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1085 Parkinson's disease among inuit in Greenland: mercury and lead as risk factors
Poster Abstracts Diagnosis was based on clinical symptoms according to the criteria of the U K Parkinson's Disease Brain Bank. Methods: High-molecalar-weight genomic D N A was prepared from venous blood using standard phenol/chloroform extraction. Genomic D N A segment containing V N T R polymovptfism o f the DATgene was amplified according to the previously published method (Persico AM, et al. 1995). Results: We detected four alleles in the locus that correspond to 10, 11, 9, and 7 repeat allele. Frequencies of the repeat variation were 0.86, 0.03, 0.06, and 0.05 respectively. Conclusion: The locus was also polylnorphic in Japanese PD population. 1084 Evaluation of liver-rdated adverse events with Tolcapone: a review of 7-Years of worldwide salary data
Watts, R 1, Krieorian, G 2. 1Department of Neurology, University of
Alabama at Birmingham, Birmingham, AL, USA.." 2Valeant Pharmaceuticals International, Costa Mesa, CA, USA Backgrouml: The COMT inhibitor tolcapone was approved as an adjunct to levodopa for use in Parkinson's Disease in 1997. Although very effective, post-marketing surveillance revealed 3 cases of fatal hepatotoxicity in patients who were not properly monitored, and new F D A guidelines for liver testing were established. Little information has since been published on the frequency o f liver-related adverse events (AEs) reported with this agent. Method: We conducted a review of the tolcapone global safety database in order to assess the incidence of liver-related AEs received by the manufacturer from February 1997 until December 2004. Results: About 100,000 patients received tolcapone worldwide between 2/97 and 5/99. A total of 156 hepatobiliary AEs were reported during this time period, and the majority of cases were isolated asymptomatic elevations in liver enzymes. Only 37 cases (0.04%) reported acute hepatitis or hepatic failure. New liver monitoring requirements were then introduced and an estimated 80,000 patients took the drug between 6/99 and 12/04. During this time, a total o f 63 cases of liverrelated AEs were reported, of which 6 cases (0.01%) were acute hepatitis (15 cases) or hepatic failure (1 case), and no deaths occurred due to liver failure. Conclusion: The overall incidence of liver-related adverse events with tolcapone was rare both before and after the new liver monitoring guidelines were implemented. The new guidelines have likely resulted in improved screening of patients and better monitoring of liver dysfunction while on tolcapone therapy.
1085 Parkinson's disease among Inuit in Greenland: mercury and lead as risk factors
Wermuth L, Koldkjur, OG, Bjerregaard P. 1Sonderborg Hospital,
Wednesday, November 9, 2005
$375
with the controls twice as high as the PD. Pb was neither elevated in controls (mean 0.60 Imaol/l; range 0.13-1.47; s.d. 0.3:1) nor in cases (mean 0.37; range 0.05-0.93; s.d. 0.24) but the controls had higher values than the cases. The differences were statistically significant (p < 0.001 for both Hg and Pb). Conclusion: The prevalence of PD in hmit is twice that found in the island o f Als, Den_mark. A lifelong exposure to Hg and other metals could alone or in combination with high concentrations of pesticides lead to a synergistic effect; probably in conjunction with genetic susceptibility. The reason for lower Hg and Pb values in the cases compared to the controls are most likely ascribed to partly replacement of marine food with a western style food at the time the PD stopped work. This and the reason for the high prevalence of PD require more investigations. 1086 The epideuliology of Parldnson's disease in the Faroe Islands
Wermuth, L l, Beth, S~, Skaalum, M ~, Joensen, P~, Weihe, P~, Grandjean, p3. 1Department of Neurology, Sonderborg Hospital,
