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3. Cognitive and Motor Decline in Dementia with Lewy Bodies and Parkinson's Disease Dementia

Author

Gonzalez MC, Tovar-Rios DA, Alves G, Dalen I, Williams-Gray CH, Camacho M, Forsgren L, Backstrom D, Lawson RA, Macleod AD, Counsell CE, Paquet C, DeLena C, D'Antonio F, Pilotto A, Padovani A, Blanc F, Falup-Pecurariu C, Lewis SJG, Rejdak K, Papuc E, Hort J, Nedelska Z, O'Brien J, Bonanni L, Marquie M, Boada M, Pytel V, Abdelnour C, Alcolea D, Beyer K, Tysnes O-B, Aarsland D, Maple-Grodem J

Published
2023
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4. Intake of vitamin B before onset of Parkinson's disease and atypical parkinsonism and olfactory function at the time of diagnosis

Author

Håglin, L, Johansson, I, Forsgren, L, and Bäckman, L

Subjects
Diagnosis, Usage, Health aspects, Parkinson disease -- Diagnosis, Vitamin B complex -- Usage -- Health aspects, Olfactory pathway -- Health aspects, Rhinencephalon -- Health aspects, Parkinson's disease -- Diagnosis, Vitamin B -- Usage -- Health aspects
Abstract

Author(s): L Håglin [sup.1] , I Johansson [sup.2] , L Forsgren [sup.3] , L Bäckman [sup.1] Author Affiliations: (1) Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, [...], Background/Objectives: To investigate whether vitamin-B density in the diet 2-8 years before diagnosis is associated with olfactory function at the time of diagnosis. Subjects/Methods: This prospective nested case-control study included patients with Parkinson's disease (PD), multiple system atrophy and progressive supranuclear paralysis identified between 2004 and 2009 in the county of Västerbotten in northern Sweden. The case database (NYPUM study; Newly Diagnosed Parkinson in Umeå; n=147) was cross-linked to the Northern Sweden Health and Disease Study (NSHDS). Identified patients (n=96) and controls (n=375) were matched for sex, age, year of health survey, sub-cohort and geographical area. Dietary intake was assessed by a food frequency questionnaire, and the brief smell identification test (B-SIT) was used to measure olfactory function at the time of diagnosis. Results: There was no difference in vitamin-B or any other macro- or micro-nutrient densities, energy intake or body mass index (kg/m.sup.2; BMI) between patients and controls at baseline at the time of the healthcare survey. A lower thiamin and folate density, amount per 1 megajoule, was reported in patients who scored below median on B-SIT ( Conclusions: A low thiamin and folate density in the reported diet, 2-8 years before PD diagnosis, was significantly associated with olfactory dysfunction at the time of PD diagnosis.

Published
2017
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7. Cardiovascular risk factors and the risk of Parkinson's disease

Author

Vikdahl, M., Backman, L., Johansson, I., Forsgren, L., and Haglin, L.

Subjects
Risk factors, Parkinson disease -- Risk factors, Cardiovascular diseases -- Risk factors
Abstract

INTRODUCTION Cardiovascular risk factors are implicated as risk factors for neuronal damage in healthy elderly persons and in persons with dementia. (1,2) Parkinson's disease (PD), the second most common neurodegenerative [...], BACKGROUND/OBJECTIVES: The objective of this study was to investigate whether serum triglycerides (S-TG), cholesterol, blood pressure and waist/height ratio are risk factors for Parkinson's disease (PD). SUBJECTS AND METHODS: A population -based sample within the Northern Sweden Health and Disease Study (NSHDS) was used in this study (n = 101 790 subjects). Cases with PD were identified prospectively in a community-based study of idiopathic Parkinsonism in the period 2004-2009 in the county of Vasterbotten in northern Sweden. The case database obtained was crosslinked to the NSHDS. Eighty-four of 147 patients with PD had visited the primary health care 2-8 years before diagnosis for participation in the NSHDS. For each case, four referents from the NSHDS population were selected, matched for sex, age, year of health survey, subcohort and geographic area. RESULTS: Cases had lower mean S-TG levels (P =0.007). After stratification for sex, the lower S-TG remained significant for men (P = 0.006) but not for women (P = 0.450), and these were confirmed by the conditional logistic regression for all cases, none adjusted (hazard ratio (HR): 0.65; 95% confidence interval (CI): 0.42, 0.99) and after adjusting for age, body mass index (BMI) and physical activity (HR: 0.61; 95% CI: 0.39, 0.96). Systolic blood pressure (SBP) was negatively associated with PD risk after adjustments for age, BMI and physical activity (HR: 0.98; 95% CI: 0.97-0.99). Smoking and former smoking were associated with a reduced risk for PD. CONCLUSIONS: We found lower S-TG and SBP 2-8 years before a diagnosis of PD. Smoking was confirmed to be negatively associated with PD, whereas recreational activity indicates a risk for women. European Journal of Clinical Nutrition (2015) 69, 729-733; doi: 10.1038/ejcn.2014.259; published online 17 December 2014

