With the growing older adult population, neurodegenerative diseases common in old age such as mild cognitive impairment (MCI) or Parkinson’s disease (PD) are becoming increasingly germane areas of research. Pharmacological treatments have thus far been unsuccessful in treating cognitive decline associated with these neurodegenerative disorders. Alternative interventions, such as cognitive training programs, have shown promise. The current dissertation contains three papers examining cognitive interventions in neurodegenerative diseases. The first paper examined the longitudinal effects of cognitive speed of processing training (SPT) among those with PD. Results showed that training gains seen at initial post-test were maintained three months later. The second paper examined the effects of SPT among those with psychometrically-defined MCI and found small to medium effect sizes for improvements in everyday functional performance among those trained. The third paper examined the effects of auditory cognitive training among cognitively healthy older adults and those with psychometrically-defined MCI and found that effects may differ between those with and with MCI. Overall, these papers show that training effects can be maintained longitudinally and may potentially transfer to everyday functioning in those with neurodegenerative diseases. However, not all cognitive training programs show benefits in all areas, and individuals with differing cognitive statuses may benefit differentially from cognitive training. Future research should further explore the longitudinal effects of these training programs as well as the possibility of transfer to untrained abilities.

Fundação de Apoio a Pesquisa e à Inovação Tecnológica do Estado de Sergipe - FAPITEC/SE / Parkinson's disease (PD) shows sex differences in susceptibility, pathogenesis and clinical condition. The most common incidence in males suggests sex hormones as a potential contributing factor to the individual susceptibility to this disease. Thus, the purpose of this study was evaluate the effect of chronic testosterone propionate (TP) administration on the motor and neurochemical changes in Parkinsonism model induced by reserpine (RES);and to compare the effects of administration of low doses of RES between males and females (intact and ovariectomized). A hundred ninety-two 6-9-month-old males and females Wistar rats were used. Animals were obtained from vivarium of the Department of Physiology - Federal University of Sergipe. The study was divided into three experiments: (I) testosterone propionate administration in intact male rats, (II) in intact female rats and (III) in ovariectomized rats. In all experiments, the rats were divided into eight groups: 1) testosterone propionate vehicle (CTRt) + reserpine vehicle (CTR); 2) 0.1mg / kg of TP (0.1TP) + CTR; 3) 1.0 mg / kg of TP (1.0TP) + CTR; 4) 5.0mg / kg of TP (5.0PT) + CTR; 5) CTRt + RES; 6) 0.1TP +RES; 7) 1.0TP+ RES and 8) 5.0TP + RES. Animals received 31 injections of testosterone propionate or vegetable oil (i.m.) daily and 15 injections of 0.1 mg / kg RES or vehicle (s.c.) every other day. During the treatment, the animals were weighed every four days and submitted to the following behavioral procedures: catalepsy (daily) and open field (day 31). On day 31, the rats were anesthetized, perfused and their brains were removed and subjected to the immunohistochemistry technique for tyrosine hydroxylase (TH). We show that the RES administration generates a sex-dependent response in the behavior of catalepsy and number of TH+ cells in the Ventral tegmental area (VTA). Regarding the co-administration of PT and RES in the catalepsy test, the treatment with TP showed reduced motor effects in males (Exp. I) in 5.0PT+RES group, while in females (Exp. II and III) this effect was observed at the dose of 1.0 mg / kg (1.0PT+RES) and 5.0 mg / kg (5.0PT+RES). In the open field, none of the doses of TP, in any of the experiments, was able to minimize the effects caused by the RES in motor activity. In intact males (Exp. I), all tested doses of TP were able to prevent the reduction of TH+cells caused by the RES in VTA, but not in Substantia nigra pars compacta. In intact