4.4 Article

Monoaminergic Markers Across the Cognitive Spectrum of Lewy Body Disease

Journal

JOURNAL OF PARKINSONS DISEASE
Volume 8, Issue 1, Pages 71-84

Publisher

IOS PRESS
DOI: 10.3233/JPD-171228

Keywords

3-methoxy-4-hydroxyphenylglycol; noradrenaline; 5-hydroxyindoleacetic acid; dementia with Lewy bodies; Parkinson's disease; Parkinson's disease dementia; monoamines; biomarkers; RP-HPLC-ECD

Categories

Funding

  1. Research Foundation Flanders (FWO)
  2. Interuniversity Poles of Attraction (IAP Network) of the Belgian Federal Science Policy Office [P7/16]
  3. Alzheimer Research Foundation Belgium (SAO-FRA
  4. P) [16003]
  5. Methusalem excellence grant of the Flemish Government
  6. Institute Born-Bunge
  7. University of Antwerp
  8. Medical Research Foundation Antwerp
  9. Thomas Riellaerts research fund, Neurosearch Antwerp
  10. Alzheimer Research Center of the University Medical Center Groningen (ARCG-UMCG)
  11. Research Foundation Flanders (FWO)
  12. Interuniversity Poles of Attraction (IAP Network) of the Belgian Federal Science Policy Office [P7/16]
  13. Alzheimer Research Foundation Belgium (SAO-FRA
  14. P) [16003]
  15. Methusalem excellence grant of the Flemish Government
  16. Institute Born-Bunge
  17. University of Antwerp
  18. Medical Research Foundation Antwerp
  19. Thomas Riellaerts research fund, Neurosearch Antwerp
  20. Alzheimer Research Center of the University Medical Center Groningen (ARCG-UMCG)

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Background: Lewy body disorders, including Parkinson's disease (PD), Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), are characterized by profound central and peripheral monoaminergic dysfunction. Objective: To investigate whether these alterations depend on dementia status, we measured cerebrospinal fluid (CSF) and serum monoamine and metabolite levels across subgroups of the cognitive spectrum, and evaluated their marker potential afterwards. Methods: In total, 153 subjects were included, of which 43 healthy controls (HC), 28 PD patients with normal cognition (PD-NC), 26 patients with PD and mild cognitive impairment (PD-MCI), 18 PDD patients, and 38 DLB patients. The levels of monoamines and metabolites in paired CSF and serum samples were analyzed applying reversed-phase high-performance liquid chromatography with electrochemical detection. Results: Firstly, when comparing subgroups, CSF 3-methoxy-4-hydroxyphenylglycol (MHPG) levels were found lowest in HC and PD-NC groups and significantly higher in PDD/DLB patients. In addition, CSF 5-hydroxyindoleacetic acid (5HIAA) levels differed significantly between HC and PD-MCI/PDD, and DLB patients (P <= 0.001), but not between HC and PD-NC patients. Secondly, when performing logistic regression, it was shown that particularly CSF/serum MHPG levels and the serum MHPG to noradrenaline (NA) ratio effectively differentiated between HC and (non-) pooled PD subgroups (AUC= 0.914-0.956), and PDD and DLB patients (AUC= 0.822), respectively. Furthermore, CSF 5-HIAA was the most discriminative parameter to differentiate between PD-NC and PD-MCI (AUC= 0.808), and, PD-NC and PDD subgroups (AUC= 0.916). Conclusions: Our data revealed that especially alterations of the noradrenergic neurotransmitter system could distinguish between Lewy body disorder subtypes, pinpointing CSF/serumMHPGandNAas potential stage markers across the cognitive spectrum.

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