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Parkinson's disease in Senegal: epidemiologic, clinical and therapeutic aspects
Parkinsonism and Related Disorders 22 (2016) e29ee75
Contents lists available at ScienceDirect
Parkinsonism and Related Disorders journal homepage: www.elsevier.com/locate/parkreldis
Poster session 1 P 1.001. THE STUDY OF THE PREVALENCE OF PARKINSON DISEASE Kunduz Karbozova. Department Neurology with Medical Genetics, Bishkek, Kyrgyzstan Objectives: Parkinson's disease (PD) is the most common neurodegenerative disease, affecting over a million people in the world, and is characterized by rigidity, bradykinesia, resting tremor, and postural instability. Methods: Author examined 1098 patients in Neurology Department in National Hospital under Ministry of Health in Kyrgyzstan from January 2015 until June 2015. Among them 78 patients (mean age 64, 09±6.1 years) were with Parkinson disease. Diagnosis was verified according to the UK Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria and Hoehn and Yahr scale for diagnosis of Parkinson disease progress. Results: Among 78 patients, 45 were man and 33 women. The mean duration of disease was 6,2 ± 3,7 years (from 2 year to 22 years). The distribution in the form of the disease was as follows: 35 patients had akinetic-rigid form, 62- a mixed, and 5 e resting tremor. At the initial examination stage of Parkinson's disease on a scale of Hoehn and Yahr was diagnosed as a 1.5 - in 12 patients; 2.0 - at 17; 2.5 - at 28; 3.0 y 21. Average on a scale of Hoehn and Yahr was 2,52 ± 0,59 (p<0.05). Conclusions: 1. The highest prevalence rate of Parkinson's was among those aged over 64 years. 2. Average on a scale of Hoehn and Yahr was 2,52 ± 0,59 (p<0.05). 3. In our patients prevailed mixed form of Parkinson disease. P 1.002. SEX DIFFERENCES IN PARKINSON'S DISEASE Urszula Fiszer, Malgorzata Michalowska, Tomasz Szatanowski. Department of Neurology and Epileptology, Centre of Postgraduate Medical Education, Warsaw, Poland Objectives: Sex-related differences in Parkinson's disease (PD) still remain poorly understood. The aimed of our study was to examine potential sex differences among patients with PD. Methods: Our study was conducted on 76 PD patients (40 female, 36 male, in similar age 67.2 ±9.4 vs 64.1 ±9.1). Outcome measures included: age of onset, duration of disease, UPDRS-III, IVA,B,C, symptoms of onset, clinical type according scale of Rooden et al., total daily levodopa equivalent dose (LEDD), and duration of levodopa (or dopamine agonist) treatment. Results: There were no differences between female and male patients with PD on: age of onset, duration of disease, UPDRS-III, IVA,B scores. Symptoms of onset, clinical type according scale of Rooden et al., were similar in both groups, as well as LEDD, duration of levodopa (or dopamine agonist) treatment. Female and male showed differences on UPDRS IVC features (0.7 ±0.9 vs 0.3 ±0.5 p¼0.039, Mann-Whitney test), (in particular: anorexia, nausea, vomiting - 10.3% female vs 0.0 % male, sleep disturbance - 39.3% female vs 22.5% male, symptomatic orthostasis - 15.4% female vs 11.8% male). Conclusions: Our study evidenced sex differences in non-motor features among patients with PD on dopaminergic treatment. Sex-delineated clinical assessment and potential differences must be considered in the
