Parkinson’s disease in Senegal: epidemiologic, clinical and therapeutic aspects

Parkinson’s disease in Senegal: epidemiologic, clinical and therapeutic aspects

Abstracts / Journal of the Neurological Sciences 357 (2015) e255–e294 M. Orsini, C.H.M. Reis, A.S. Ferreira, G. Quintanilha, J.A. Souza, M.A.A. Leite...

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Abstracts / Journal of the Neurological Sciences 357 (2015) e255–e294

M. Orsini, C.H.M. Reis, A.S. Ferreira, G. Quintanilha, J.A. Souza, M.A.A. Leite, V. Guedes, M. Xavier, A.C.A.F. Ferreira, M.R.G. Freitas, O.J.M. Nascimento. Neurology, Universidade Federal Fluminense, Rio de Janeiro, Brazil

doi:10.1016/j.jns.2015.08.936

878 WFN15-1390 Movement Disorders Parkinson’s disease in Senegal: epidemiologic, clinical and therapeutic aspects N.M. Gaye, L.B. Seck, M.S. Diop, A.D. Sow, N.S. Diagne, A. Bass, K. Toure, M. Ndiaye, A.G. Diop, M.M. Ndiaye. Neurology, Fann Teaching Hospital, Dakar, Senegal

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Introduction: Patients with spinocerebellar ataxia have important balance impairment and risk of falls; the more severe the ataxia, the greater the impairment of postural balance. Objective: Describe the postural balance of patients with MJD using force platform stabilometry under different combinations of visual and biomechanical demands. Methods: Twelve patients with MJD were invited to participate in this study. The inclusion criteria: clinical manifestations of cerebellar ataxia with axial predominance. Exclusion criteria: musculoskeletal or cardiorespiratory affections that could compromise gait performance, pain or utilization of auxiliary equipment for gait or medications that interfere in postural control. Five patients were included in the quantitative study. Participants performed four postural tasks on the undisturbed upright stance: ‘feet apart eyes open’ (FAEO), ‘feet apart eyes closed’ (FAEC), ‘feet together eyes open’ (FTEO) and ‘feet together eyes closed’ (FTEC). Parameters computed comprised: standard deviation (SDX; SDY), maximum velocity (Vmax X; Vmax Y), elliptical area (Area PCA) and the average velocity (Vavg). Results: A significant increase (P b 0.001) in all parameters was observed among postural tasks (FAEC, FTEO, FTEC) as compared to the reference task (FAEO). Discussion: Dysfunction in generation or control of anticipatory postural adjustments is associated with postural deficits in some subjects with cerebellar damage. The role of cortico-subcortical pathways underlying this has been identified in animal studies. Conclusion: Despite the presence of cerebellar damage in MJD patients, the observed motor behavior under demanding postural tasks suggests that these patients reweight their sensory system to perform postural adjustments to avoid falling in undisturbed stance.

Methods: We used control rats, 6-OHDA-lesioned rats (PD) and 6-OHDA-lesioned rats chronically treated with levodopa (levodopaPD). After fixation, sections through NAc were prepared. Lucifer yellow was injected into soma of NAc MSN labeled by DAPI to visualize dendritic spines. We measured density and volume of spines using confocal laser scanning microscope and Neurolucida in MSN in the shell and core of NAc. Results: Dopamine denervation decreased the density of spines in core and shell MSN, but levodopa treatment restored the decrement. Although spine volume was unchanged by dopamine denervation, levodopa treatment to the PD rats enlarged the dendritic spines. Conclusions: The morphologic changes of dendritic spines in the levodopa-PD rats are like those observed in cocaine treated rats.

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876 WFN15-1305 Movement Disorders Postural balance in Machado-Joseph disease

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Background: Parkinson’s disease (PD) is the first cause of parkinsonian syndrome. It is also the second disease that leads to neurological disability after stroke. Objective: The aim of this study was to determine the epidemiologic, clinical and therapeutic aspects of patients treated for PD. Patients and methods: This was a prospective and transversal study conducted over 13 months on 19 patients aged between 52 and 79 years and treated for Parkinson’s disease at the Neurology department of Fann teaching hospital, Dakar. Results: Sex ratio was 1.71 and the mean age was 65.26 years. Notion of consanguinity was found in 42.12 % cases and the use of pesticides was noted in 15.78% of our patients. The average age of onset was around 60.52 years. Tremor was the first functional sign (68.42%) and this sign was present in 84.21% of patients. However, rigidity was found in 94.73% of them. The other signs were represented by motor fluctuations (78.94%), painful syndrome (73.68%), mood disorder (52.63%), hallucinations (42.10%), insomnia (31.57%), falls (10.52%) and orthostatic hypotension (5.26%). Brain CT was available in five patients and was normal in four of them. 36.84% of the patients were receiving (Levodopa +benserazide), (Levodopa + carbidopa) or piribedil and 52.63% in association with Trihexyphenidyl. 42.10% received physiotherapy. Conclusion: PD diagnosis is clinical. Frequency of PD signs in our setting is not different from those in western countries. It is important to educate general practitioners and people for early recognition of PD signs for a better management.

doi:10.1016/j.jns.2015.08.935

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877 WFN15-0274 Movement Disorders Dendritic spines of medium spiny neurons in nucleus accumbens in 6-OHDA-lesioned rats chronically treated with levodopa

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Y. Funamizua, H. Nishijimaa, T. Uenoa, S. Uenob, S. Yagihashic, M. Tomiyamaa. aNeurology, Aomori Prefectural Central Hospital, Aomori, Japan; bNeurophysiology, Hirosaki University Graduate School of Medicine, Aomori, Japan; cPathology and Molecular Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan

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Background: Dendritic spines of medium spiny neurons (MSN) in nucleus accumbens (NAc) in cocaine-treated rats increased in density and become enlarged. Although levodopa is most efficacious to ameliorate motor dysfunction in Parkinson's disease (PD), its chronic use to PD patients often induces dopamine dysregulation syndrome (DDS), a compulsive use of levodopa like addiction. The mechanisms of DDS have been suggested to be similar to those of cocaine addiction. We hypothesized that the morphological changes of dendritic spines, observed in cocaine-treated rats, also occur in NAc neurons in rats repeatedly treated with levodopa. Objective: To examine morphological changes of dendritic spines in MSN in core and shell of NAc in 6-OHDA-lesioned rats repeatedly treated with levodopa.

doi:10.1016/j.jns.2015.08.937

879 WFN15-1434 Movement Disorders Holmes' and palatal tremor following a ponto-mesencephalic hemorrhage E. Golombievski, A. Kapler, J. Biller. Neurology, Loyola University Medical Center, Chicago, USA