Paracrine factors for neurodegenerative disorders:special emphasis on Parkinson's disease

The progressive loss of dopaminergic neurons in the ventral mesencephalon is the main pathological hallmark of Parkinson’s disease（PD）.Drugs currently available only alleviate the principal symptomatic motor-related disturbances and their benefit is counteracted by side effects in the long time.

Clinical Characteristics of Sleep Disorders in Patients with Parkinson's Disease

In order to investigate the sleep quality and influencing factors in patients with Parkinson＇s disease（PD）, 201 PD patients were enrolled and underwent extensive clinical evaluations. Subjective sleep evaluation was assessed using the Pittsburgh Sleep Quality Index（PSQI）, and the Epworth Sleepiness Scale（ESS）. It was found that poor sleep quality（77.11%） and excessive daytime sleepiness（32.34%） were commonly seen in PD patients and positively correlated with disease severity. Then 70 out of the 201 PD patients and 70 age- and sex-matched controls underwent a polysomnographic recording. The parameters were compared between PD group and control group and the influencing factors of sleep in PD patients were analyzed. The results showed that sleep efficiency（SE） was significantly decreased（P〈0.01）, and sleep latency（SL） and the arousal index（AI） were increased（P〈0.05） in the PD group as compared with those in the control group. SE and total sleep time（TST） were positively correlated with the Hoehn and Yahr（H＆Y） stage. There was significant difference in the extent of hypopnea and hypoxemia between the PD group and the control group（P〈0.05）. Our results indicate that PD patients have an overall poor sleep quality and a high prevalence of sleep disorder, which may be correlated with the disease severity. Respiratory function and oxygen supply are also affected to a certain degree in PD patients.

NO ASSOCIATION BETWEEN TUMOR NECROSIS FACTOR ALPHA AND OBSESSIVE COMPULSIVE DISORDER IN CHINESE HAN POPULATION

Objective To investigate association between tumor necrosis factor alpha (TNF-α) and obsessive compulsive disorder (OCD) in Chinese Han population.Methods Plasma concentrations of TNF-α were measured in 61 drug-free patients who fulfilled DSM-Ⅳ criteria for OCD and 93 healthy controls.TNF-α concentrations in blood were determined by enzyme-linked immunosorbent assay (ELISA).Two polymorphisms of TNF-α gene were investigated in the same patients and healthy controls:-308 G/A and-238 G/A.The allelic and genotypic frequencies of these polymorphisms were examined by using DNA sequencing method.Results Plasma levels of TNF-α did not differ between patients and controls (P=0.292).No significant results were observed for any of the alleles at the-308 G/A or-238 G/A polymorphism of the TNF-α gene.Finally a haplotype consisting of genotypes of these two markers was also examined.No association was observed for any haplotype (P=0.108).Conclusion No significant differences were observed between patients and controls in plasma levels of TNF-α.There is no association between the-308 G/A and-238 G/A TNF-α gene polymorphisms and OCD in our Chinese samples.However,the results need to be replicated in larger samples.

Investigation of Urination Disorder in Parkinson＇s Disease

Background： Urination disorders are common in Parkinson＇s disease （PD） and respond poorly to medication. This study aimed to analyze the risk factors for urination disorders in PD. Methods： Ninety-one patients with PD （aged 34-83 years old） were recruited. Patients were assessed with the Unified PD Rating Scale （UPDRS）, Hoehn and Yahr stage, Pittsburgh Sleep Quality Index （PSQ1）, Hamilton Depression Rating Scale （HAMD）, and Hamilton Anxiety Scale （HAMA）. Micturition number was recorded, and Type B ultrasound was used to evaluate residual urine. Statistics was performed using binary logistic regression, bivariate correlations, and Chi-square and t-tests. Results： Of 91 patients, urinary dysfunction occurred in 55.0%. Among these, 49.5% suffered with nocturia, 47.3% with pollakiuria. Nocturia number had a positive linear relationship with HAMA score （odds ratio [OR] = 0.340, P = 0.001 ）, HAMD score （OR = 0.323, P = 0.002）, duration of L-dopa medication （OR = 0.328, P = 0.001 ）, dose of L-dopa （OR = 0.273, P = 0.009）, UPDRS-II （OR = 0.402, P = 0.000）, UPDRS-III score （OR = 0.291, P = 0.005）, and PSQI score （OR = 0.249, P = 0.017）. Micturition number over 24 h was positively associated with HAMA （OR = 0.303, P = 0.004） and UPDRS-II scores （OR = 0.306, P = 0.003）. Of patients with residual urine, 79.3% had a volume of residual urine 〈50 ml. Residual urine was present in 44.4% of the patients with nocturia~ 46.5% of the patients with pollakiuria, and 80.0% of the patients with dysuria. More men than women had residual urine （35.2% male vs. 13.3% female; P = 0.002）. Conclusions： Nocturia and pollakiuria were common micturition symptoms in our participants with PD. Nocturia was associated with depression, anxiety, sleep problems, and severity of PD. Pollakiuria was associated with anxiety and severity of PD. Male patients were more prone to residual urine and pollakiuria.

Modifying the Autism Spectrum Rating Scale(6–18 years)to a Chinese Context:An Exploratory Factor Analysis

The purpose of this study was to explore the psychometric properties of the Chinese version of the autism spectrum rating scale（ASRS）. We recruited 1,625community-based children and 211 autism spectrum disorder（ASD） cases from 4 sites, and the parents of all participants completed the Chinese version of the ASRS. A robust weighted least squares means and variance adjusted estimator was used for exploratory factor analysis. The3-factor structure included 59 items suitable for the current sample. The item reliability for the modi？ed Chinese version of the ASRS（MC-ASRS） was excellent. Moreover,with 60 as the cut-off point, receiver operating characteristic analysis showed that the MC-ASRS had excellent discriminate validity, comparable to that of the unmodi？ed Chinese version（UC-ASRS）, with area under the curve values of 0.952（95% CI： 0.936–0.967） and 0.948（95% CI：0.930–0.965）, respectively. Meanwhile, the con？rm factor analysis revealed that MC-ASRS had a better construct validity than UC-ASRS based on the above factor solution in another children sample. In conclusion, the MC-ASRS shows better ef？cacy in epidemiological screening for ASD in Chinese children.

Clinical Significance of REM Sleep Behavior Disorders and Other Non-motor Symptoms of Parkinsonism

Rapid eye movement sleep behavior disorder （RBD） is one of the most common non-motor symptoms of parkinsonism, and it may serve as a prodromal marker of neurodegenerative disease. The mechanism underlying RBD is unclear. Several prospective studies have reported that specific non-motor symptoms predict a conversion risk of developing a neurodegenerative disease, including olfactory dysfunction, abnormal color vision, autonomic dysfunction, excessive daytime sleepiness, depression, and cognitive impairment. Parkinson＇s disease （PD） with RBD exhibits clinical heterogeneity with respect to motor and non-motor symptoms compared with PD without RBD. In this review, we describe the main clinical and pathogenic features of RBD, focusing on its association with other non-motor symptoms of parkinsonism.