females (Exp. II), only the dose of 5.0 mg / kg (5.0PT+RES) was able to prevent the reduction of TH+ cells in the SNpc. In ovariectomized females (Exp. III) the treatment with all doses of TP (0.1PT+RES, 1.0PT+RES and 5.0PT+RES) was able to maintain the intensity of TH in the dorsal striatum, preventing reduction caused by the RES. Taken together our results show that Chronic treatment with TP, in progressive model of parkinsonism induced by RES, showed different effects in behavioral tests and animals of different sex and conditions, showing multiple possible mechanisms of action. / A doença de Parkinson (DP) exibe diferenças sexuais na suscetibilidade, patogênese e quadro clinico, sendo a incidência mais comum no sexo masculino, evidenciando os hormônios sexuais como potencial fator que contribui para predisposição do indivíduo a esta doença. Diante disso, o objetivo do presente trabalho foi avaliar a ação da administração crônica de propionato de testosterona (PT) sobre as alterações motoras e neuroquímicas no modelo de parkinsonismo induzido por reserpina (RES); além de comparar os efeitos da administração de baixas doses de RES entre machos e fêmeas (intactas e ovariectomizadas). Foram utilizados 192 ratos Wistar de ambos os sexos, 6-9 meses, provenientes do Biotério Setorial do Departamento de Fisiologia da Universidade Federal de Sergipe. O estudo foi dividido em 3 experimentos: (I) administração de propionato de testosterona em ratos intactos, (II) em ratas intactas e (III) em ratas ovariectomizadas. Os ratos foram divididos em oito grupos: 1- veículo proprionato de testosterona (CTRt)+veículo RES (CTR); 2- 0,1mg/kg de PT (0,1PT)+CTR; 3- 1,0 mg/kg de PT (1,0PT)+CTR; 4- 5,0mg/kg de PT (5,0PT)+CTR; 5- CTRt+RES; 6- 0,1PT+RES; 7- 1,0PT+RES e 8- 5,0PT+RES. Os animais receberam 31 injeções, uma a cada dia, de propionato de testosterona ou óleo vegetal (i.m) e 15 injeções, em dias alternados, de 0,1 mg/kg de RES ou veículo (s.c.). Durante o tratamento, os animais foram pesados a cada 4 dias e submetidos a testes comportamentais: catalepsia (diariamente) e campo aberto (dia 31). No dia 31, os ratos foram anestesiados, perfundidos, seus cérebros removidos e submetidos a imunohistoquímica para Tirosina Hidroxilase (TH). Mostramos que a administração de RES gera uma resposta sexo-dependente no comportamento de catelepsia e número de células TH+ na Área tegumentar ventral (VTA). Em relação a administração concomitante de PT e RES, observamos que no teste de catalepsia, o tratamento com PT mostrou redução dos efeitos motores, nos machos (exp. I) do grupo 5,0PT+RES, enquanto em fêmeas (exp. II e III) esse efeito foi observado já na dose de 1,0 mg/kg (1,0PT+RES) e também na de 5,0 mg/kg (5,0PT+ RES). Na atividade motora em campo aberto, nenhuma das doses de PT, em nenhum dos experimentos, foi capaz de minimizar os efeitos causados pela RES. Em machos intactos (Exp. I), todas as doses de PT testadas foram capazes de prevenir a diminuição de células TH+ causadas pela RES em VTA, mas não na Substância negra parte compacta. Em fêmeas intactas (Exp. II), apenas a dose de 5,0 mg/kg (5,0PT+RES) foi capaz de prevenir a diminuição de células TH+ na SNpc. Nas fêmeas ovarectomizadas (Exp. III), o tratamento com PT em todas as doses (grupos 0,1PT+RES, 1,0PT+RES e 5,0PT+RES), foi capaz de manter a intensidade de TH no estriado dorsal, prevenindo a redução causada pela RES. O tratamento crônico com PT, no modelo progressivo de parkinsonismo induzido por RES, apresentou diferentes efeitos nos testes comportamentais e nos animais de sexos e condições diferentes, mostrando possíveis mecanismos múltiplos de ação.