Published
2015
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8. Management of dystonia in Europe: a survey of the European network for the study of the dystonia syndromes

Author

Valadas, A., Contarino, M-F., Albanese, A., Bhatia, K. P., Falup-Pecurariu, C., Forsgren, L., Friedman, A., Giladi, N., Hutchinson, M., Kostic, V. S., Krauss, J. K., Lokkegaard, A., Marti, M. J., Milanov, I., Pirtosek, Z., Relja, M., Skorvanek, M., Stamelou, M., Stepens, A., Tamás, G., Taravari, A., Tzoulis, C., Vandenberghe, W., Vidailhet, M., Ferreira, J. J., and Tijssen, M. A.

Published
2016
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12. The Effects of Working Memory Updating Training in Parkinson’s Disease : A Feasibility and Single-Subject Study on Cognition, Movement and Functional Brain Response

Author

Walton, Lois, Domellöf, M. E., Boraxbekk, C. -J, Domellöf, E., Rönnqvist, L., Bäckström, D., Forsgren, L., Stigsdotter Neely, Anna, Walton, Lois, Domellöf, M. E., Boraxbekk, C. -J, Domellöf, E., Rönnqvist, L., Bäckström, D., Forsgren, L., and Stigsdotter Neely, Anna

Abstract

In Parkinson’s disease (PD), the fronto-striatal network is involved in motor and cognitive symptoms. Working memory (WM) updating training engages this network in healthy populations, as observed by improved cognitive performance and increased striatal BOLD signal. This two-part study aimed to assess the feasibility of WM updating training in PD and measure change in cognition, movement and functional brain response in one individual with PD after WM updating training. A feasibility and single-subject (FL) study were performed in which patients with PD completed computerized WM updating training. The outcome measures were the pre-post changes in criterion and transfer cognitive tests; cognitive complaints; psychological health; movement kinematics; and task-related BOLD signal. Participants in the feasibility study showed improvements on the criterion tests at post-test. FL displayed the largest improvements on the criterion tests and smaller improvements on transfer tests. Furthermore, FL reported improved cognitive performance in everyday life. A shorter onset latency and smoother upper-limb goal-directed movements were measured at post-test, as well as increased activation within the striatum and decreased activation throughout the fronto-parietal WM network. This two-part study demonstrated that WM updating training is feasible to complete for PD patients and that change occurred in FL at post-test in the domains of cognition, movement and functional brain response.

Published
2021
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15. Incidence (1988-97) and prevalence (1997) of multiple sclerosis in Vasterbotten County in northern Sweden. (Paper)

Author

Sundstrom, P., Nystrom, L., and Forsgren, L.

Subjects
Sweden -- Health aspects, Statistics, Health aspects, Multiple sclerosis -- Statistics -- Health aspects
Abstract

Objective: To investigate the incidence and prevalence of multiple sclerosis in Vasterbotten County in northern Sweden. Methods: Multiple sources were used in the case identification process. Fallow up interviews with [...]

Published
2003

23. Alcohol Consumption and Risk of Parkinson's Disease: Data From a Large Prospective European Cohort

Author

Peters, S. Gallo, V. Vineis, P. Middleton, L.T. Forsgren, L. Sacerdote, C. Sieri, S. Kyrozis, A. Chirlaque, M.-D. Zamora-Ros, R. Hansson, O. Petersson, J. Katzke, V. Kühn, T. Mokoroa, O. Masala, G. Ardanaz, E. Panico, S. Bergmann, M.M. Key, T.J. Weiderpass, E. Ferrari, P. Vermeulen, R.