University of Southern Denmark; 2The National Hospital, Torshavn, Faroe Islands," 3Department of Environmental Medicine, University of Southern Denmark Background: Epiderniological surveys on Parkinson's disease have shown great variation in prevalence depending on methods used. Crude levodopa use (LDU) in Denmark amounted to a level sirnilar to that of Sweden. However, in the Faroe Islands and Greenland the levels of L D U are twofold higher, adjusted for indicators of socioeconomic development. In 1995 a prevalence study in the Faroe Islands with a total population o f 43.703 inhabitants with case-finding methods was made. The crude prevalence of parkinsonism per July 1 1995 was 233,4 and of idiopathic Parkinson's disease 187.6 per 100.000 persons. In 1998 in Als (Dermmrk) a prevalence study with the same method used the crude prevalence of idiopathic Parkinson's disease was estimated to be 102.0 per 100 000 persons. Method: The same case-finding methods will be used: Collection of data from the pharmacies in the Faroe Islands. Registered patients with suspected PD in the National Hospital in Torshavn and information from all general practitioners. Patients will be examined, interviewed and blood samples taken. Results: In the smmner 2005 a new prevalence and incidence study is planned. In Denmark the LDU are 3.:1 DDD/1000 inhabitants per day, in the Faroe Islands the L D U are 4.69 DDD/1000 inhabitant per day and still higher than in Denmark. Conclusion: The case ascertainment and the diagnostic accuracy in tiffs study will be at the same high level as the last study. Data will be presented to the congress. 1087 Inhibitory control in Parldnson's disease
University of Southern Denmark, Dept. Of Clin. Biochernistry, Sonderborg, Denmark
Winograd-Gurvidl, C 1,z, Georgiou-Karistianis, N ~, Millist, L 2, White, 01"2. 2Monash University, Melbourne, Australia; 2The Mental
Objective: To investigate mercury (Hg) and lead (Pb) as possible risk factors for Parkinson's disease (PD) in an arctic population which has never been done before. Backgrouml: The arctic area has for decades been contaminated by heavy metals with accmnulation in the marine food. Inuit with their high consmnption of marine animals therefore bioaccunmlate the metals. Environmental factors, including metals, are believed to play an important role in PD. Method: Case-control study of Inuit in Greenland. Full-blood from 39 PD (mean age 68 yr) and 54 controls (mean age 63 yr) was analysed for Hg and Pb by atomic absorption spectrometry. Results: Hg was very high in both controls (mean 267 nmol/l; range 66935, s.d.197) and PD-cases (mean 134 rmlol/1); range 23-410; s.d. 86)
Parkinson's disease (PD) is a clinical syndrome characterized by a combination of tremor, rigidity and bradykinesia. The primary neuropathology is loss of dopaminergic neurons in nigrostriatal tracts. Failure in inhibitory control has recently become a focus of not only the cognitive functions related to PD, but also of the understanding of motor control. Eye movement paradigms provide a useful behavioural measure to precisely and non-nivasively investigate basic sensorimotor functions as well as higher order cognitive aspects of motor control, including the ability to inhibit and select (in)appropriate movements. This study investigated inlfibitory control in 13 individuals with mild-moderate PD and 13 age-matched healthy controls utilizing a number of saccadic eye movement
Health Research Institute, Melbourne, Australia
Watts, R 1, Krieorian, G 2. 1Department of Neurology, University of
Alabama at Birmingham, Birmingham, AL, USA.." 2Valeant Pharmaceuticals International, Costa Mesa, CA, USA Backgrouml: The COMT inhibitor tolcapone was approved as an adjunct to levodopa for use in Parkinson's Disease in 1997. Although very effective, post-marketing surveillance revealed 3 cases of fatal hepatotoxicity in patients who were not properly monitored, and new F D A guidelines for liver testing were established. Little information has since been published on the frequency o f liver-related adverse events (AEs) reported with this agent. Method: We conducted a review of the tolcapone global safety database in order to assess the incidence of liver-related AEs received by the manufacturer from February 1997 until December 2004. Results: About 100,000 patients received tolcapone worldwide between 2/97 and 5/99. A total of 156 hepatobiliary AEs were reported during this time period, and the majority of cases were isolated asymptomatic elevations in liver enzymes. Only 37 cases (0.04%) reported acute hepatitis or hepatic failure. New liver monitoring requirements were then introduced and an estimated 80,000 patients took the drug between 6/99 and 12/04. During this time, a total o f 63 cases of liverrelated AEs were reported, of which 6 cases (0.01%) were acute hepatitis (15 cases) or hepatic failure (1 case), and no deaths occurred due to liver failure. Conclusion: The overall incidence of liver-related adverse events with tolcapone was rare both before and after the new liver monitoring guidelines were implemented. The new guidelines have likely resulted in improved screening of patients and better monitoring of liver dysfunction while on tolcapone therapy.
