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      Association of Parkinson's disease to Parkinson's plus syndromes, Lewy body dementia, and Alzheimer's dementia

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          Abstract

          Background

          Parkinson's disease (PD) is a condition that affects movement and is usually seen in those over the age of 50. It is caused by the death of dopaminergic neurons, particularly in the substantia nigra. PD has shifted from being perceived as an uncommon condition to a significant neurological illness, mostly due to the increasing number of elderly individuals and the impact of environmental factors. Parkinson's plus syndromes, such as progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD), and vascular Parkinsonism (VaP), provide difficulties in distinguishing them clinically from PD since they have similar characteristics.

          Methodology

          A thorough examination was performed utilizing the PubMed, Medline, Scopus, and Web of Science databases. The search utilized specific keywords like “Parkinson's disease,” “Parkinson's plus syndrome,” “Lewy body dementia,” “Alzheimer's dementia,” “progressive supranuclear palsy,” and “multiple system atrophy.” The selection criteria were aimed at English‐language literature, with a particular focus on examining the connection between PD and associated disorders or dementias.

          Results and Discussion

          Parkinson's plus syndromes, such as PSP, MSA, CBD, and VaP, exhibit unique clinical characteristics, imaging results, and diverse reactions to levodopa. This makes it difficult to distinguish them from PD. LBD is characterized by Lewy bodies containing α‐synuclein, which leads to both motor and cognitive deficits. PD and Alzheimer's disease (AD) exhibit a complex interaction, including common pathogenic processes, genetic predispositions, and clinical characteristics of dementia.

          Conclusion

          The interrelatedness of PD, Parkinson's plus syndromes, LBD, and AD highlights the significance of comprehending shared disease‐causing processes. Aberrant protein clumping, impaired functioning of mitochondria, increased oxidative stress, and inflammation in the brain are common factors which can be addressed for specific treatments. More research is essential for understanding complicated connections and developing effective therapies for these sophisticated neurological illnesses.

          Highlights

          • We discusses the association between Parkinson's disease (PD) and related syndromes like Parkinson's plus syndrome, Lewy body dementia (LBD), and Alzheimer's dementia (AD).

          • Parkinson's plus syndrome includes disorders like PSP, MSA, and CBD, sharing similar symptoms with PD but exhibiting additional features due to progressive neurodegeneration beyond the dopaminergic system.

          • Shared pathogenic mechanisms among these disorders include abnormal protein aggregation, mitochondrial dysfunction, oxidative stress, and inflammation.

          • We also emphasized the potential for developing targeted therapies and diagnostic approaches by understanding these shared mechanisms, impacting treatment strategies, prognosis, and quality of life for patients.

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          Most cited references31

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          The amyloid hypothesis of Alzheimer's disease at 25 years

          Abstract Despite continuing debate about the amyloid β‐protein (or Aβ hypothesis, new lines of evidence from laboratories and clinics worldwide support the concept that an imbalance between production and clearance of Aβ42 and related Aβ peptides is a very early, often initiating factor in Alzheimer's disease (AD). Confirmation that presenilin is the catalytic site of γ‐secretase has provided a linchpin: all dominant mutations causing early‐onset AD occur either in the substrate (amyloid precursor protein, APP) or the protease (presenilin) of the reaction that generates Aβ. Duplication of the wild‐type APP gene in Down's syndrome leads to Aβ deposits in the teens, followed by microgliosis, astrocytosis, and neurofibrillary tangles typical of AD. Apolipoprotein E4, which predisposes to AD in > 40% of cases, has been found to impair Aβ clearance from the brain. Soluble oligomers of Aβ42 isolated from AD patients' brains can decrease synapse number, inhibit long‐term potentiation, and enhance long‐term synaptic depression in rodent hippocampus, and injecting them into healthy rats impairs memory. The human oligomers also induce hyperphosphorylation of tau at AD‐relevant epitopes and cause neuritic dystrophy in cultured neurons. Crossing human APP with human tau transgenic mice enhances tau‐positive neurotoxicity. In humans, new studies show that low cerebrospinal fluid (CSF) Aβ42 and amyloid‐PET positivity precede other AD manifestations by many years. Most importantly, recent trials of three different Aβ antibodies (solanezumab, crenezumab, and aducanumab) have suggested a slowing of cognitive decline in post hoc analyses of mild AD subjects. Although many factors contribute to AD pathogenesis, Aβ dyshomeostasis has emerged as the most extensively validated and compelling therapeutic target.
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            Parkinson disease