Abstract

Background: Parkinson's disease (PD) etiology is not well understood. Reported inverse associations with smoking and coffee consumption prompted the investigation of alcohol consumption as a risk factor, for which evidence is inconclusive. Objective: To assess the associations between alcohol consumption and PD risk. Methods: Within NeuroEPIC4PD, a prospective European population-based cohort, 694 incident PD cases were ascertained from 209,998 PD-free participants. Average alcohol consumption at different time points was self-reported at recruitment. Cox regression hazard ratios were estimated for alcohol consumption and PD occurrence. Results: No associations between baseline or lifetime total alcohol consumption and PD risk were observed. Men with moderate lifetime consumption (5–29.9 g/day) were at ~50% higher risk compared with light consumption (0.1–4.9 g/day), but no linear exposure–response trend was observed. Analyses by beverage type also revealed no associations with PD. Conclusion: Our data reinforce previous findings from prospective studies showing no association between alcohol consumption and PD risk. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Published
2020

32. Teaching of neuroepidemiology in Europe: time for action

Author

Feigin, V., Brainin, M., Breteler, M. M. B., Martyn, C., Wolfe, C., Bornstein, N., Fieschi, C., Sevcik, P., Lima, M. L., Boysen, G., Beghi, E., Tzourio, C., Demarin, V., Gusev, E., López-Pousa, S., and Forsgren, L.

Published
2004

38. General and abdominal adiposity and the risk of Parkinson's disease: A prospective cohort study

Author

Riso, L. Kaaks, R. Kühn, T. Sookthai, D. Forsgren, L. Trupp, M. Trichopoulou, A. La Vecchia, C. Karakatsani, A. Gavrila, D. Ferrari, P. Freisling, H. Petersson, J. Lewan, S. Vermeulen, R.C. Panico, S. Masala, G. Ardanaz, E. Krogh, V. Perneczky, R. Middleton, L.T. Mokoroa, O. Sacerdote, C. Sieri, S. Hayat, S.A. Brayne, C. Riboli, E. Vineis, P. Gallo, V. Katzke, V.A.

Abstract

Introduction: Due to demographic change, an increase in the frequency of Parkinson's disease (PD) patients is expected in the future and, thus, the identification of modifiable risk factors is urgently needed. We aimed to examine the associations of body mass index (BMI) and waist circumference (WC) with incident PD. Methods: In 13 of the 23 centers of the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a total of 734 incident cases of PD were identified between 1992 and 2012 with a mean follow-up of 12 years. Cox proportional hazards regression was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). We modelled anthropometric variables as continuous and categorical exposures and performed subgroup analyses by potential effect modifiers including sex and smoking. Results: We found no association between BMI, WC and incident PD, neither among men nor among women. Among never and former smokers, BMI and waist circumference were also not associated with PD risk. For male smokers, however, we observed a statistically significant inverse association between BMI and PD risk (HR 0.51, 95%CI: 0.30, 0.84) and the opposite for women, i.e. a significant direct association of BMI (HR 1.79, 95%CI: 1.04, 3.08) and waist circumference (HR 1.64, 95%CI: 1.03, 2.61) with risk of PD. Conclusion: Our data revealed no association between excess weight and PD risk but a possible interaction between anthropometry, sex and smoking. © 2019 Elsevier Ltd

Published
2019

39. Exploring causality of the association between smoking and Parkinson's disease

Author

Gallo, V. Vineis, P. Cancellieri, M. Chiodini, P. Barker, R.A. Brayne, C. Pearce, N. Vermeulen, R. Panico, S. Bueno-De-Mesquita, B. Vanacore, N. Forsgren, L. Ramat, S. Ardanaz, E. Arriola, L. Peterson, J. Hansson, O. Gavrila, D. Sacerdote, C. Sieri, S. Kühn, T. Katzke, V.A. Van Der Schouw, Y.T. Kyrozis, A. Masala, G. Mattiello, A. Perneczky, R. Middleton, L. Saracci, R. Riboli, E.

