Clinical and laboratory status in Parkinson’s disease patients with and without polyneuropathy

Sanela Popović; Nemanja Popović; Dragica Hajder; Smiljana Kostic; Aleksandra  Lučić Prokin

doi:10.2298/VSP240528061P

Sanela Popović University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Clinic for Neurology, Novi Sad, Serbia
Nemanja Popović University Clinical Center of Vojvodina, Clinic for Neurology, Novi Sad, Serbia https://orcid.org/0000-0002-6268-4001
Dragica Hajder University Clinical Center of Vojvodina, Clinic for Neurology, Novi Sad, Serbia
Smiljana Kostic Military Medical Academy, Neurology Clinic, Belgrade, Serbia
Aleksandra Lučić Prokin University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Clinic for Neurology, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP240528061P

Ključne reči: životno doba, faktor;, levodopa;, parkinsonova bolest;, polineuropatije;, bolest, indeks težine;, vitamin b12

Sažetak

Uvod/Cilj. Etiologija polineuropatije (PNP) kod Parkinsonove bolesti (PB) je nejasna, a moguća je povezanost između terapije levodopom, hiperhomocisteinemije i razvoja PNP zbog procesa metilacije, koji uključuje vitamin B12 i folnu kiselinu. Cilj rada bio je da se utvrdi razlika u kliničkoj prezentaciji i težini bolesti između bolesnika obolelih od PB sa i bez PNP, kao i da se proceni nivo vitamina B12, homocisteina i folne kiseline u krvi ovih bolesnika. Metode. Studijom preseka analizirano je 200 konsekutivnih bolesnika sa dijagnozom PB, podeljenih u dve grupe: bolesnici sa PNP i oni bez PNP. Dijagnoza PNP potvrđena je elektromioneurografijom. Prvu grupu činilo je 50 bolesnika obolelih od PB sa potvrđenom PNP, a drugu 50 bolesnika obolelih od PB bez PNP. Svi bolesnici bili su na terapiji levodopom. Laboratorijskim testovima analizirani su nivoi vitamina B12, folne kiseline i homocisteina. Rezultati. Bolesnici sa PNP bili su stariji u momentu postavljanja dijagnoze PNP (71 vs. 66 godina, p < 0,0001), bez statistički značajnih razlika u dužini uzimanja (p = 0,359) ili dnevnim dozama levodope (p = 0,442) i sa statistički značajno izraženijim motornim deficitom prema Unified Parkinson’s Disease Rating Scale III (p = 0,017). Nisu nađene razlike između grupa za nivoe vitamina B12 (p = 1,0), folne kiseline (p = 0,124) i homocisteina (p= 0,313) u serumu. Zaključak. Bolesnici oboleli od PB sa PNP imaju izraženiji motorni deficit, dok razlike u vrednostima vitamina B12, homocisteina i folne kiseline u odnosu na grupu bez PNP nisu registrovane.

Reference

Simon DK, Tanner CM, Brundin P. Parkinson Disease Epidemi-ology, Pathology, Genetics, and Pathophysiology. Clin Geriatr Med 2020; 36(1): 1–12.

Dorsey ER, Sherer T, Okun MS, Bloem BR. The emerging evi-dence of the Parkinson pandemic. J Parkinsons Dis 2018; 8(s1): S3–S8.

Baldereschi M, Di Carlo A, Rocca WA, Vanni P, Maggi S, Perissi-notto E, et al. Parkinson’s disease and parkinsonism in a longi-tudinal study: two-fold higher incidence in men. ILSA Work-ing Group. Italian Longitudinal Study on Aging. Neurology 2000; 55(9): 1358–63.

Ou Z, Pan J, Tang S, Duan D, Yu D, Nong H, et al. Global Trends in the Incidence, Prevalence, and Years Lived With Disability of Parkinson’s Disease in 204 Countries/Territories From 1990 to 2019. Front Public Health 2021; 9: 776847.

Shahed J, Jankovic J. Motor symptoms in Parkinson’s disease. Handb Clin Neurol 2007; 83: 329–42.

Chaudhuri KR, Schapira AH. Non-motor symptoms of Parkin-son’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol 2009; 8(5): 464–74.

Toth C, Breithaupt K, Ge S, Duan Y, Terris JM, Thiessen A, et al. Levodopa, methylmalonic acid, and neuropathy in idiopathic Parkinson disease. Ann Neurol 2010; 68(1): 28–36.

Toth C, Brown MS, Furtado S, Suchowersky O, Zochodne D. Neuropathy as a potential complication of levodopa use in Parkinson’s disease. Mov Disord 2008; 23(13): 1850–9.

Corrà MF, Vila-Chã N, Sardoeira A, Hansen C, Sousa AP, Reis I, et al. Peripheral neuropathy in Parkinson’s disease: preva-lence and functional impact on gait and balance. Brain 2023; 146(1): 225–36.

Stević Z. Neuropathy – Principles of modern diagnostics and therapy. Belgrade: Academic mind; 2018. p. 325.

Ceravolo R, Cossu G, Bandettini di Poggio M, Santoro L, Barone P, Zibetti M, et al. Neuropathy and levodopa in Parkinson’s dis-ease: Evidence from a multicenter study. Mov Disord 2013; 28(10): 1391–7.

Mathukumalli NL, Kandadai MR, Shaik JA, Kanikannan MA, Borgohain R. Serum B12, Homocysteine Levels, and their Ef-fect on Peripheral Neuropathy in Parkinson’s Disease: Indian Cohort. Ann Indian Acad Neurol 2020; 23(1): 48–53.

Hu XW, Qin SM, Li D, Hu LF, Liu CF. Elevated homocyste-ine levels in levodopa-treated idiopathic Parkinson’s disease: A meta-analysis. Acta Neurol Scand 2013; 128(2): 73–82.

