Hulya Apaydin

α-Synuclein pathology in the spinal cords of neurologically asymptomatic aged individuals

The authors assessed the frequency of spinal cord α-synuclein pathology in neurologically asymptomatic individuals older than 60 years of age (N = 106). Using α-synuclein immunohistochemistry, nine cases (8%) had incidental Lewy neurites in the intermediolateral column and at least some α-synuclein pathology in the dorsal motor nucleus of the vagus, locus ceruleus, and central raphe nucleus. Sparse α-synuclein pathology was also detected in the substantia nigra, basal forebrain, amygdala, or cortex in all but two cases.

Collection and Analysis of a Parkinson Speech Dataset With Multiple Types of Sound Recordings

There has been an increased interest in speech pattern analysis applications of Parkinsonism for building predictive telediagnosis and telemonitoring models. For this purpose, we have collected a wide variety of voice samples, including sustained vowels, words, and sentences compiled from a set of speaking exercises for people with Parkinsons disease. There are two main issues in learning from such a dataset that consists of multiple speech recordings per subject: 1) How predictive these various types, e.g., sustained vowels versus words, of voice samples are in Parkinsons disease (PD) diagnosis? 2) How well the central tendency and dispersion metrics serve as representatives of all sample recordings of a subject? In this paper, investigating our Parkinson dataset using well-known machine learning tools, as reported in the literature, sustained vowels are found to carry more PD-discriminative information. We have also found that rather than using each voice recording of each subject as an independent data sample, representing the samples of a subject with central tendency and dispersion metrics improves generalization of the predictive model.

The interleukin 1 alpha, interleukin 1 beta, interleukin 6 and alpha-2-macroglobulin serum levels in patients with early or late onset Alzheimer's disease, mild cognitive impairment or Parkinson's disease

Alzheimers disease (EOAD, LOAD), mild cognitive impairment (MCI), Parkinsons disease (PD) and healthy controls were included to determine the serum interleukin-1s (IL-1α, IL-1β), IL-6 and alpha-2-macroglobulin (α2M) levels using ELISA. IL-6 might be a significant contributor to the inflammatory response in LOAD. The MCI data indicate that IL-1s, α2M and BDNF are somehow related, and this relationship might allow MCI patients to be more similar to the healthy controls. A correlation analysis of multiple biomarkers in different neurodegenerative disorders might be more useful than determining the levels of a single cytokine in a single disorder.

Clinical features of 35 patients with Parkinson's disease displaying REM behavior disorder

OBJECTIVE To assess and compare the disease severity, the treatment properties and the frequency of motor complications in the patients with Parkinsons disease (PD) having and not having REM sleep behavior disorder (RBD). PATIENTS AND METHODS Based on chart review, patients with Parkinsons disease whose bed partners have reported prominent motor activity while dreaming were identified. Standard questionnaires assessing the presence of RBD have been addressed to these patients and their informants. Obtained data fulfilled clinical diagnostic criteria of probable RBD in 35 patients (RBD group) with the mean age at symptom onset was 61.8 years. Of them 77% were men. Clinical features of these patients concerning Hoehn-Yahr stage of PD, the severity of PD according to the Unified Parkinsons disease rating scale (UPDRS), the mean dose and duration of levodopa (LD) therapy, the presence of motor complications were compared with those of gender and age at PD-onset matched 35 PD patients without RBD (NRBD group). RESULTS The mean values of PD duration, Hoehn-Yahr stage and UPDRS scores did not differ between groups. The duration of LD therapy was significantly longer in RBD group in comparison to NRBD group (6.2 years versus 3.05 years, respectively, P<0.005) and also mean actual dose of LD was higher (460.3 mg/day versus 320.3 mg/day respectively, P<0.02). The dose and duration of dopamine agonists did not differ between groups. In RBD group, wearing-off phenomenon was significantly common (P<0.01), its duration was longer (P<0.005), and LD-related dyskinesias were more frequent (P<0.01). CONCLUSION In the current study, when compared with NRBD group, the patients with RBD required higher doses of LD treatment at an earlier stage of PD which eventually led to motor complications. In these patients, dopaminergic treatment restored UPDRS scores, but did not prevent the occurrence of RBD.

