Search

Objective: In view of the fact that cancer patterns in patients with Parkinson disease (PD) differ from the general population, we aimed to verify whether patients with PD with LRRK2 mutations have an increased risk for particular cancer types. Methods: In this cross-sectional study, eligible consenting Jewish patients with PD were genotyped for the predominant LRRK2 G2019S mutation. Oncologic data were obtained by personal interview and reviewing patients9 files. Stepwise logistic regression was applied to model the probability of cancer occurrence in carriers vs noncarriers. Results: Overall, 79/490 (16.1%) genotyped patients carried the G2019S mutation. Seventy-seven (16%) were diagnosed with cancer; of those, 67 (14%) with a non-skin cancer. Eighteen (23%) carriers vs 49 (12%) noncarriers had a non-skin cancer ( p = 0.01, odds ratio [OR] = 2.18, 95% confidence interval [CI] 1.19–3.99). A significant ethnicity effect was noted ( p = 0.045, OR = 1.84, 95% CI 1.02–3.34). Among Ashkenazi patients, age and LRRK2 emerged as significant using stepwise logistic regression including age, gender, and LRRK2 status as explanatory variables. The OR for LRRK2 mutation carriers adjusted for age was 3.38 (95% CI 1.64–6.97, p = 0.0009). Conclusions: Ashkenazi Jewish patients with PD who harbor the G2019S LRRK2 mutation are more likely to have a concomitant non-skin cancer than noncarriers.

In the present study we compared the efficacy and safety of the new dopamine agonist cabergoline (CBG) with bromocriptine (BCR) in Parkinson's disease (PD).CBG has a very long half-life and can be administered as a single daily dose. Forty-four PD patients with uncontrolled motor fluctuations participated in the study. Patients were randomly and blindly assigned to equivalent doses of either CBG or BCR in addition to preexisting levodopa. Dosage was titrated to optimal, using up to 6 mg of CBG or 40 mg of BCR daily. CBG was given as a single morning dose whereas BCR was administered tid. Sixteen patients were followed for 1 year and 16 additional patients for 6 months. The mean follow-up duration was 9 +/- 5 months. The main effect of both drugs was observed on motor UPDRS scores, rigidity, bradykinesia items, and the percentage of awake hours spent during ``on'' and ``off.'' In general, the effect of CBG was similar to that of BCR. The percentage of awake hours spent during ``on'' was higher with CBG as compared with BCR. Adverse events included dyskinesias, orthostatism, confusion, edema, and paresthesias in limbs. These effects were seen at similar frequencies with both drugs. The study shows that CBG given as a single morning dose is at least as efficacious as BCR given tid. CBG is a promising dopamine agonist for the treatment of motor fluctuations in PD.NEUROLOGY 1996;47: 785-788

To identify familial risk factors for hallucinations in patients with Parkinson disease (PD).Two hundred seventy-six outpatients with PD participated in the study. The presence of hallucinations was determined using a validated questionnaire, including items regarding the occurrence of visual, auditory, or other types of hallucinations. Family history of PD and dementia was determined by a structured interview and examination of medical records and affected family members. Patients with young-onset PD (50 years) who reported another PD patient among their siblings were tested for parkin mutations. Stepwise logistic regression was applied for the detection of risk factors. The regression model included a set of family history-related variables (family history of PD and of dementia) and a set of disease-related variables (age, age at onset of PD, stage, duration of PD and of l-dopa therapy, l-dopa dose, and number of antiparkinsonian drugs).Hallucinations were present in 32% of the 276 patients. Risk factors for hallucinations included Mini-Mental State Examination score (p0.0001) and positive family history of dementia (p = 0.0005).Family history of dementia and lower Mini-Mental State Examination scores are risk factors for hallucinations in Parkinson disease.