Interleukin-6 and fatigue syndrome in Parkinson’s disease

WCN 2013 No: 1420 Topic: 2 — Movement Disorders Interleukin-6 and fatigue syndrome in Parkinson’s disease T. Torgan, T. Baidina, N. Demchuk. Neurology of the Medical Faculty, Perm Academy of Medicine, Perm, Russia Introduction: Fatigue syndrome is one of the non-motor symptoms of Parkinson's disease (PD) that significantly reduces the quality of life. The pathophysiology of this symptom is poorly studied. Objective: To assess the potential role of proinflammatory cytokine interleukin-6 (IL-6) in the development of fatigue syndrome in PD. Methods:We determined the level of IL-6 in the serum of 65 patients with Parkinson's disease by immunosorbent assay. To determine the severity of fatigue syndrome, we used Multidimensional Fatigue Inventory (MFI-20). Operation compared with the concentration of IL-6 in serum was compared with the severity of fatigue. Results: Fatigue syndrome was diagnosed in 30 patients (46%). Mean severity of fatigue in patients with PD was 58 (49–66) points, which was significantly (p = 0.000) higher than in the control group (33, 30–36 points). The value of IL-6 was significantly (p= 0.012) higher in patients with the FS (1.0, 0.5–1.9 pgml) than without this syndrome (0.35 0.0–0, pgml). There was a significant correlation between IL-6 with physical fatigue (R= 0.42; p = 0.000), reduced activity (R= 0.46; p = 0.000), reduced motivation (R= 0.24; p = 0.051), and general fatigue (R= 0.52; p = 0.000). Conclusion: Fatigue syndrome is present in 46% of patients with PD, being a very common and important symptom. Patients with fatigue syndrome have higher levels of IL-6 in serum. The higher level of serum proinflammatory cytokines in PD patients leads to the increasing of the fatigue symptoms. doi:10.1016/j.jns.2013.07.383 Abstract — WCN 2013 No: 1367 Topic: 2 — Movement Disorders Autonomic dysfunction in patients with early untreated Parkinson's disease WCN 2013 No: 1367 Topic: 2 — Movement Disorders Autonomic dysfunction in patients with early untreated Parkinson's disease M. Asahina, C.J. Mathias, A. Katagiri, D.A. Low, E. Vichayanrat, Y. Fujinuma, Y. Yamanaka, S. Kuwabara. Neurology, Chiba University School of Medicine, Chiba, Japan; Imperial College London, UK; The National Hospital for Neurology and Neurosurgery, London, UK To determinewhether the autonomic nervous system is involved in the early stage of Parkinson's disease (PD), we evaluated orthostatic blood pressure regulation, heart rate variability, skin vasomotor function and sympathetic sweat responses (emotional sweating) in 50 untreated PD patients (age 64.3 ± 8.8 years, disease duration 1.8 ±1.4 year) and compared them with 20 healthy control subjects (age 63.6 ± 7.9 years). Five PD patients fulfilled the criteria for orthostatic hypotension. The mean decrease in systolic blood pressure during head-up tilt in PD patients was mildly but significantly lower than in controls (p= 0.0001). Therewere no differences between the 2 groups in heart rate variability, with analysis of low frequency (LF;mediated by baroreflex feedback), and high frequency (HF; an index of parasympathetic vagal activity) modulation. However, LF/HF, an index of cardiac sympatho-parasympathetic balance, was significantly lower in the PD group than in controls (p= 0.02). Amplitudes of sympathetic sweat responses were significantly lower than in controls (p b 0.01), with negative correlations with modified Hoehn & Yahr stage. Amplitudes of skin vasomotor reflexes in PD patients did not differ from controls. Our study in early untreated PD patients, without the confounding effect of drugs, suggests impairment of sympathetic cardiovascular and sudomotor function with orthostatic dysregulation of blood pressure control, reduced LF/HF (parasympathetic dominancy of cardiac sympatho-parasympathetic balance) and reduction in sympathetic sweat responses. doi:10.1016/j.jns.2013.07.384 Abstract — WCN 2013 No: 1365 Topic: 2 — Movement Disorders Total antioxidant activity, glutathione and lipid peroxidation in neurologic Wilson disease: Clinical, biochemical and MRI correlation WCN 2013 No: 1365 Topic: 2 — Movement Disorders Total antioxidant activity, glutathione and lipid peroxidation in neurologic Wilson disease: Clinical, biochemical and MRI correlation J. Kalita, V. Kumar, A. Ranjan, S. Chandra, U.K. Misra. Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India Background: Increased free copper in neurologic Wilson disease (WD) is a potent oxidant but there is no study evaluating the role of glutathione, total antioxidant activity (TAC) and lipid peroxidation in them. Objective: To evaluate TAC, glutathione and malonodialdehyde (MDA) in neurologic WD and correlate their levels with clinical, MRI and biochemical changes. Subjects and methods: 28 patients with neurologic WD whose median age was 16 years were included. Neurological severity was categorized on a 0–3 grade. Cranial MRI, blood counts, hemoglobin, liver and kidney function tests, ultrasound abdomen, serum ceruloplasmin, serum free copper and 24 hour urinary copper were done. Plasma glutathione (GSH), TAC and malonodialdehyde (MDA) were measured in the patients and 64 matched controls. Result: The plasma GSH (2.26 ± 0.49 vs 2.6 ± 0.39 mg/dl p b 0.001) and TAC levels were reduced (1.63 ± 0.02 Vs 2.09 ± 0.03 mmol Troloxequivalant/l; P b 0.001) and MDA increased (4.90 ± 0.74 vs 3.21 ± 0.69 nmol/ml p b 0.001) in the neurologic WD compared to controls. The GSH (r= 0.54) level positively correlated with serum ceruloplasmin and negatively with free serum copper (r =−0.52) and urinary copper(r =−0.75). TAC correlated with duration (r =−0.39) and ceruloplasmin (r = 0.48). MDA level correlated negatively with serum ceruloplasmin (r =−0.61) and positively with serum free copper (r = 0.41) and urinary copper (r = 0.61). The clinical severity and hematological, liver, renal and MRI findings however did not correlate with GSH, TAC and MDA levels. Conclusion: Lower GSH, TAC and higher MDA levels suggest copper induced oxidative injury in neurologic WD. The role of adjunctive antioxidant in the treatment of neurologic WD needs to be explored. doi:10.1016/j.jns.2013.07.385 Abstract — WCN 2013 No: 1381 Topic: 2 — Movement Disorders A rare case of osteodural arteriovenous fistulas with focal hand myoclonous presentation WCN 2013 No: 1381 Topic: 2 — Movement Disorders A rare case of osteodural arteriovenous fistulas with focal hand myoclonous presentation T.Worakijthamrongchai. Department of Neurology, Prasat Neurological Institute, Bangkok, Thailand Introduction: Dural arteriovenous fistulas(DAVFs) are found approximately 10–15% of all vascular abnormalities. The most of DAVFs have leptomeningeal reflux and vascular congestion. Symptoms of DAVFs may be characterized either nonaggressive (e.g. tinnitus) or aggressive symptoms (e.g. intracerebral, subarachnoid hemorrhage Abstracts / Journal of the Neurological Sciences 333 (2013) e109–e151 e114