Nataša Klepac

Is quality of life in non-demented Parkinson’s disease patients related to cognitive performance? A clinic-based cross-sectional study

Whilst the association between dementia and poorer health‐related quality of life (Hr‐QoL) in Parkinson’s disease (PD) has been well established, we aimed to explore the relationship between cognitive performance and Hr‐QoL in PD without dementia. Consecutive PD patients (nu2003=u2003124, 54% men, age 60.4u2003±u200310.3u2003years) judged as non‐demented based on DSM‐IV criteria and Mini Mental State Examination, free of other neurodegenerative diseases or psychotic difficulties and antipsychotic/antidepressive/anxyolitic treatment were assessed in a battery of neuropsychological tests. We used Parkinson’s disease questionnaire (PDQ‐39) to asses Hr‐QoL and Beck’s Depression Inventory (BDI) to quantify depression. In the univariate analysis, better performance in each of the tests evaluating visual attention/memory or visuospatial and executive functions was associated with better Hr‐QoL. In multivariate analysis [adjustment for BDI score, PD severity and duration, l‐dopa dose, age, sex, education, employment status and early PD onset (<50u2003years of age)] in which these tests were either represented by a common variable identified in a principal components analysis or were considered individually, better cognitive performance was independently associated with better Hr‐QoL. The association was conditional on the level of depression, i.e., apparent only in patients with low(er) BDI scores. Cognitive performance appears associated with Hr‐QoL even in non‐demented PD patients.

Oxidative stress parameters in plasma of Huntington's disease patients, asymptomatic Huntington’s disease gene carriers and healthy subjects

BackgroundAnimal data and postmortem studies suggest a role of oxidative stress in the Huntingtons disease (HD), but in vivo human studies have been scarce.AimTo assess the presence of oxidative stress in HD patients and its occurrence relative to clinical symptoms.MethodsOxidative stress markers were determined in plasma of HD patients (n = 19), asymptomatic HD gene carriers (with > 38 CAG repeats) (n = 11) and their respective sex and agematched healthy controls (n = 47 and n = 22) in a cross-sectional study.ResultsWith adjustment for age and sex, HD patients had higher plasma lipid peroxidation (LP) levels (ratio 1.20, 95% CI 1.09 to 1.32, p < 0.001) and lower reduced glutathione (GSH) levels (ratio 0.72, CI 0.55 to 0.94, p = 0.011) than their age and sex-matched controls. Although considerably younger, HD gene carriers did not differ from HD patients regarding LP and GSH levels, and had higher plasma LP (ratio 1.16, CI 1.02 to 1.32, p = 0.016) and lower GSH than their matched controls (ratio 0.73, CI 0.5 to 1.05). They had higher LP (ratio 1.18, CI 1.02 to 1.34, p = 0.019) and lower GSH (ratio 0.75, CI 0.51 to 1.11) than the healthy subjects matched to HD patients.ConclusionsOxidative stress is more pronounced in HD patients and asymptomatic HD gene carriers than in healthy subjects. Differences in plasma LP and GSH are in line with the brain findings in animal models of HD. Data suggest that oxidative stress occurs before the onset of the HD symptoms.

Association of rural life setting and poorer quality of life in Parkinson's disease patients: a cross-sectional study in Croatia

Assessment of quality of life (QoL) has become an important measure in Parkinsons disease (PD) healthcare as a part of the efforts to evaluate the ‘total burden’ of the illness, and not only the motor disabilities. By analogy with some other diseases, we aimed to investigate potential urban–rural disparities in QoL in PD patients. A total of 111 consecutive PD patients were assessed for QoL using a specific 39‐item version of PD quality of life questionnaire (PDQ‐39) in a cross‐sectional study involving two centers in Croatia. Rural life setting (adjustment for center, age, sex, levodopa dose, disease duration and severity, education, employment status and number of household co‐members) was an independent negative predictor of QoL: rural patients had significantly (Pu2003<u20030.05) worse PDQ‐39 Summary Index Score and most of the PDQ‐39 subscale scores (cognition, social support, stigma, emotional wellbeing and mobility score, and communication and activity of daily living scores with borderline significance) than their urban counterparts. Socioeconomic background should be considered in attempts to achieve the best management of PD patients’ needs.

A dopamine agonist, pramipexole, and cognitive functions in Parkinson's disease

The cognitive performance of 55 non-demented idiopathic Parkinsons disease (PD) patients treated with levodopa alone or receiving dopamine agonist pramipexole as add-on therapy to levodopa was evaluated in the present study during 6 months of treatment. Neuropsychological tests were administered two times. In the first assessment to differentiate test sensitive to cognitive changes typical for PD control group was also assessed. After 6 months of treatment PD patients were retested only with tests that differentiate them from control group. Compared to controls PD patients showed inferior performance on Stroop Interference test, Trail Making test, letter fluency and Hooper Visual Organization Test. No statistically significant differences between two groups and first and second neuropsychological assessment were found. Present findings indicate that pramipexole as add-on therapy to levodopa is safe in non-demented PD patients in terms of the effect on cognitive performance.

Association of MAPT haplotype-tagging polymorphisms with cerebrospinal fluid biomarkers of Alzheimer's disease: A preliminary study in a Croatian cohort

Abstract Introduction Alzheimers disease (AD) is the world leading cause of dementia. Early detection of AD is essential for faster and more efficacious usage of therapeutics and preventive measures. Even though it is well known that one ε4 allele of apolipoprotein E gene increases the risk for sporadic AD five times, and that two ε4 alleles increase the risk 20 times, reliable genetic markers for AD are not yet available. Previous studies have shown that microtubule‐associated protein tau (MAPT) gene polymorphisms could be associated with increased risk for AD. Methods The present study included 113 AD patients and 53 patients with mild cognitive impairment (MCI), as well as nine healthy controls (HC) and 53 patients with other primary causes of dementia. The study assessed whether six MAPT haplotype‐tagging polymorphisms (rs1467967, rs242557, rs3785883, rs2471738, del–In9, and rs7521) and MAPT haplotypes are associated with AD pathology, as measured by cerebrospinal fluid (CSF) AD biomarkers amyloid β1–42 (Aβ1–42), total tau (t‐tau), tau phosphorylated at epitopes 181 (p‐tau181), 199 (p‐tau199), and 231 (p‐tau231), and visinin‐like protein 1 (VILIP‐1). Results Significant increases in t‐tau and p‐tau CSF levels were found in patients with AG and AA MAPT rs1467967 genotype, CC MAPT rs2471738 genotype and in patients with H1H2 or H2H2 MAPT haplotype. Conclusions These results indicate that MAPT haplotype‐tagging polymorphisms and MAPT haplotypes should be further tested as potential genetic biomarkers of AD.