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-20T20:16:16Z No. of bitstreams: 1 Gileno Edu Lameira de Melo.pdf: 2303187 bytes, checksum: dfdc9eb2889c78ff7007dee09856d636 (MD5) / Made available in DSpace on 2018-07-20T20:16:16Z (GMT). No. of bitstreams: 1 Gileno Edu Lameira de Melo.pdf: 2303187 bytes, checksum: dfdc9eb2889c78ff7007dee09856d636 (MD5) Previous issue date: 2017-10-24 / Objective: Determine the effect of gait training with virtual reality in comparison to over ground training and treadmill training on balance and gait in individuals with Parkinson’s disease. Material and Methods: Study I: A systematic review was performed of articles published between 2011 and 2016 retrieved from four databases using the following keywords and synonyms: Parkinson’s Disease, Gait, and Virtual Reality Exposure Therapy. Study II: Detailed description of the study protocol. Study III: A population-based sample was composed of 37 individuals with Parkinson’s randomly allocated to three groups (control, treadmill and virtual reality). The participants were evaluated on four occasions: pre-intervention; immediately after first intervention session; post-intervention; and one month after last intervention session). Evaluations involved the administration of the Hoehn & Yahr scale, the motor section of the Unified Parkinson’s Disease Rating Scale and Parkinson ’s disease Questionnaire (PDQ-39 for the evaluation of quality of life). Long-distance walking was evaluated using the Six-Minute Walk Test with the aid of the G-WALK (BTS) inertial sensor and monitoring of heart rate, blood pressure and perceived exertion (modified Borg scale). Training was performed in 20-minute sessions at a frequency of three sessions per week for four weeks. Study IV: Thirty-seven individuals with Parkinson’s were allocated to a control group, treadmill group and Xbox group Training in each group was performed in 12 sessions. The participants were evaluated on four occasions: pre-intervention; immediately after first training session; after 12 sessions; and one month after last training session). The evaluations involved the administration of the Hoehn & Yahr scale, the motor section of the Unified Parkinson’s Disease Rating Scale, Parkinson’s Disease Questionnaire (PDQ-39 for the evaluation of quality of life), the Berg Balance Scale, and the Tinetti Test. For the evaluation of spatiotemporal gait variables, the Timed Up and Go test was performed using the G-WALK (BTS) inertial sensor. Results: Study I: Twenty-one studies with a methodological quality of 5 or more points on the PEDro scale were analyzed and the review was published in the journal Archives of Neuropsychiatry. Study II: Protocol study published in the journal Manual Therapy. Study III: Significant improvements in the distance travelled and velocity on the Six-Minute Walk Test were found in the virtual reality and treadmill groups in comparison to the control group (p < 0.05), whereas no significant differences were found between the virtual reality and treadmill groups. Study IV: Improvements in the Berg Balance Scale, Tinetti balance and cognition subscales and mobility domain of the PDQ-39 were found in the treadmill and Xbox groups in comparison to the control group. Conclusion: The results of Studies III and IV suggest that, when used with the aim of improving mobility, balance and spatiotemporal gait variables in individuals with Parkinson’s disease, training with virtual reality is as effective as treadmill training. / Objetivo: Verificar o efeito do treino de marcha com realidade virtual em comparação com treino de marcha em esteira e treino de marcha livre sobre o equilíbrio e a marcha de indivíduos com doença de Parkinson (DP). Material e método: Estudo I: Foi realizada uma revisão sistemática com uma busca em quatro bases de dados com as seguintes palavras chave e seus sinônimos: doença de Parkinson, Marcha, Terapia de exposição à realidade virtual, publicados entre 2011 e 2016. Estudo II: Descrição detalhada do protocolo do estudo. Estudo III: A amostra populacional foi composta de 37 indivíduos com DP, alocados randomicamente em três grupos (Grupo Controle; Grupo Esteira e Grupo Realidade Virtual). Os participantes foram avaliados: pré-intervenção, efeito imediato, pós-intervenção e um mês após a última intervenção. A avaliação foi composta pela Escala de Hoehn e Yahr, pela seção motora da Escala Unificada de Avaliação da Doença de Parkinson e a percepção da qualidade de vida pelo questionário de Qualidade de Vida na Doença de Parkinson (PDQ-39). Para avaliação da caminhada de longa distância, realizou o Teste de Caminhada de 6 minutos, utilizando o sensor inercial G-WALK- BTS e os parâmetros clínicos da Frequência Cardíaca, Pressão Arterial e escala de Borg modificada. Os