clinical management of PD. References: 1. van Rooden SM, et al., Clinical subtypes of Parkinson's disease. Mov Disord 2011, 26:51-58. Liu R, et al., Potential sex differences in nonmotor symptoms in early drug-naive Parkinson disease. Neurology 2015;84:2107-2115. P 1.003. AN UNEXPECTED HIGHER PREVALENCE OF PARKINSON'S DISEASE IN FEMALES THAN MALES IN THE PROVINCE OF TRENTO (ITALY): A CLUES FOR THE ETIOPATHOGENESIS? Maria Chiara Malaguti 1, Nicola Vanacore 2, Stefania Ferrari 3, Silvano Piffer 4, Riccardo Pertile 4, Riccardo Roni 5, Andrea Polverino 5, Maria Fabio Cembrani 6, Vincenzo Bertozzi 7, Maria Gentilini 4, Pellegrini 3, Daniele Orrico 3. 1 Neurology department, Santa Chiara Hospital, Trento, Trento, Italy; 2 National Institute of Health, Rome, Italy; 3 Department of Neurology, Santa Chiara Hospital Trento, Trento, Italy; 4 Epidemiology Unit APSS Trento, Trento, Italy; 5 Pharmaceutical Services APSS, Trento, Italy; 6 Forensic Medicine Unit APSS, Trento, Italy; 7 Provincial Statistical Institute Trento, Trento, Italy Objectives: Parkinson's disease (PD) is a sporadic neurodegenerative disorder that affects mainly older individuals. The worldwide estimate of the prevalence rate of PD is 31.5 cases per 10,000 pop (95% CI 11.3-87.3). The aim of the present study is to estimate for the first time the prevalence of PD along with its relation to age, gender, and geographical location in the population of Trentino using a novel methodology. Methods: We identified all potential PD cases using five sources. The originality of our methodological approach is the use of the provincial health information system (PIS), that allowed us to screen singularly the clinical reports of each possible patient with PD. Pre-existing diagnoses of PD were not accepted as reported, but Gelb's criteria were applied to confirm each diagnosis. Results: Overall crude prevalence of PD was 21.43 per 10.000 pop, while crude prevalence rates of PD in males and females were respectively 20.64 and 22.19 per 10.000 pop. These prevalence rates are very similar to those reported by high quality studies such as door to door studies. Conclusions: Our study used a novel methodological approach to estimate the prevalence of PD in Trentino. Our results confirm that the prevalence of PD increases with age. However, we found an unexpected higher prevalence of PD in females, with an M/F ratio lower than one. Our findings open new perspectives in the complex pathogenic mechanisms of PD, including possible interactions between genetic and environmental factors. P 1.004. PARKINSON'S DISEASE IN SENEGAL: EPIDEMIOLOGIC, CLINICAL AND THERAPEUTIC ASPECTS Ndiaga Matar Gaye, Lala Bouna Seck, Ngor Side Diagne, Adjaratou Dieynabou Sow, Alassane Mamadou Diop, Ousmane Cisse, Anna Basse me Soda Diop, Kamadore Toure, Moustapha Ndiaye, Amadou Faye, Marie Gallo Diop, Mouhamadou Mansour Ndiaye. Department of Neurology, Fann Teaching Hospital, Dakar, Senegal
e30
Abstracts / Parkinsonism and Related Disorders 22 (2016) e29ee75
Objectives: The aim was to determine the epidemiologic, clinical and therapeutic aspects of patients treated for PD. Methods: This was a prospective and cross-sectional study conducted over 13 months on 19 patients treated for Parkinson's disease at the Neurology department of Dakar. The data have been collected using a pre-established form for the survey. Results: Sex ratio was 12/7 and the mean age was 65.26 ± years. The Wolof was the most represented ethnic group with 47.36%. 68.42% were married. 21.05% were farmers and 63.15% had achieved the primary level education. Consanguinity was found in 42.12% cases and the use of pesticides was noted in 15.78%. The average age of onset was around 60.52 ± years. Tremor was the first functional sign (68.42%) and 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%), sleep disturbances (31.57%). Brain CT was available in five patients and was normal in four of them. 36.84% of the patients were receiving only (Levodopa + benserazide or carbidopa) or piribedil and 52.63% one of these in association with Trihexyphenidyl. 42.10% were benefiting of physiotherapy. Conclusions: 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. P 1.006. BIRTH MONTH RELATIONSHIP?
