the diagnosis of dopa-responsive dystonia. This entity is very significant in differential diagnostics of both early dystonia (< 26 years) and early parkinsonism (< 40 years) since it can be successfully managed by applyng relatively low doses of levodopa over a long period of time.