1085 Parkinson's disease among Inuit in Greenland: mercury and lead as risk factors
Wermuth L, Koldkjur, OG, Bjerregaard P. 1Sonderborg Hospital,
Wednesday, November 9, 2005
$375
with the controls twice as high as the PD. Pb was neither elevated in controls (mean 0.60 Imaol/l; range 0.13-1.47; s.d. 0.3:1) nor in cases (mean 0.37; range 0.05-0.93; s.d. 0.24) but the controls had higher values than the cases. The differences were statistically significant (p < 0.001 for both Hg and Pb). Conclusion: The prevalence of PD in hmit is twice that found in the island o f Als, Den_mark. A lifelong exposure to Hg and other metals could alone or in combination with high concentrations of pesticides lead to a synergistic effect; probably in conjunction with genetic susceptibility. The reason for lower Hg and Pb values in the cases compared to the controls are most likely ascribed to partly replacement of marine food with a western style food at the time the PD stopped work. This and the reason for the high prevalence of PD require more investigations. 1086 The epideuliology of Parldnson's disease in the Faroe Islands
Wermuth, L l, Beth, S~, Skaalum, M ~, Joensen, P~, Weihe, P~, Grandjean, p3. 1Department of Neurology, Sonderborg Hospital,
University of Southern Denmark; 2The National Hospital, Torshavn, Faroe Islands," 3Department of Environmental Medicine, University of Southern Denmark Background: Epiderniological surveys on Parkinson's disease have shown great variation in prevalence depending on methods used. Crude levodopa use (LDU) in Denmark amounted to a level sirnilar to that of Sweden. However, in the Faroe Islands and Greenland the levels of L D U are twofold higher, adjusted for indicators of socioeconomic development. In 1995 a prevalence study in the Faroe Islands with a total population o f 43.703 inhabitants with case-finding methods was made. The crude prevalence of parkinsonism per July 1 1995 was 233,4 and of idiopathic Parkinson's disease 187.6 per 100.000 persons. In 1998 in Als (Dermmrk) a prevalence study with the same method used the crude prevalence of idiopathic Parkinson's disease was estimated to be 102.0 per 100 000 persons. Method: The same case-finding methods will be used: Collection of data from the pharmacies in the Faroe Islands. Registered patients with suspected PD in the National Hospital in Torshavn and information from all general practitioners. Patients will be examined, interviewed and blood samples taken. Results: In the smmner 2005 a new prevalence and incidence study is planned. In Denmark the LDU are 3.:1 DDD/1000 inhabitants per day, in the Faroe Islands the L D U are 4.69 DDD/1000 inhabitant per day and still higher than in Denmark. Conclusion: The case ascertainment and the diagnostic accuracy in tiffs study will be at the same high level as the last study. Data will be presented to the congress. 1087 Inhibitory control in Parldnson's disease
University of Southern Denmark, Dept. Of Clin. Biochernistry, Sonderborg, Denmark
Winograd-Gurvidl, C 1,z, Georgiou-Karistianis, N ~, Millist, L 2, White, 01"2. 2Monash University, Melbourne, Australia; 2The Mental
Objective: To investigate mercury (Hg) and lead (Pb) as possible risk factors for Parkinson's disease (PD) in an arctic population which has never been done before. Backgrouml: The arctic area has for decades been contaminated by heavy metals with accmnulation in the marine food. Inuit with their high consmnption of marine animals therefore bioaccunmlate the metals. Environmental factors, including metals, are believed to play an important role in PD. Method: Case-control study of Inuit in Greenland. Full-blood from 39 PD (mean age 68 yr) and 54 controls (mean age 63 yr) was analysed for Hg and Pb by atomic absorption spectrometry. Results: Hg was very high in both controls (mean 267 nmol/l; range 66935, s.d.197) and PD-cases (mean 134 rmlol/1); range 23-410; s.d. 86)
Parkinson's disease (PD) is a clinical syndrome characterized by a combination of tremor, rigidity and bradykinesia. The primary neuropathology is loss of dopaminergic neurons in nigrostriatal tracts. Failure in inhibitory control has recently become a focus of not only the cognitive functions related to PD, but also of the understanding of motor control. Eye movement paradigms provide a useful behavioural measure to precisely and non-nivasively investigate basic sensorimotor functions as well as higher order cognitive aspects of motor control, including the ability to inhibit and select (in)appropriate movements. This study investigated inlfibitory control in 13 individuals with mild-moderate PD and 13 age-matched healthy controls utilizing a number of saccadic eye movement
Health Research Institute, Melbourne, Australia