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Nigral pathology and parkinsonian signs in elders without Parkinson disease.
Ann Neurol. 2012 Feb; 71(2):258-66.AN

Abstract

OBJECTIVE

Motor symptoms such as mild parkinsonian signs are common in older persons, but little is known about their underlying neuropathology. We tested the hypothesis that nigral pathology is related to parkinsonism in older persons without Parkinson disease (PD).

METHODS

More than 2,500 persons participating in the Religious Orders Study or the Memory and Aging Project agreed to annual assessment of parkinsonism with a modified version of the Unified Parkinson Disease Rating Scale and brain donation. Brains from 744 deceased participants without PD were assessed for nigral neuronal loss and α-synuclein immunopositive Lewy bodies.

RESULTS

Mean age at death was 88.5 years. Mean global parkinsonism was 18.6 (standard deviation, 11.90). About ⅓ of cases had mild or more severe nigral neuronal loss, and about 17% had Lewy bodies. In separate regression models that adjusted for age, sex, and education, nigral neuronal loss and Lewy bodies were both related to global parkinsonism (neuronal loss: estimate, 0.231; standard error [SE], 0.068; p < 0.001; Lewy bodies: estimate, 0.291; SE, 0.133; p = 0.029). Employing a similar regression model that included both measures, neuronal loss remained associated with global parkinsonism (neuronal loss: estimate, 0.206; SE, 0.075; p = 0.006). By contrast, the association between Lewy bodies and global parkinsonism was attenuated by >60% and was no longer significant (Lewy bodies: estimate, 0.112; SE, 0.148; p = 0.447), suggesting that neuronal loss may mediate the association of Lewy bodies with global parkinsonism.

INTERPRETATION

Nigral pathology is common in persons without PD and may contribute to loss of motor function in old age.

Authors+Show Affiliations

Rush Alzheimer's Disease Center, Chicago, IL, USA. Aron_S_Buchman@rush.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22367997

Citation

Buchman, Aron S., et al. "Nigral Pathology and Parkinsonian Signs in Elders Without Parkinson Disease." Annals of Neurology, vol. 71, no. 2, 2012, pp. 258-66.
Buchman AS, Shulman JM, Nag S, et al. Nigral pathology and parkinsonian signs in elders without Parkinson disease. Ann Neurol. 2012;71(2):258-66.
Buchman, A. S., Shulman, J. M., Nag, S., Leurgans, S. E., Arnold, S. E., Morris, M. C., Schneider, J. A., & Bennett, D. A. (2012). Nigral pathology and parkinsonian signs in elders without Parkinson disease. Annals of Neurology, 71(2), 258-66. https://doi.org/10.1002/ana.22588
Buchman AS, et al. Nigral Pathology and Parkinsonian Signs in Elders Without Parkinson Disease. Ann Neurol. 2012;71(2):258-66. PubMed PMID: 22367997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nigral pathology and parkinsonian signs in elders without Parkinson disease. AU - Buchman,Aron S, AU - Shulman,Joshua M, AU - Nag,Sukriti, AU - Leurgans,Sue E, AU - Arnold,Steven E, AU - Morris,Martha C, AU - Schneider,Julie A, AU - Bennett,David A, PY - 2012/2/28/entrez PY - 2012/3/1/pubmed PY - 2012/4/27/medline SP - 258 EP - 66 JF - Annals of neurology JO - Ann Neurol VL - 71 IS - 2 N2 - OBJECTIVE: Motor symptoms such as mild parkinsonian signs are common in older persons, but little is known about their underlying neuropathology. We tested the hypothesis that nigral pathology is related to parkinsonism in older persons without Parkinson disease (PD). METHODS: More than 2,500 persons participating in the Religious Orders Study or the Memory and Aging Project agreed to annual assessment of parkinsonism with a modified version of the Unified Parkinson Disease Rating Scale and brain donation. Brains from 744 deceased participants without PD were assessed for nigral neuronal loss and α-synuclein immunopositive Lewy bodies. RESULTS: Mean age at death was 88.5 years. Mean global parkinsonism was 18.6 (standard deviation, 11.90). About ⅓ of cases had mild or more severe nigral neuronal loss, and about 17% had Lewy bodies. In separate regression models that adjusted for age, sex, and education, nigral neuronal loss and Lewy bodies were both related to global parkinsonism (neuronal loss: estimate, 0.231; standard error [SE], 0.068; p < 0.001; Lewy bodies: estimate, 0.291; SE, 0.133; p = 0.029). Employing a similar regression model that included both measures, neuronal loss remained associated with global parkinsonism (neuronal loss: estimate, 0.206; SE, 0.075; p = 0.006). By contrast, the association between Lewy bodies and global parkinsonism was attenuated by >60% and was no longer significant (Lewy bodies: estimate, 0.112; SE, 0.148; p = 0.447), suggesting that neuronal loss may mediate the association of Lewy bodies with global parkinsonism. INTERPRETATION: Nigral pathology is common in persons without PD and may contribute to loss of motor function in old age. SN - 1531-8249 UR - https://www.unboundmedicine.com/medline/citation/22367997/Nigral_pathology_and_parkinsonian_signs_in_elders_without_Parkinson_disease_ L2 - https://doi.org/10.1002/ana.22588 DB - PRIME DP - Unbound Medicine ER -