AND
PARKINSON'S
DISEASE:
IS
THERE
ANY
Ryoichi Kurisaki, Hiroko Hori, Keiichi Nakahara, Aki Kuratomi, Yasuto Nishida, Kazutoshi Uekawa. Department of Neurology, National Hospital Organization Kumamoto-Minami National Hospital, Uki, Japan Objectives: It is reported that some lifetime disease risks are affected by a patient's birth month. Concerning Parkinson's disease (PD), little information has been reported on the relationship. The objective of this study is to investigate the affect of the birth month on patients with PD. Methods: We researched the birth months of all out- and in-patients with PD in our institute (Kumamoto, Japan) in March and April, 2015. We performed a statistical analysis to clarify the relationship of birth months and patients with PD. Results: Demographic characteristics of patients with PD were: total, 176, male, 71, female, 105; mean age, 72.2 ± 10.1 years old; median birth year, 1941 (1922 - 1973). We found the highest number of PD patients were born in January (n¼22, 12.5%), most of them being male (n¼13). The fewest PD subjects were born in June (n¼8, 4.5%) and the second least in September (n¼10, 5.7%). However, these findings were not significant after a x2-test and these tendencies were very similar to pre- World War II monthly birth ratios in Japan. Conclusions: The birth month may have a limited effect on the onset in PD patients; however, these tendencies may change within the next several decades. Further study is needed. References: 1. Statistics and Information Department, Ministry of Health, Labour and Welfare [Internet]. [updated 2002 March 15; cited 2015 August 31]. Available from: http://www.mhlw.go.jp/toukei/saikin/hw/jinkou/tokusyu/ syussyo-4/syussyo1-2.html P 1.009. OCCUPATIONAL EXPOSURE TO ORGANIC SOLVENTS AND WELDING FUMES AND RISK OF PARKINSON'S DISEASE Kalimuthu Kovendan 1, Ramachandran Chandirasekar 1, Kadarkarai Murugan 1, Savariar Vincent 2. 1 Department of Zoology, School of Life Sciences, Bharathiar University, Coimbatore, 641 046, Tamil Nadu, India; 2 P.G. Research & Department of Advanced Zoology and Biotechnology, Loyola College, Nungambakkam, Chennai 600 034, India Objectives: Organic solvents are widely used in industry and are present in products as fuels, paints, printing inks, degreasers and cleaning products.
Long term exposures might be associated with neurodegenerative diseases, such as Parkinson's disease (PD). The aim of this study was to investigate the potential association between occupational exposure to solvents welding fumes and risk of developing PD and genetics susceptibility. Methods: 65 Occupational exposed subjects and 65 controls were studied (age and sex matched). Blood samples were collected from the study subjects, Occupational histories and lifestyle information of cases and controls were collected in hospital. Exposures to aromatic solvents and welding fumes were estimated using self-reported information on welding and painting activities. Results: Welders have increased chromosome aberrations when compared to controls. Furthermore, more aberrations were observed in the chromosomes of the smoking welders when compared to the nonsmoking welders as well as controls. The XRCC 1 (arg339gln) polymorphic analysis heterozygous (arg/gln) genotype was higher. A mild PD risk was found in painting and welding workers with high exposures but there was no significance reached. Conclusion: Metal compounds should be considered as a warning indication of potentially adverse genetic and somatic effects in humans. Failure of this system may lead to development of cancer and other genetic diseases. After occupational exposure to aromatic solvents, chlorinated solvents or exposure to metals the results showed reduced risk estimates for welding and painting. A very limited role of genetic polymorphism was investigated in modulating the PD risk, but the combined effect of these variants may interact to increase the risk of PD. P 1.011. AN EXPLORATIVE ASSESSMENT OF ANTIOXIDANT AND INFLAMMATORY BIOMARKERS FOR IDENTIFICATION OF PRODROMAL PARKINSON'S DISEASE (PD) Jonica Campolo 1, Renata De Maria 1, Lorena Cozzi 1, Marina Parolini 1, Paola Proserpio 2, Lino Nobili 2, Giorgio Gelosa 3, Immacolata Piccolo 4, Paolo Granda Marraccini 1. 