Abstract

Background: The aim of this paper is to investigate the causality of the inverse association between cigarette smoking and Parkinson's disease (PD). The main suggested alternatives include a delaying effect of smoking, reverse causality or an unmeasured confounding related to a low-risk-taking personality trait. Methods: A total of 715 incident PD cases were ascertained in a cohort of 220 494 individuals from NeuroEPIC4PD, a prospective European population-based cohort study including 13 centres in eight countries. Smoking habits were recorded at recruitment. We analysed smoking status, duration, and intensity and exposure to passive smoking in relation to PD onset. Results: Former smokers had a 20% decreased risk and current smokers a halved risk of developing PD compared with never smokers. Strong dose-response relationships with smoking intensity and duration were found. Hazard ratios (HRs) for smoking 30 years 0.54 (95% CI 0.43-0.36) compared with never smokers. The proportional hazard assumption was verified, showing no change of risk over time, arguing against a delaying effect. Reverse causality was disproved by the consistency of dose-response relationships among former and current smokers. The inverse association between passive smoking and PD, HR 0.70 (95% CI 0.49-0.99) ruled out the effect of unmeasured confounding. Conclusions: These results are highly suggestive of a true causal link between smoking and PD, although it is not clear which is the chemical compound in cigarette smoking responsible for the biological effect. © 2018 The Author(s) 2018. Published by Oxford University Press on behalf of the International Epidemiological Association.

Published
2019

44. General and abdominal adiposity and the risk of Parkinson's disease: A prospective cohort study

Author

Riso, L., Kaaks, R., Kühn, T., Sookthai, D., Forsgren, L., Trupp, M., Trichopoulou, A., La Vecchia, C., Karakatsani, A., Gavrila, D., Ferrari, P., Freisling, H., Petersson, J., Lewan, S., Vermeulen, R.C., Panico, S., Masala, G., Ardanaz, E., Krogh, V., Perneczky, R., Middleton, L.T., Mokoroa, O., Sacerdote, C., Sieri, S., Hayat, S.A., Brayne, C., Riboli, E., Vineis, P., Gallo, V., Katzke, V.A., Riso, L., Kaaks, R., Kühn, T., Sookthai, D., Forsgren, L., Trupp, M., Trichopoulou, A., La Vecchia, C., Karakatsani, A., Gavrila, D., Ferrari, P., Freisling, H., Petersson, J., Lewan, S., Vermeulen, R.C., Panico, S., Masala, G., Ardanaz, E., Krogh, V., Perneczky, R., Middleton, L.T., Mokoroa, O., Sacerdote, C., Sieri, S., Hayat, S.A., Brayne, C., Riboli, E., Vineis, P., Gallo, V., and Katzke, V.A.

Published
2019

45. Low prevalence of known pathogenic mutations in dominant PD genes: A Swedish multicenter study

Author

Puschmann, A. (Andreas), Jiménez-Ferrer, I. (Itzia), Lundblad-Andersson, E. (Elin), Mårtensson, E. (Emma), Hansson, O. (Oskar), Odin, P. (Per), Widner, H. (Håkan), Brolin, K. (Kajsa), Mzezewa, R. (Ropafadzo), Kristensen, J. (Jonas), Soller, M. (Maria), Rödström, E.Y. (Emil Ygland), Ross, O.A. (Owen), Toft, M. (Mathias), Breedveld, G.J. (Guido), Bonifati, V. (Vincenzo), Brodin, L. (Lovisa), Zettergren, A. (Anna), Sydow, O. (Olof), Linder, J. (Jan), Wirdefeldt, K. (Karin), Svenningsson, P. (Per), Nissbrandt, H. (Hans), Belin, A.C. (Andrea Carmine), Forsgren, L. (Lars), Swanberg, M. (Maria), Puschmann, A. (Andreas), Jiménez-Ferrer, I. (Itzia), Lundblad-Andersson, E. (Elin), Mårtensson, E. (Emma), Hansson, O. (Oskar), Odin, P. (Per), Widner, H. (Håkan), Brolin, K. (Kajsa), Mzezewa, R. (Ropafadzo), Kristensen, J. (Jonas), Soller, M. (Maria), Rödström, E.Y. (Emil Ygland), Ross, O.A. (Owen), Toft, M. (Mathias), Breedveld, G.J. (Guido), Bonifati, V. (Vincenzo), Brodin, L. (Lovisa), Zettergren, A. (Anna), Sydow, O. (Olof), Linder, J. (Jan), Wirdefeldt, K. (Karin), Svenningsson, P. (Per), Nissbrandt, H. (Hans), Belin, A.C. (Andrea Carmine), Forsgren, L. (Lars), and Swanberg, M. (Maria)