Jost WH. Unwanted effects and interaction of intrajejunal levodopa/carbidopa administration. Expert Opin Drug Saf 2014; 13(4): 447–58.

Cossu G, Ceravolo R, Zibetti M, Arca R, Ricchi V, Paribello A, et al. Levodopa and neuropathy risk in patients with Parkinson disease: Effect of COMT inhibition. Parkinsonism Relat Dis-ord 2016; 27: 81–4.

Madenci G, Bilen S, Arli B, Saka M, Ak F. Serum iron, vitamin B12 and folic acid levels in parkinson’s disease. Neurochem Res 2012; 37(7): 1436–41.

Wang N, Garcia J, Freeman R, Gibbons CH. Phosphorylated Al-pha-Synuclein Within Cutaneous Autonomic Nerves of Pa-tients With Parkinson’s Disease: The Implications of Sample Thickness on Results. J Histochem Cytochem 2020; 68(10): 669–78.

Doppler K, Ebert S, Üçeyler N, Trenkwalder C, Ebentheuer J, Volkmann J, et al. Cutaneous neuropathy in Parkinson’s dis-ease: A window into brain pathology. Acta Neuropathol 2014; 128(1): 99–109.

Kühn E, Averdunk P, Huckemann S, Müller K, Biesalski AS, Hof Zum Berge F, et al. Correlates of polyneuropathy in Parkin-son’s disease. Ann Clin Transl Neurol 2020; 7(10): 1898–907.

Schindlbeck KA, Mehl A, Geffe S, Benik S, Tütüncü S, Klostermann F, et al. Somatosensory symptoms in unmedicated de novo pa-tients with idiopathic Parkinson’s disease. J Neural Transm (Vienna) 2016; 123(3): 211–7.

Beaulieu ML, Müller MLTM, Bohnen NI. Peripheral neuropathy is associated with more frequent falls in Parkinson’s disease. Park Relat Disord 2018; 54: 46–50.

Berardelli A, Wenning GK, Antonini A, Berg D, Bloem BR, Boni-fati V, et al. EFNS/MDS-ES/ENS [corrected] recommenda-tions for the diagnosis of Parkinson’s disease. Eur J Neurol 2013; 20(1): 16–34. Erratum in: Eur J Neurol. 2013; 20(2): 406.

Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins GT, Counsell C, et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations. Mov Disord 2004; 19(9): 1020–8.

Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Mar-tinez-Martin P, et al. Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing re-sults. Mov Disord 2008; 23(15): 2129–70.

Martinez-Martin P, Skorvanek M, Rojo-Abuin JM, Gregova Z, Stebbins GT, Goetz CG. Validation study of the hoehn and yahr scale included in the MDS-UPDRS. Mov Disord 2018; 33(4): 651–2.

Merola A, Romagnolo A, Zibetti M, Bernardini A, Cocito D, Lopi-ano L. Peripheral neuropathy associated with levodopa-carbidopa intestinal infusion: A long-term prospective assess-ment. Eur J Neurol 2016; 23(3): 501–9.

Loens S, Chorbadzhieva E, Kleimann A, Dressler D, Schrader C. Effects of levodopa/carbidopa intestinal gel versus oral levo-dopa/carbidopa on B vitamin levels and neuropathy. Brain Behav 2017; 7(5): e00698.

Ramachandran A, Jose J, Gafoor VA, Das S, Balaram N. Preva-lence and Risk Factors of Peripheral Neuropathy in Parkin-son’s Disease. Ann Indian Acad Neurol 2022; 25(6): 1109–15.

Savica R, Grossardt BR, Bower JH, Ahlskog JE, Rocca WA. Risk factors for Parkinson’s disease may differ in men and women: an exploratory study. Horm Behav 2013; 63(2): 308–14.

Abraham A, Barnett C, Katzberg HD, Lovblom LE, Perkins BA, Bril V. Sex differences in neuropathic pain intensity in diabe-tes. J Neurol Sci 2018; 388: 103–6.

Cardinez N, Lovblom LE, Orszag A, Bril V, Cherney DZ, Perkins BA. Sex differences in neuropathy & neuropathic pain: A brief report from the Phase 2 Canadian Study of Longevity in Type 1 Diabetes. J Diabetes Complications 2019; 33(12): 107397.

De Araújo DF, de Melo Neto AP, Oliveira ÍS, Brito BS, de Araújo IT, Barros IS, et al. Small (autonomic) and large fiber neuropa-thy in Parkinson disease and parkinsonism. BMC Neurol 2016; 16: 139.

Hanewinckel R, van Oijen M, Ikram MA, van Doorn PA. The epi-demiology and risk factors of chronic polyneuropathy. Eur J Epidemiol 2016; 31(1): 5–20.

Andréasson M, Brodin L, Laffita-Mesa JM, Svenningsson P. Correlations between Methionine Cycle Metabolism, COMT Genotype, and Polyneuropathy in L-Dopa Treated Parkinson’s Disease: A Preliminary Cross-Sectional Study. J Parkinsons Dis 2017; 7(4): 619–28.

Liu Y, Gou M, Guo X. Features of Plasma Homocysteine, Vit-amin B12, and Folate in Parkinson’s Disease: An Updated Meta-Analysis. J Integr Neurosci 2023; 22(5): 115.

Schindlbeck KA, Mehl A, Geffe S, Benik S, Tütüncü S, Klostermann F, et al. Somatosensory symptoms in unmedicated de novo pa-tients with idiopathic Parkinson’s disease. J Neural Transm 2016; 123: 211–7.

Klinička i laboratorijska slika obolelih od Parkinsonove bolesti sa i bez polineuropatije

Sažetak

Reference