Modified somatosensory processing in PINK1 (PARK6)-mutation carriers: preclinical evidence by the use of quantitative sensory testing

Introduction: Sensory symptoms are common in Parkinson's disease (PD). It is unclear whether these symptoms are of primary origin or secondary due to pathophysiological changes occurring in PD. Recently, mutations of the PINK1 (PARK6) gene have been identified as one cause for the development o...

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Hauptverfasser: Ludwig, J., Lienau, F., Maag, R., Hagenah, J.M., Deuschl, G., Klein, C., Baron, R., Helmchen, C.
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creator Ludwig, J.
Lienau, F.
Maag, R.
Hagenah, J.M.
Deuschl, G.
Klein, C.
Baron, R.
Helmchen, C.
description Introduction: Sensory symptoms are common in Parkinson's disease (PD). It is unclear whether these symptoms are of primary origin or secondary due to pathophysiological changes occurring in PD. Recently, mutations of the PINK1 (PARK6) gene have been identified as one cause for the development of PD. Asymptomatic carriers of PINK1 mutations represent individuals at risk who can be identified prior to the development of PD by molecular genetic testing. Therefore, PINK1-associated PD may serve as a model to detect presymptomatic signs and sensory abnormalities before subjects show definite clinical signs of PD. This might shed light on the pathomechanisms related to sensory abnormalities in patients with the more frequent idiopathic PD. Methods: 14 family-members with PINK1 mutation (3 homozygous, 11 heterozygous) and 14 healthy controls were examined. A clinical examination, nerve conduction studies and a shortened form of the QST protocol of the German Research Network on Neuropathic Pain (DFNS) were performed. The QST protocol included perception thresholds for warm, cold, cold pain, heat pain, mechanical and painful mechanical stimuli, vibration and pain pressure. For evaluation, z-values were calculated and compared by the U-test. P
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It is unclear whether these symptoms are of primary origin or secondary due to pathophysiological changes occurring in PD. Recently, mutations of the PINK1 (PARK6) gene have been identified as one cause for the development of PD. Asymptomatic carriers of PINK1 mutations represent individuals at risk who can be identified prior to the development of PD by molecular genetic testing. Therefore, PINK1-associated PD may serve as a model to detect presymptomatic signs and sensory abnormalities before subjects show definite clinical signs of PD. This might shed light on the pathomechanisms related to sensory abnormalities in patients with the more frequent idiopathic PD. Methods: 14 family-members with PINK1 mutation (3 homozygous, 11 heterozygous) and 14 healthy controls were examined. A clinical examination, nerve conduction studies and a shortened form of the QST protocol of the German Research Network on Neuropathic Pain (DFNS) were performed. The QST protocol included perception thresholds for warm, cold, cold pain, heat pain, mechanical and painful mechanical stimuli, vibration and pain pressure. For evaluation, z-values were calculated and compared by the U-test. P&lt;0.05 was considered to be statistically significant. Results: The homozygous PINK1 mutation carriers were all symptomatic and had a definite PD. Despite the lack of symptoms for PD, five heterozygous PINK1 mutation carriers showed mild clinical signs for PD upon neurological examination. All individuals with parkinsonian signs upon neurological examination were considered “affected“ (n=8), family members without signs as “unaffected“ (n=6). Comparison of affected and unaffected PINK1 mutation carriers revealed significant lower z-values for mechanical detection (p&lt;0.0005) and vibration detection threshold (p&lt;0.01) in the affected PINK1 mutation carrier group. Both parameters correlated significantly negative with the UPDRS III. Conclusion: In contrast to patients suffering from idiopathic PD (Hägele et al. 2005), higher somatosensory thresholds seem to be a marker not only in affected, but also in unaffected PINK1 mutation carriers. Since neurography showed normal data, we hypothesize that sensory impairment is of primary origin, probably due to altered central somatosensory processing.</description><identifier>ISSN: 0302-4350</identifier><identifier>EISSN: 1438-9428</identifier><identifier>DOI: 10.1055/s-2006-953144</identifier><language>eng ; ger</language><ispartof>Aktuelle Neurologie, 2006, Vol.33 (S 1)</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,780,784,789,790,3017,3018,23930,23931,25140,27924,27925</link.rule.ids></links><search><creatorcontrib>Ludwig, J.</creatorcontrib><creatorcontrib>Lienau, F.</creatorcontrib><creatorcontrib>Maag, R.</creatorcontrib><creatorcontrib>Hagenah, J.M.</creatorcontrib><creatorcontrib>Deuschl, G.</creatorcontrib><creatorcontrib>Klein, C.</creatorcontrib><creatorcontrib>Baron, R.</creatorcontrib><creatorcontrib>Helmchen, C.