Abstract

Objective: To determine the frequency of mutations known to cause autosomal dominant Parkinson disease (PD) in a series with more than 10% of Sweden's estimated number of PD patients. Methods: The Swedish Parkinson Disease Genetics Network was formed as a national multicenter consortium of clinical researchers who together have access to DNA from a total of 2,206 PD patients; 85.4% were from population-based studies. Samples were analyzed centrally for known pathogenic mutations in SNCA (duplications/triplications, p.Ala30Pro, p.Ala53Thr) and LRRK2 (p.Asn1437His, p.Arg1441His, p.Tyr1699Cys, p.Gly2019Ser, p.Ile2020Thr). We compared the frequency of these mutations in Swedish patients with published PD series and the gnomAD database. Results: A family history of PD in first- and/or second-degree relatives was reported by 21.6% of participants. Twelve patients (0.54%) carried LRRK2 p.(Gly2019Ser) mutations, one patient (0.045%) an SNCA duplication. The frequency of LRRK2 p.(Gly2019Ser) carriers was 0.11% in a matched Swedish control cohort and a similar 0.098% in total gnomAD, but there was a marked difference between ethnicities in gnomAD, with 42-fold higher frequency among Ashkenazi Jews than all others combined. Conclusions: In relative terms, the LRRK2 p.(Gly2019Ser) variant is the most frequent mutation among Swedish or international PD patients, and in gnomAD. SNCA duplications were the second most common of the mutations examined. In absolute terms, however, these known pathogenic variants in dominant PD genes are generally very rare and can only explain a minute fraction of familial aggregation of PD. Additional genetic and environmental mechanisms may explain the frequent co-occurrence of PD in close relatives.

Published
2019
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46. Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology: A Systematic Review and Meta-analysis