1 CNR Institute of Clinical Physiology, Niguarda Ca Hospital, Milan, Italy; 2 Centre of Sleep Medicine, Department of Granda Hospital, Milan, Italy; 3 Neurology, Neuroscience, Niguarda Ca Granda Hospital, Milan, Italy; Department of Neuroscience, Niguarda Ca 4 Spinale, Niguarda Ca Granda Hospital., Milan, Italy Unita Objectives: Elevated oxidative stress and a pro-inflammatory response occur early in the course of Parkinson's disease (PD) and contribute to nigro-striatal degeneration. Non-motor symptoms (NMS), including sleep disturbances, olfactory and autonomic dysfunction affect all patients with PD. NMS may precede the onset of motor symptoms by many years and have been studied as prodromal PD markers. Whether antioxidant/inflammatory markers correlate with NMS in PD and idiopathic REM behaviour disorder (iRBD) and hence may serve as diagnostic and prognostic biomarkers of PD is currently unknown. Methods: Among patients with idiopathic PD [median and quartile (IIII), Hohen-Yahr stage 2.50 (2.50-3.00), nM-EDL-1 score 22.50 (13.7530.25), on L-DOPA 850 mg/day (263-928) and dopaminergic agents] subjects with documented iRBD, and healthy age- and gender-matched controls (CTRL) we compared the following (table): antioxidant/inflammatory markers [blood reduced glutathione (BR-GSH)/urine neopterin (NEO)], cardiac dysautonomia indexes [deep breathing ratio (DBR), lying to standing ratio (LSR), Valsalva ratio (MVR)] total olfactory score (TOS) by the Sniffin' Sticks Extended Test, Burghart. Results: TOS values were lower in iRBD and PD than in CTRL. BR-GSH concentrations differed significantly among groups, while MVR was lower in PD than CTRL. TOS correlated positively with MVR (R¼0.455, P¼0.026) and BR-GSH (R¼0.439, P¼0.028), and negatively with NEO (R¼-0.517, P¼0.007). Conclusions: Reduced antioxidant capacity and increased inflammatory response correlated with olfactory dysfunction, that was associated to iRBD and PD status. Antioxidant and inflammatory biomarkers deserved further investigation as useful tools for the identification of prodromal PD.
Contents lists available at ScienceDirect
Parkinsonism and Related Disorders journal homepage: www.elsevier.com/locate/parkreldis
Poster session 1 P 1.001. THE STUDY OF THE PREVALENCE OF PARKINSON DISEASE Kunduz Karbozova. Department Neurology with Medical Genetics, Bishkek, Kyrgyzstan Objectives: Parkinson's disease (PD) is the most common neurodegenerative disease, affecting over a million people in the world, and is characterized by rigidity, bradykinesia, resting tremor, and postural instability. Methods: Author examined 1098 patients in Neurology Department in National Hospital under Ministry of Health in Kyrgyzstan from January 2015 until June 2015. Among them 78 patients (mean age 64, 09±6.1 years) were with Parkinson disease. Diagnosis was verified according to the UK Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria and Hoehn and Yahr scale for diagnosis of Parkinson disease progress. Results: Among 78 patients, 45 were man and 33 women. The mean duration of disease was 6,2 ± 3,7 years (from 2 year to 22 years). The distribution in the form of the disease was as follows: 35 patients had akinetic-rigid form, 62- a mixed, and 5 e resting tremor. At the initial examination stage of Parkinson's disease on a scale of Hoehn and Yahr was diagnosed as a 1.5 - in 12 patients; 2.0 - at 17; 2.5 - at 28; 3.0 y 21. Average on a scale of Hoehn and Yahr was 2,52 ± 0,59 (p<0.05). Conclusions: 1. The highest prevalence rate of Parkinson's was among those aged over 64 years. 2. Average on a scale of Hoehn and Yahr was 2,52 ± 0,59 (p<0.05). 