engleski

Enviromental influences and toxic substance exposure and characteristics of Parkinson's disease

Objectives: Epidemiological studies support the hypothesis that Parkinson&#8217; s disease (PD) may be caused by environmental factors, but etiology of PD is still uncertain. It is also widely accepted that there is a genetic component of the disease and the earlier the age of onset, the greater the likelihood that genetic factors play a dominant role.We initiated this study to detect possible neurotoxic influence on clinical course, disease characteristics and morphology of Substantia Nigra (SN) as detected by transcranial sonography (TCS) in PD patients. Methods:Our study included 47 PD patients with PD diagnosis based on Parkinson&#8217; s disease Society Brain Research Centre clinical criteria. Severity of the disease was recorded according to Unified Parkinson&#8217; s Disease rating Scale (UPDRS) and Hoehn&Yahr rating scale.According to epidemiological screen three subgroups were made ; 26 PD patients without any data about exposure to known PD related toxins, 15 PD patients occasionally exposed and 6 patients professionally daily exposed to numerous neurotoxic potent chemicals.Epidemiological screen data included exposure to pesticides, herbicides, heavy metals (manganese, mercury, lead, iron, zinc), organic solvents, head trauma, smoking, rural living and well water drinking. All patients underwent complete neurological and sonographic examination. Each patient underwent brain parenchyma sonography and hyperechogenicity of SN was measured by standardized protocol. Results: Our results showed younger age of PD onset (p<0.05), the fastest development of late motor complications (p<0.001), rigor as dominating symptom, and UPDRS and H&Y score showing higher motor disability (p<0.05) in highly exposed group. However, sonographic examination revealed no statistically significant difference in SN echogenicity between groups. Conclusion: Results of this study suggest that exposure to toxins could cause younger age of onset of PD, acceleration of PD progression and higher incidence of motor disability. However, it appears like toxic influence does not have influence on SN size as detected by sonography.

Parkinson's disease; Environmental influence; toxins; heavy metals

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