treinos foram realizados durante quatro semanas, com três sessões por semana, com duração de 20 minutos de treino. Estudo IV: 37 parkinsonianos foram alocados em grupo controle, grupo esteira e grupo Xbox. Realizaram quatro avaliações distintas antes da intervenção, após a primeira sessão de treino, após 12 sessões de treino e 30 dias após o último treino. As avaliações foram constituídas dos seguintes testes e escalas: Escala de Hoehn e Yahr, pela seção motora da Escala Unificada de Avaliação da Doença de Parkinson e a percepção da qualidade de vida, pelo questionário de Qualidade de Vida na Doença de Parkinson (PDQ-39), Escala de Equilíbrio de Berg, Teste de Tinetti. E para avaliação dos parâmetros espaço temporais da marcha, Teste Timed Up and Go, utilizando o sensor inercial G-WALK- BTS. Foram realizadas 12 sessões de treino para cada grupo. Resultados: Estudo I: 21 estudos foram encontrados com uma qualidade metodológica de 5 pontos ou mais na escala PEDro e submetido à publicação na Revista Arquivos de Neuropsiquiatria. Estudo II: artigo publicado na revista Terapia Manual. Estudo III: O grupo Realidade virtual e Esteira apresentou estatisticamente melhora nos parâmetros da distância e velocidade, durante o teste de caminhada de 6 minutos em relação ao grupo controle (p<0,05). Não foram encontradas diferenças significativas entre o grupo esteira e o grupo Realidade Virtual. O estudo IV: Para as escalas clínicas, os grupos Esteira e XBOX apresentaram melhores escores para a Escala de Berg, Tinetti-equilíbrio e cognição e mobilidade do PDQ-39 do que o grupo controle. Conclusão: os resultados dos estudos III e IV sugerem que o treino com RV, quando utilizado para a melhoria da mobilidade, equilíbrio e dos parâmetros espaço temporais da marcha, tem efeito positivo em indivíduos com DP tanto quanto o treinamento em esteira.

A Doença de Parkinson (DP) é a segunda doença neurodegenerativa mais comum. Atinge 3,3% das pessoas com mais de 64 anos. Com o envelhecimento populacional, sua prevalência deve dobrar. A doença classicamente se caracteriza por degeneração dos neurônios da substantia nigra, afetando principalmente a transmissão dopaminérgica. O tratamento mais eficaz na DP continua sendo a levodopa, um precursor dopaminérgico com excelente resposta motora. Entretanto, à medida que a doença progride, aparece uma série de complicações motoras e não motoras que limitam o tratamento. Para facilitar o reconhecimento destas complicações, foram criados questionários que aumentam a possibilidade de diagnóstico, abordando aspectos motores e não motores. O principal deles é um questionário de 19 itens. Ele consiste em 19 manifestações que o paciente deve assinalar, caso tenha determinado sintoma, e se ele melhora com a próxima dose da medicação. Quando existem pelo menos duas respostas positivas, o questionário tem ótima sensibilidade e especificidade. A Doença de Parkinson tem evolução heterogênea, sendo que uma das causas atribuídas para tal é genética. Tem se estudado muitos genes da rota de dopamina por sua relação íntima com a fisiopatologia e tratamento da doença. O transportador de dopamina (DAT), que realiza a retirada da dopamina da fenda sináptica, desempenha papel fundamental nesta rota. Existe um polimorfismo VNTR com cópias de uma unidade de repetição variando de 3 a 11 com as repetições 9 e 10 sendo os alelos mais comuns. Diversos estudos correlacionaram esse polimorfismo com transtorno do déficit de atenção e hiperatividade quando há 10 repetições e com a Doença de Parkinson quando há 9 repetições. Seria um candidato ideal para avaliação com relação às complicações do tratamento e progressão. Assim, avaliamos pacientes com Doença de Parkinson longitudinalmente para comparar a progressão da doença com polimorfismo do DAT e verificar as complicações associadas ao tratamento. Inicialmente, realizamos uma revisão sistemática das propriedades clinimétricas dos questionários de wearing off. Esta revisão mostrou que o questionário de 9 itens tem sensibilidade de 0,87-1 e especificidade de 0,1-0,69. Já o questionário de 19 itens tem sensibilidade de 0,81-0,9 e especificidade de 0,63-0,8 com ponto de corte igual a 2 itens positivos. Realizamos a validação