3. In our patients prevailed mixed form of Parkinson disease. P 1.002. SEX DIFFERENCES IN PARKINSON'S DISEASE Urszula Fiszer, Malgorzata Michalowska, Tomasz Szatanowski. Department of Neurology and Epileptology, Centre of Postgraduate Medical Education, Warsaw, Poland Objectives: Sex-related differences in Parkinson's disease (PD) still remain poorly understood. The aimed of our study was to examine potential sex differences among patients with PD. Methods: Our study was conducted on 76 PD patients (40 female, 36 male, in similar age 67.2 ±9.4 vs 64.1 ±9.1). Outcome measures included: age of onset, duration of disease, UPDRS-III, IVA,B,C, symptoms of onset, clinical type according scale of Rooden et al., total daily levodopa equivalent dose (LEDD), and duration of levodopa (or dopamine agonist) treatment. Results: There were no differences between female and male patients with PD on: age of onset, duration of disease, UPDRS-III, IVA,B scores. Symptoms of onset, clinical type according scale of Rooden et al., were similar in both groups, as well as LEDD, duration of levodopa (or dopamine agonist) treatment. Female and male showed differences on UPDRS IVC features (0.7 ±0.9 vs 0.3 ±0.5 p¼0.039, Mann-Whitney test), (in particular: anorexia, nausea, vomiting - 10.3% female vs 0.0 % male, sleep disturbance - 39.3% female vs 22.5% male, symptomatic orthostasis - 15.4% female vs 11.8% male). Conclusions: Our study evidenced sex differences in non-motor features among patients with PD on dopaminergic treatment. Sex-delineated clinical assessment and potential differences must be considered in the
clinical management of PD. References: 1. van Rooden SM, et al., Clinical subtypes of Parkinson's disease. Mov Disord 2011, 26:51-58. Liu R, et al., Potential sex differences in nonmotor symptoms in early drug-naive Parkinson disease. Neurology 2015;84:2107-2115. P 1.003. AN UNEXPECTED HIGHER PREVALENCE OF PARKINSON'S DISEASE IN FEMALES THAN MALES IN THE PROVINCE OF TRENTO (ITALY): A CLUES FOR THE ETIOPATHOGENESIS? Maria Chiara Malaguti 1, Nicola Vanacore 2, Stefania Ferrari 3, Silvano Piffer 4, Riccardo Pertile 4, Riccardo Roni 5, Andrea Polverino 5, Maria Fabio Cembrani 6, Vincenzo Bertozzi 7, Maria Gentilini 4, Pellegrini 3, Daniele Orrico 3. 1 Neurology department, Santa Chiara Hospital, Trento, Trento, Italy; 2 National Institute of Health, Rome, Italy; 3 Department of Neurology, Santa Chiara Hospital Trento, Trento, Italy; 4 Epidemiology Unit APSS Trento, Trento, Italy; 5 Pharmaceutical Services APSS, Trento, Italy; 6 Forensic Medicine Unit APSS, Trento, Italy; 7 Provincial Statistical Institute Trento, Trento, Italy Objectives: Parkinson's disease (PD) is a sporadic neurodegenerative disorder that affects mainly older individuals. The worldwide estimate of the prevalence rate of PD is 31.5 cases per 10,000 pop (95% CI 11.3-87.3). The aim of the present study is to estimate for the first time the prevalence of PD along with its relation to age, gender, and geographical location in the population of Trentino using a novel methodology. Methods: We identified all potential PD cases using five sources. The originality of our methodological approach is the use of the provincial health information system (PIS), that allowed us to screen singularly the clinical reports of each possible patient with PD. Pre-existing diagnoses of PD were not accepted as reported, but Gelb's criteria were applied to confirm each diagnosis. Results: Overall crude prevalence of PD was 21.43 per 10.000 pop, while crude prevalence rates of PD in males and females were respectively 20.64 and 22.19 per 10.000 pop. These prevalence rates are very similar to those reported by high quality studies such as door to door studies. Conclusions: Our study used a novel methodological approach to estimate the prevalence of PD in Trentino. Our results confirm that the prevalence of PD increases with age. However, we found an unexpected higher prevalence of PD in females, with an M/F ratio lower than one. Our findings open new perspectives in the complex pathogenic mechanisms of PD, including possible interactions between genetic and environmental factors. P 1.004. PARKINSON'S DISEASE IN SENEGAL: EPIDEMIOLOGIC, CLINICAL AND THERAPEUTIC ASPECTS Ndiaga Matar Gaye, Lala Bouna Seck, Ngor Side Diagne, Adjaratou Dieynabou Sow, Alassane Mamadou Diop, Ousmane Cisse, Anna Basse me Soda Diop, Kamadore Toure, Moustapha Ndiaye, Amadou Faye, Marie Gallo Diop, Mouhamadou Mansour Ndiaye. Department of Neurology, Fann Teaching Hospital, Dakar, Senegal