</creatorcontrib><title>Modified somatosensory processing in PINK1 (PARK6)-mutation carriers: preclinical evidence by the use of quantitative sensory testing</title><title>Aktuelle Neurologie</title><addtitle>Akt Neurol</addtitle><description>Introduction: Sensory symptoms are common in Parkinson's disease (PD). It is unclear whether these symptoms are of primary origin or secondary due to pathophysiological changes occurring in PD. Recently, mutations of the PINK1 (PARK6) gene have been identified as one cause for the development of PD. Asymptomatic carriers of PINK1 mutations represent individuals at risk who can be identified prior to the development of PD by molecular genetic testing. Therefore, PINK1-associated PD may serve as a model to detect presymptomatic signs and sensory abnormalities before subjects show definite clinical signs of PD. This might shed light on the pathomechanisms related to sensory abnormalities in patients with the more frequent idiopathic PD. Methods: 14 family-members with PINK1 mutation (3 homozygous, 11 heterozygous) and 14 healthy controls were examined. A clinical examination, nerve conduction studies and a shortened form of the QST protocol of the German Research Network on Neuropathic Pain (DFNS) were performed. The QST protocol included perception thresholds for warm, cold, cold pain, heat pain, mechanical and painful mechanical stimuli, vibration and pain pressure. For evaluation, z-values were calculated and compared by the U-test. P&lt;0.05 was considered to be statistically significant. Results: The homozygous PINK1 mutation carriers were all symptomatic and had a definite PD. Despite the lack of symptoms for PD, five heterozygous PINK1 mutation carriers showed mild clinical signs for PD upon neurological examination. All individuals with parkinsonian signs upon neurological examination were considered “affected“ (n=8), family members without signs as “unaffected“ (n=6). Comparison of affected and unaffected PINK1 mutation carriers revealed significant lower z-values for mechanical detection (p&lt;0.0005) and vibration detection threshold (p&lt;0.01) in the affected PINK1 mutation carrier group. Both parameters correlated significantly negative with the UPDRS III. Conclusion: In contrast to patients suffering from idiopathic PD (Hägele et al. 2005), higher somatosensory thresholds seem to be a marker not only in affected, but also in unaffected PINK1 mutation carriers. 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It is unclear whether these symptoms are of primary origin or secondary due to pathophysiological changes occurring in PD. Recently, mutations of the PINK1 (PARK6) gene have been identified as one cause for the development of PD. Asymptomatic carriers of PINK1 mutations represent individuals at risk who can be identified prior to the development of PD by molecular genetic testing. Therefore, PINK1-associated PD may serve as a model to detect presymptomatic signs and sensory abnormalities before subjects show definite clinical signs of PD. This might shed light on the pathomechanisms related to sensory abnormalities in patients with the more frequent idiopathic PD. Methods: 14 family-members with PINK1 mutation (3 homozygous, 11 heterozygous) and 14 healthy controls were examined. A clinical examination, nerve conduction studies and a shortened form of the QST protocol of the German Research Network on Neuropathic Pain (DFNS) were performed. The QST protocol included perception thresholds for warm, cold, cold pain, heat pain, mechanical and painful mechanical stimuli, vibration and pain pressure. For evaluation, z-values were calculated and compared by the U-test. P&lt;0.05 was considered to be statistically significant. Results: The homozygous PINK1 mutation carriers were all symptomatic and had a definite PD. Despite the lack of symptoms for PD, five heterozygous PINK1 mutation carriers showed mild clinical signs for PD upon neurological examination. All individuals with parkinsonian signs upon neurological examination were considered “affected“ (n=8), family members without signs as “unaffected“ (n=6). Comparison of affected and unaffected PINK1 mutation carriers revealed significant lower z-values for mechanical detection (p&lt;0.0005) and vibration detection threshold (p&lt;0.01) in the affected PINK1 mutation carrier group. Both parameters correlated significantly negative with the UPDRS III. Conclusion: In contrast to patients suffering from idiopathic PD (Hägele et al. 2005), higher somatosensory thresholds seem to be a marker not only in affected, but also in unaffected PINK1 mutation carriers. Since neurography showed normal data, we hypothesize that sensory impairment is of primary origin, probably due to altered central somatosensory processing.</abstract><doi>10.1055/s-2006-953144</doi><oa>free_for_read</oa></addata></record>
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title Modified somatosensory processing in PINK1 (PARK6)-mutation carriers: preclinical evidence by the use of quantitative sensory testing
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