Lewy bodies are not increased in progressive supranuclear palsy compared with normal controls

Objective: To determine the frequency of Lewy bodies (LB) in progressive supranuclear palsy (PSP). Background: LB are characteristic of PD, but are also found in normal controls and in other neurodegenerative diseases, especially AD. Method: The authors evaluated the brains of 72 consecutive cases of pathologically confirmed PSP and 98 normal controls, ranging in age from 60 to 100 years, with immunohistochemistry for α-synuclein. Results: LB and Lewy neurites were found in 13 cases of PSP, with the most numerous LB and Lewy neurites in the basal forebrain and amygdala; most cases also had LB in the substantia nigra. The frequency of LB in the substantia nigra (12%) was comparable to the frequency of LB in controls (9%). Conclusions: In contrast to increased frequency of LB in AD, there is no apparent interaction between LB and the tau pathology in PSP.

Features associated with the development of hallucinations in Parkinson's disease

Objective –  To identify features related to the development of hallucinations in Parkinsons disease (PD).

A consanguineous Turkish family with early-onset Parkinson's disease and an exon 4 parkin deletion

The importance of parkin in early‐onset Parkinsons disease in Japan, Europe, and the United States is well established. The contribution of this gene to the risk of Parkinsons disease in other populations is less well known. To explore the importance of parkin in those of Turkish ancestry, we studied familial cases from that country, and identified a consanguineous family with early‐onset Parkinsons disease due to a homozygous mutation in parkin.

A hospital-based study: risk factors in development of motor complications in 555 Parkinson's patients on levodopa therapy.

OBJECTIVES Although levodopa (LD) is the gold standard therapy for symptomatic treatment of Parkinsons disease (PD), the chronic use of LD leads to the development of motor complications in almost all patients. PATIENTS AND METHODS We assessed the presence and risk factors for motor complications in PD patients on LD therapy. We examined 555 PD patients on LD for the presence or absence of wearing-off (WO+/-) and dyskinesia (DK+/-). RESULTS WO was present in 46.3%, and DK in 30.1% of patients. The mean age at onset of symptoms were earlier in WO(+)/DK(+) groups (p<0.001). The duration of PD was longer in WO(+)/DK(+) groups (p<0.001). The time between the first symptom and the occurrence of WO/DK, or LD initiation were not significantly different. The initial LD dose was significantly higher in WO(+) compared to WO(-) (300.1mg/d versus 232.5mg/d, p<0.001), and DK(+) compared to DK(-) groups (291.4 mg/d versus 251.9 mg/d, p=0.001). The time until dopamine agonist (DA) initiation was longer in WO(+)/DK(+) groups (p<0.001). WO (p<0.001) and DK (p=0.002) were more common in patients with H&Y stages 3+4. UPDRS scores were higher in WO(+) and DK(+) patients (p<0.001 and p=0.027). CONCLUSION Our study showed that the development of motor complications was associated with early onset PD, longer disease duration, advanced disease, higher initial LD dose, longer LD use, and late DA initiation, but not with the timing of LD initiation.

Apraxia in Parkinson’s disease and multiple system atrophy

Objective:  To determine praxis function in patients with Parkinson’s disease (PD) and multiple system atrophy (MSA).

Two siblings with homocystinuria presenting with dystonia and parkinsonism

Movement disorders such as dystonia, chorea or tremor are rarely encountered in patients with homocystinuria. We present 2 siblings with laboratory‐confirmed homocystinuria, one with severe generalized dystonia and the other with mild parkinsonism. The movement disorders in our patients appeared in the second and first decades, respectively.