e30
Abstracts / Parkinsonism and Related Disorders 22 (2016) e29ee75
Objectives: The aim was to determine the epidemiologic, clinical and therapeutic aspects of patients treated for PD. Methods: This was a prospective and cross-sectional study conducted over 13 months on 19 patients treated for Parkinson's disease at the Neurology department of Dakar. The data have been collected using a pre-established form for the survey. Results: Sex ratio was 12/7 and the mean age was 65.26 ± years. The Wolof was the most represented ethnic group with 47.36%. 68.42% were married. 21.05% were farmers and 63.15% had achieved the primary level education. Consanguinity was found in 42.12% cases and the use of pesticides was noted in 15.78%. The average age of onset was around 60.52 ± years. Tremor was the first functional sign (68.42%) and 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%), sleep disturbances (31.57%). Brain CT was available in five patients and was normal in four of them. 36.84% of the patients were receiving only (Levodopa + benserazide or carbidopa) or piribedil and 52.63% one of these in association with Trihexyphenidyl. 42.10% were benefiting of physiotherapy. Conclusions: 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. P 1.006. BIRTH MONTH RELATIONSHIP?
AND
PARKINSON'S
DISEASE:
IS
THERE
ANY
Ryoichi Kurisaki, Hiroko Hori, Keiichi Nakahara, Aki Kuratomi, Yasuto Nishida, Kazutoshi Uekawa. Department of Neurology, National Hospital Organization Kumamoto-Minami National Hospital, Uki, Japan Objectives: It is reported that some lifetime disease risks are affected by a patient's birth month. Concerning Parkinson's disease (PD), little information has been reported on the relationship. The objective of this study is to investigate the affect of the birth month on patients with PD. Methods: We researched the birth months of all out- and in-patients with PD in our institute (Kumamoto, Japan) in March and April, 2015. We performed a statistical analysis to clarify the relationship of birth months and patients with PD. Results: Demographic characteristics of patients with PD were: total, 176, male, 71, female, 105; mean age, 72.2 ± 10.1 years old; median birth year, 1941 (1922 - 1973). We found the highest number of PD patients were born in January (n¼22, 12.5%), most of them being male (n¼13). The fewest PD subjects were born in June (n¼8, 4.5%) and the second least in September (n¼10, 5.7%). However, these findings were not significant after a x2-test and these tendencies were very similar to pre- World War II monthly birth ratios in Japan. Conclusions: The birth month may have a limited effect on the onset in PD patients; however, these tendencies may change within the next several decades. Further study is needed. References: 1. Statistics and Information Department, Ministry of Health, Labour and Welfare [Internet]. [updated 2002 March 15; cited 2015 August 31]. Available from: http://www.mhlw.go.jp/toukei/saikin/hw/jinkou/tokusyu/ syussyo-4/syussyo1-2.html P 1.009. OCCUPATIONAL EXPOSURE TO ORGANIC SOLVENTS AND WELDING FUMES AND RISK OF PARKINSON'S DISEASE Kalimuthu Kovendan 1, Ramachandran Chandirasekar 1, Kadarkarai Murugan 1, Savariar Vincent 2. 1 Department of Zoology, School of Life Sciences, Bharathiar University, Coimbatore, 641 046, Tamil Nadu, India; 2 P.G. Research & Department of Advanced Zoology and Biotechnology, Loyola College, Nungambakkam, Chennai 600 034, India Objectives: Organic solvents are widely used in industry and are present in products as fuels, paints, printing inks, degreasers and cleaning products.