Author

Bridel, C. (Claire), Van Wieringen, W.N. (Wessel N.), Zetterberg, H. (Henrik), Tijms, B.M. (Betty M.), Teunissen, C.E. (Charlotte), Álvarez-Cermeño, J.C. (José C), Andreasson, U. (Ulf), Axelsson, M. (Markus), Bäckström, D.C. (David C.), Bartos, A. (Ales), Bjerke, M. (Maria), Blennow, K. (Kaj), Boxer, A.L. (Adam), Brundin, L. (Lou), Burman, J. (Joachim), Christensen, T. (Tove), Fialová, L. (Lenká), Forsgren, L. (Lars), Frederiksen, H., Gisslén, M. (Magnus), Gray, E. (Elizabeth), Gunnarsson, M. (Martin), Hall, S. (Sara), Hansson, O. (Oskar), Herbert, M.K. (Megan K.), Jakobsson, J. (Joel), Jessen-Krut, J. (Jan), Janelidze, S. (Shorena), Johannsson, G., Jonsson, M. (Michael), Kappos, L. (Ludwig), Khademi, M. (Mohsen), Khalil, M. (Michael), Kuhle, J. (Jens), Landén, M. (Mikael), Leinonen, V. (Ville), Logroscino, G. (Giancarlo), Lu, C.-H. (Ching-Hua), Lycke, J. (Jan), Magdalinou, N. (Nadia), Malaspina, A. (Andrea), Mattsson, N. (Niklas), Meeter, L.H.H. (Lieke), Mehta, S.R. (Sanjay R.), Modvig, S. (Signe), Olsson, T., Paterson, R.W. (Ross W.), Pérez-Santiago, J. (Josué), Piehl, F. (Fredrik), Pijnenburg, Y.A.L. (Yolande), Pyykkö, O.T. (Okko T.), Ragnarsson, O. (Oskar), Rojas, J.C. (Julio C.), Romme Christensen, J. (Jeppe), Sandberg, L. (Linda), Scherling, C.S. (Carole S.), Schott, J.M. (Jonathan M.), Sellebjerg, F. (Finn), Simone, I.L. (Isabella L.), Skillbäck, T. (Tobias), Stilund, M. (Morten), Sundström, P. (Peter), Svenningsson, A. (Anders), Tortelli, R. (Rosanna), Tortorella, C. (Carla), Trentini, A. (Alessandro), Troiano, M. (Maria), Turner, M.R. (Martin R.), Swieten, J.C. (John) van, Vågberg, M. (Mattias), Verbeek, M.M. (Marcel), Villar, L.M. (Luisa María), Visser, P. (Pim), Wallin, A. (Anders), Weiss, A. (Andreas), Wikkelsø, C. (Carsten), Wild, E.J. (Edward J.), Bridel, C. (Claire), Van Wieringen, W.N. (Wessel N.), Zetterberg, H. (Henrik), Tijms, B.M. (Betty M.), Teunissen, C.E. (Charlotte), Álvarez-Cermeño, J.C. (José C), Andreasson, U. (Ulf), Axelsson, M. (Markus), Bäckström, D.C. (David C.), Bartos, A. (Ales), Bjerke, M. (Maria), Blennow, K. (Kaj), Boxer, A.L. (Adam), Brundin, L. (Lou), Burman, J. (Joachim), Christensen, T. (Tove), Fialová, L. (Lenká), Forsgren, L. (Lars), Frederiksen, H., Gisslén, M. (Magnus), Gray, E. (Elizabeth), Gunnarsson, M. (Martin), Hall, S. (Sara), Hansson, O. (Oskar), Herbert, M.K. (Megan K.), Jakobsson, J. (Joel), Jessen-Krut, J. (Jan), Janelidze, S. (Shorena), Johannsson, G., Jonsson, M. (Michael), Kappos, L. (Ludwig), Khademi, M. (Mohsen), Khalil, M. (Michael), Kuhle, J. (Jens), Landén, M. (Mikael), Leinonen, V. (Ville), Logroscino, G. (Giancarlo), Lu, C.-H. (Ching-Hua), Lycke, J. (Jan), Magdalinou, N. (Nadia), Malaspina, A. (Andrea), Mattsson, N. (Niklas), Meeter, L.H.H. (Lieke), Mehta, S.R. (Sanjay R.), Modvig, S. (Signe), Olsson, T., Paterson, R.W. (Ross W.), Pérez-Santiago, J. (Josué), Piehl, F. (Fredrik), Pijnenburg, Y.A.L. (Yolande), Pyykkö, O.T. (Okko T.), Ragnarsson, O. (Oskar), Rojas, J.C. (Julio C.), Romme Christensen, J. (Jeppe), Sandberg, L. (Linda), Scherling, C.S. (Carole S.), Schott, J.M. (Jonathan M.), Sellebjerg, F. (Finn), Simone, I.L. (Isabella L.), Skillbäck, T. (Tobias), Stilund, M. (Morten), Sundström, P. (Peter), Svenningsson, A. (Anders), Tortelli, R. (Rosanna), Tortorella, C. (Carla), Trentini, A. (Alessandro), Troiano, M. (Maria), Turner, M.R. (Martin R.), Swieten, J.C. (John) van, Vågberg, M. (Mattias), Verbeek, M.M. (Marcel), Villar, L.M. (Luisa María), Visser, P. (Pim), Wallin, A. (Anders), Weiss, A. (Andreas), Wikkelsø, C. (Carsten), and Wild, E.J. (Edward J.)