deste último para português, com boa estabilidade no teste-reteste com correlação intraclasse de 0,87 (IC 95% 0,69-0,95 p < 0,01) e sensibilidade de 0,97 (IC 95% 0,94-1 p < 0,01) e especificidade de 0,71 (IC 95% 0,56-0,85 p < 0,01). Para progressão, foi demonstrada uma associação de sexo feminino e a presença de alelo com 9 repetições como fatores de risco para progressão mais rápida. A progressão em homens medida pelo UPDRS 3 era menor em 1,277 (IC 95% 2,18-0,38 p < 0,01) e pelo UPDRS total era menor em 1,50 (IC 95% 2,92-0,11 p = 0,031). Com presença de alelo com 9 repetições, a progressão do UPDRS 3 era menor em 1,92 (ICC 95% 0,04-1,01 p = 0,0317), e presente mesmo controlando para sexo. Não houve diferença na escala de discinesias ou questionário wearing off. Assim, os resultados obtidos mostraram que o questionário de 19 itens é uma boa ferramenta diagnóstica, sendo validado para português. Além disso, o polimorfismo DAT está associado à progressão mais rápida da DP com 9 repetições. / Parkinson’s disease (PD) is the second most common neurodegenerative disease. It affects 3.3% of people over 64 years. With population aging, its prevalence should double. The disease is classically characterized by degeneration of substantia nigra neurons, mainly affecting dopaminergic transmission. The most effective treatment for PD continues to be levodopa, a dopaminergic precursor with excellent motor response. However, as the disease progresses, there is a number of motor and non-motor complications that limits the treatment. To facilitate the recognition of these complications, questionnaires were created to increase the possibility of diagnosis, addressing motor and non-motor aspects. The main one is a questionnaire of 19 items. It consists of 19 symptoms that the patients should indicate, if they feel particular symptom, and if they get better with the next dose of medication. When there are at least two positive responses, the questionnaire has optimal sensitivity and specificity. Parkinson’s disease has a heterogeneous evolution, and one of the reasons attributed for that is genetic. Many genes of the dopamine route have been studied for their intimate relationship with the pathophysiology and treatment of the disease. The dopamine transporter, with synaptic cleft reuptake, plays a key role in this route. It has a VNTR polymorphism with copies of a repeating unit ranging from 3 to 11 with repetitions 9 and 10 being the most common alleles. Several studies correlated this polymorphism with Attention Deficit Hyperactivity Disorder with 10 repetition allele and Parkinson’s disease with 9 repetition alleles. It would be an ideal candidate for evaluation regarding treatment complications and progression. Thus, we evaluated patients with Parkinson’s disease longitudinally to compare disease progression with DAT polymorphism and to verify treatment-related complications. Initially we performed a systematic review of the clinimetric properties of the wearing off questionnaires. That showed that the questionnaire of 9 items has sensitivity of 0.87-1 and specificity of 01-0.69. The questionnaire of 19 items has a sensitivity of 0.81-0.9 and a specificity of 0.63-0.8 with a cut-off point of 2 items. We performed the validation of the latter for Portuguese, with good stability in the testretest with intraclass correlation of 0.87 (95% CI 0.69-0.95 p < 0.01) and sensitivity of 0.97 (CI 95% 0.94-1 p < 0.01) and specificity of 0.71 (95% CI 0.56-0.85 p < 0.01). We demonstrated a female association and presence of 9 DAT allele repetition as risk factors for faster progression. The progression in men ofwith UPDRS 3 was lower in 1.277 (95% CI 2.18-0.38 p < 0.01) and total UPDRS was lower in 1.50 (95% CI 2.92-0.11 p = 0.031). With the presence of allele with 9 repetitions the progression of UPDRS 3 was lower in 1.92 (ICC 95% 0.04-1.01 p = 0.0317), and present even correcting sex. There was no difference in the dyskinesia scale or wearing off questionnaire. Thus, the results obtained showed wearing off questionnaire is a good tool for clinical and research, and it is validated to Portuguese. Also, DAT polymorphism is associated with faster PD progression with 9 repetition allele.