Long term exposures might be associated with neurodegenerative diseases, such as Parkinson's disease (PD). The aim of this study was to investigate the potential association between occupational exposure to solvents welding fumes and risk of developing PD and genetics susceptibility. Methods: 65 Occupational exposed subjects and 65 controls were studied (age and sex matched). Blood samples were collected from the study subjects, Occupational histories and lifestyle information of cases and controls were collected in hospital. Exposures to aromatic solvents and welding fumes were estimated using self-reported information on welding and painting activities. Results: Welders have increased chromosome aberrations when compared to controls. Furthermore, more aberrations were observed in the chromosomes of the smoking welders when compared to the nonsmoking welders as well as controls. The XRCC 1 (arg339gln) polymorphic analysis heterozygous (arg/gln) genotype was higher. A mild PD risk was found in painting and welding workers with high exposures but there was no significance reached. Conclusion: Metal compounds should be considered as a warning indication of potentially adverse genetic and somatic effects in humans. Failure of this system may lead to development of cancer and other genetic diseases. After occupational exposure to aromatic solvents, chlorinated solvents or exposure to metals the results showed reduced risk estimates for welding and painting. A very limited role of genetic polymorphism was investigated in modulating the PD risk, but the combined effect of these variants may interact to increase the risk of PD. P 1.011. AN EXPLORATIVE ASSESSMENT OF ANTIOXIDANT AND INFLAMMATORY BIOMARKERS FOR IDENTIFICATION OF PRODROMAL PARKINSON'S DISEASE (PD) Jonica Campolo 1, Renata De Maria 1, Lorena Cozzi 1, Marina Parolini 1, Paola Proserpio 2, Lino Nobili 2, Giorgio Gelosa 3, Immacolata Piccolo 4, Paolo Granda Marraccini 1. 1 CNR Institute of Clinical Physiology, Niguarda Ca Hospital, Milan, Italy; 2 Centre of Sleep Medicine, Department of Granda Hospital, Milan, Italy; 3 Neurology, Neuroscience, Niguarda Ca Granda Hospital, Milan, Italy; Department of Neuroscience, Niguarda Ca 4 Spinale, Niguarda Ca Granda Hospital., Milan, Italy Unita Objectives: Elevated oxidative stress and a pro-inflammatory response occur early in the course of Parkinson's disease (PD) and contribute to nigro-striatal degeneration. Non-motor symptoms (NMS), including sleep disturbances, olfactory and autonomic dysfunction affect all patients with PD. NMS may precede the onset of motor symptoms by many years and have been studied as prodromal PD markers. Whether antioxidant/inflammatory markers correlate with NMS in PD and idiopathic REM behaviour disorder (iRBD) and hence may serve as diagnostic and prognostic biomarkers of PD is currently unknown. Methods: Among patients with idiopathic PD [median and quartile (IIII), Hohen-Yahr stage 2.50 (2.50-3.00), nM-EDL-1 score 22.50 (13.7530.25), on L-DOPA 850 mg/day (263-928) and dopaminergic agents] subjects with documented iRBD, and healthy age- and gender-matched controls (CTRL) we compared the following (table): antioxidant/inflammatory markers [blood reduced glutathione (BR-GSH)/urine neopterin (NEO)], cardiac dysautonomia indexes [deep breathing ratio (DBR), lying to standing ratio (LSR), Valsalva ratio (MVR)] total olfactory score (TOS) by the Sniffin' Sticks Extended Test, Burghart. Results: TOS values were lower in iRBD and PD than in CTRL. BR-GSH concentrations differed significantly among groups, while MVR was lower in PD than CTRL. TOS correlated positively with MVR (R¼0.455, P¼0.026) and BR-GSH (R¼0.439, P¼0.028), and negatively with NEO (R¼-0.517, P¼0.007). Conclusions: Reduced antioxidant capacity and increased inflammatory response correlated with olfactory dysfunction, that was associated to iRBD and PD status. Antioxidant and inflammatory biomarkers deserved further investigation as useful tools for the identification of prodromal PD.