Abstract

Importance: Neurofilament light protein (NfL) is elevated in cerebrospinal fluid (CSF) of a number of neurological conditions compared with healthy controls (HC) and is a candidate biomarker for neuroaxonal damage. The influence of age and sex is largely unknown, and levels across neurological disorders have not been compared systematically to date. Objectives: To assess the associations of age, sex, and diagnosis with NfL in CSF (cNfL) and to evaluate its potential in discriminating clinically similar conditions. Data Sources: PubMed was searched for studies published between January 1, 2006, and January 1, 2016, reporting cNfL levels (using the search terms neurofilament light and cerebrospinal fluid) in neurological or psychiatric conditions and/or in HC. Study Selection: Studies reporting NfL levels measured in lumbar CSF using a commercially available immunoassay, as well as age and sex. Data Extraction and Synthesis: Individual-level data were requested from study authors. Generalized linear mixed-effects models were used to estimate the fixed effects of age, sex, and diagnosis on log-transformed NfL levels, with cohort of origin modeled as a random intercept. Main Outcome and Measure: The cNfL levels adjusted for age and sex across diagnoses. Results: Data were collected for 10059 individuals (mean [SD] age, 59.7 [18.8] years; 54.1% female). Thirty-five diagnoses were identified, including inflammatory diseases of the central nervous system (n = 2795), dementias and predementia stages (n = 4284), parkinsonian disorders (n = 984), and HC (n = 1332). The cNfL was elevated compared with HC in a majority of neurological conditions studied. Highest levels were observed in cognitively impaired HIV-positive individuals (iHIV), amyotrophic lateral sclerosis, frontotemporal dementia (FTD), and Huntington disease. In 33.3% of diagnoses, including HC, multiple sclerosis, Alzheimer disease (AD), and Parkinson disease (PD), cNfL was higher in men than women. The cNfL incr

Published
2019
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47. Low prevalence of known pathogenic mutations in dominant PD genes: A Swedish multicenter study

Author

Puschmann, A, Jimenez-Ferrer, I, Lundblad-Andersson, E, Martensson, E, Hansson, O, Odin, P, Widner, H, Brolin, K, Mzezewa, R, Kristensen, J, Soller, M, Rodstrom, EY, Ross, OA, Toft, M, Breedveld, Guido, Bonifati, Vincenzo, Brodin, L, Zettergren, A, Sydow, O, Linder, J, Wirdefeldt, K, Svenningsson, P, Nissbrandt, H, Belin, A C, Forsgren, L, Swanberg, M, Puschmann, A, Jimenez-Ferrer, I, Lundblad-Andersson, E, Martensson, E, Hansson, O, Odin, P, Widner, H, Brolin, K, Mzezewa, R, Kristensen, J, Soller, M, Rodstrom, EY, Ross, OA, Toft, M, Breedveld, Guido, Bonifati, Vincenzo, Brodin, L, Zettergren, A, Sydow, O, Linder, J, Wirdefeldt, K, Svenningsson, P, Nissbrandt, H, Belin, A C, Forsgren, L, and Swanberg, M

Published
2019

50. Management of dystonia in Europe: A survey of the European network for the study of the dystonia syndromes

Author

Valadas, A. Contarino, M.-F. Albanese, A. Bhatia, K.P. Falup-Pecurariu, C. Forsgren, L. Friedman, A. Giladi, N. Hutchinson, M. Kostic, V.S. Krauss, J.K. Lokkegaard, A. Marti, M.J. Milanov, I. Pirtosek, Z. Relja, M. Skorvanek, M. Stamelou, M. Stepens, A. Tamás, G. Taravari, A. Tzoulis, C. Vandenberghe, W. Vidailhet, M. Ferreira, J.J. Tijssen, M.A.

Subjects
otorhinolaryngologic diseases, nervous system diseases
Abstract

Background and purpose: Dystonia is difficult to recognize due to its large phenomenological complexity. Thus, the use of experts in dystonia is essential for better recognition and management of dystonia syndromes (DS). Our aim was to document managing strategies, facilities and expertise available in various European countries in order to identify which measures should be implemented to improve the management of DS. Methods: A survey was conducted, funded by the Cooperation in Science and Technology, via the management committee of the European network for the study of DS, which is formed from representatives of the 24 countries involved. Results: Lack of specific training in dystonia by general neurologists, general practitioners as well as other allied health professionals was universal in all countries surveyed. Genetic testing for rare dystonia mutations is not readily available in a significant number of countries and neurophysiological studies are difficult to perform due to a lack of experts in this field of movement disorders. Tetrabenazine is only readily available for treatment of dystonia in half of the surveyed countries. Deep brain stimulation is available in three-quarters of the countries, but other surgical procedures are only available in one-quarter of countries. Conclusions: Internationally, collaboration in training, advanced diagnosis, treatment and research of DS and, locally, in each country the creation of multidisciplinary teams for the management of dystonia patients could provide the basis for improving all aspects of dystonia management across Europe. European Journal of Neurology ©.

Published
2016

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