            Parkinson disease is the second-most common neurodegenerative disorder that affects 2-3% of the population ≥65 years of age. Neuronal loss in the substantia nigra, which causes striatal dopamine deficiency, and intracellular inclusions containing aggregates of α-synuclein are the neuropathological hallmarks of Parkinson disease. Multiple other cell types throughout the central and peripheral autonomic nervous system are also involved, probably from early disease onwards. Although clinical diagnosis relies on the presence of bradykinesia and other cardinal motor features, Parkinson disease is associated with many non-motor symptoms that add to overall disability. The underlying molecular pathogenesis involves multiple pathways and mechanisms: α-synuclein proteostasis, mitochondrial function, oxidative stress, calcium homeostasis, axonal transport and neuroinflammation. Recent research into diagnostic biomarkers has taken advantage of neuroimaging in which several modalities, including PET, single-photon emission CT (SPECT) and novel MRI techniques, have been shown to aid early and differential diagnosis. Treatment of Parkinson disease is anchored on pharmacological substitution of striatal dopamine, in addition to non-dopaminergic approaches to address both motor and non-motor symptoms and deep brain stimulation for those developing intractable L-DOPA-related motor complications. Experimental therapies have tried to restore striatal dopamine by gene-based and cell-based approaches, and most recently, aggregation and cellular transport of α-synuclein have become therapeutic targets. One of the greatest current challenges is to identify markers for prodromal disease stages, which would allow novel disease-modifying therapies to be started earlier.
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              Epidemiology of Parkinson's disease

              The causes of Parkinson's disease (PD), the second most common neurodegenerative disorder, are still largely unknown. Current thinking is that major gene mutations cause only a small proportion of all cases and that in most cases, non-genetic factors play a part, probably in interaction with susceptibility genes. Numerous epidemiological studies have been done to identify such non-genetic risk factors, but most were small and methodologically limited. Larger, well-designed prospective cohort studies have only recently reached a stage at which they have enough incident patients and person-years of follow-up to investigate possible risk factors and their interactions. In this article, we review what is known about the prevalence, incidence, risk factors, and prognosis of PD from epidemiological studies.
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                Author and article information

                Contributors
                omniatamir123@gmail.com
                Journal
                Health Sci Rep
                Health Sci Rep
                10.1002/(ISSN)2398-8835
                HSR2
                Health Science Reports
                John Wiley and Sons Inc. (Hoboken )
                2398-8835
                31 March 2024
                April 2024
                : 7
                : 4 ( doiID: 10.1002/hsr2.v7.4 )
                : e2019
                Affiliations
                [ 1 ] Department of Neurology Bharati Vidyapeeth Deemed University Pune India
                [ 2 ] Department of Neurology China Medical University Shenyang China
                [ 3 ] Department of Internal Medicine Zaporozhyea State Medical University Zaporozhyea Ukraine
                [ 4 ] Department of Internal Medicine Shadan Hospital and Institute of Medical Sciences Hyderabad India
                [ 5 ] Department of Internal Medicine, Al‐Kindy College of Medicine University of Baghdad Baghdad Iraq
                [ 6 ] Department of Internal Medicine MNR Medical College Sangareddy India
                [ 7 ] Department of Neurology, Narendra Modi Medical College Gujarat University Ahmedabad India
                [ 8 ] Department of Neurology Dr. Somervell Memorial CSI Medical College and Hospital Neyyāttinkara Karakonam India
                [ 9 ] Department of Internal Medicine, Acute Medicine University Hospital Ayr Ayr Scotland UK
                [ 10 ] Department of Internal Medicine Sudan Academy of Sciences Khartoum Sudan
                Author notes
                [*] [* ] Correspondence Omniat Amir Hussin, Al Manhal Academy, Khartoum, Sudan.

                Email: omniatamir123@ 123456gmail.com

                Author information
                http://orcid.org/0000-0001-7894-1829
                http://orcid.org/0000-0002-3481-4534
                http://orcid.org/0009-0003-2435-4348
                http://orcid.org/0000-0002-5021-263X
                Article
                HSR22019
                10.1002/hsr2.2019
                10982460
                38562616
                b90b6c0b-d8e7-421d-9677-8099f8207a8a
                © 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 09 March 2024
                : 05 August 2023
                : 11 March 2024
                Page count
                Figures: 1, Tables: 1, Pages: 7, Words: 4126
                Categories
                Neurology
                Public Health
                General Medicine
                Cardiology
                Gastroenterology/Hepatology
                Respiratory Medicine
                Critical Care Medicine
                Geriatrics
                Psychiatry
                Genetics and Genomics
                Epidemiology
                Narrative Review
                Narrative Review
                Custom metadata
                2.0
                April 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.0 mode:remove_FC converted:01.04.2024

                alzheimer's dementia,lewy body dementia,multiple system atrophy,parkinson's disease,parkinson's plus syndrome,progressive supranuclear palsy

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