We present a 56-year-old patient suffering from frontotemporal dementia with parkinsonism linked to chromosome 17 (FTDP-17). The history included a three-generation pedigree and the patient was found to be a mutation carrier. The diagnosis was hindered by late appearance of the hypokinetic movement disorder. For clinicians, it is important to consider rare neurodegenerative disease variants in early-onset familial dementia syndromes with behavioral, cognitive, and motor symptoms

This work deals with analysis of phonation in patients with Parkinson’s disease (PD). Approximately 90% of patients with Parkinson’s disease suffer from speech motor dysfunction called hypokinetic dysarthria. System for Parkinson’s disease analysis from speech signals is proposed and several types of features are examined. Czech Parkinson’s speech database called PARCZ is used for classification. This dataset consists of 84 PD patients and 49 healthy controls. Results are evaluated in two ways. Firstly, features are individually analysed by Spearman correlation, mutual information and Mann-Whitney U test. Classification is based on random forests along with leave-one-out validation. Secondly, SFFS algorithm is employed for feature selection in order to get the best classification result. Proposed system is tested for each gender individually and both genders together as well. Best result for both genders together is expressed by accuracy 89,47 %, sensitivity 91,67% and specificity 85,71 %. Results of this work showed that the most important vowel realizations for phonation analysis are sustained vowels pronounced with maximum or minimum intensity (not whispering).

Parkinson's disease (PD) is the second most common chronic neurodegenerative disease characterized by dopamine decrease in the substantia nigra. Currently, there is no promising cure for PD and this has resulted in extensive research into alternative medicines. The aim of this study was to investigate the effect of methanol and ethyl acetate extracts of Lannea schweinfurthii (Engl. Engl) (Anacardiaceae), Zanthoxylum capense (Thunb. Harv) (Rutaceae), Scadoxus puniceus ((L.) Friis & Nordal) (Amaryllidaceae) and Crinum bulbispermum (Burm. f.) Milne-Redh. & Schweick) (Amaryllidaceae) on rotenone-induced toxicity in SH-SY5Y neuroblastoma cells. The latter which mimics PD symptoms in vitro. Cytotoxicity of the plant extracts was assessed using sulforhodamine B (SRB) assay. Intracellular reactive oxygen species (ROS) were measured fluorometrically with the use of the fluorescent dye 2‟,7‟-dichlorodihydrofluorescein diacetate (H2DCF-DA). Intracellular glutathione content was measured fluorometrically after staining with monochlorobimane (MCB). Fluorescent dye 5,5‟ ,6,6‟ -tetrachloro-1,1‟ ,3,3‟ -tetraethylbenzimidazolcarbocyanine iodide (JC-1) was used to assess the mitochondrial membrane potential (MMP) status of cells. Apoptosis was assessed by determining caspase-3 activity through detection of 7-amino-4-methylcoumarin (AMC) which is a product of caspace-3 substrate, acetyl-Asp-Glu-Val-Asp 7-amino-4-methylcoumarin (Ac-DEVD-AMC), cleaved by the caspase-3 enzyme. Rotenone was used as an in vitro model to induce PD-like symptoms. Cytotoxicity studies for methanol extract of Zanthoxylum capense revealed the highest IC50 value of 121.3 μg/mL, indicating low toxicity. The ethyl acetate extract of Crinum bulbispermum was observed to have no effect on the normal proliferation of the SH-SY5Y cells and produced an IC50 value >100 μg/mL. The calculated IC50 value obtained from rotenone cytotoxicity studies was 112 iv nM. Zanthoxylum capense and Scadoxus puniceus plant extracts were observed to be neuroprotective against rotenone-induced toxicity. A decrease in intracellular glutathione content as well as MMP was also observed in cells exposed to rotenone alone (50 nM). There was no intracellular ROS generation observed in cells exposed to rotenone alone (50 nM) after 24 h and 72 h. However, apoptotic cell death was observed in cells treated with rotenone (50 nM). Intracellular ROS production was observed to be elevated by methanol and ethyl acetate extracts of C. bulbispermum. Methanol extracts of Z. capense was observed to increase intracellular glutathione content. MMP was increased effectively following treatment with ethyl acetate extract of C. bulbispermum. Moreover, both methanol and ethyl acetate plant extracts were found to decrease caspase-3 activity significantly (p<0.05), in cells exposed to 50 nM rotenone. Z. capense methanol extract reduced caspase-3 activity the most effectively. Treatment with plant extracts was protective and decreased cell death. Furthermore, L. schweinfurthii, Z. capense, S. puniceus and C. bulbispermum, demonstrated strong antioxidant and anti-apoptotic effects against rotenone-toxicity, making them potential agents in developing therapies for treating PD. / Dissertation (MSc)--University of Pretoria, 2013. / gm2014 / Pharmacology / unrestricted

Background: The efferent dorsal motor nucleus of the vagal nuclei complex may degenerate early in the course of Parkinson’s disease (PD), while efferent nucleus ambiguous, the principal source of parasympathetic vagal neurons innervating the heart, and afferent somatosensory nuclei remain intact.

Background/Aim: Little is known about the clinical significance of phantosmia. The literature on phantosmia indicates that this symptom has a wide range of differential diagnoses. However, most cases of phantosmia remain of unknown origin. Our goal was to follow up patients with idiopathic phantosmia, with special regard to improvement rates and possible severe health conditions preceded by phantosmia of unknown origin. Methods: Forty-four patients with idiopathic phantosmia which had consulted our Ear-Nose-Throat Smell and Taste Clinic over the last 10 years were contacted by telephone and underwent a structured medical interview. Results: None of the patients had eveloped any severe health condition or Parkinson’s disease. More than 5 years after the occurrence of hantosmia, more than 50% of the patients experienced disappearance (31.8%) or improvement (25%). In the remaining cases, phantosmia did not change (38.7%) or became worse ( ! 5%). Conclusion: The main findings of the present study were that idiopathic phantosmia improves or disappears in almost two thirds of the patients after more than 5 years, and that idiopathic phantosmia seems to be more likely a harmless symptom rather than a reliable predictor of early Parkinson’s disease or other severe diseases. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

This review is a brief summary of the effects of nicotine on neural plasticity and behavior, with a focus on the preclinical literature and the effects of nicotine on neurotrophic factors. Focus areas include underlying mechanisms of nicotine addiction and the therapeutic potential for nicotine and nicotinic receptor agonists in Parkinson’s disease, Alzheimer’s disease, traumatic brain injury, as well as cutting across these different areas of research with a brief review of the antiinflammatory effects of nicotine. It is clear that agonists at nicotinic receptors have therapeutic potential, but this should be weighed in the context of the effects of nicotine across the brain and its enhancement of neurotrophic factors. Although nicotine may have neuroprotective properties, it is important to keep in mind that these same effects underlie its addictive characteristics.