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Frontiers in Neuroscience
Parkinson’s disease (PD) is a heterogenous neurodegenerative disorder. Genetic factors play a sig... more Parkinson’s disease (PD) is a heterogenous neurodegenerative disorder. Genetic factors play a significant role, especially in early onset and familial cases. Mutations are usually found in the LRRK2 gene, but their importance varies. Some mutations, such as p.Arg1441Cys or other alterations in the 1441 codon, show clear correlation with PD, whereas others are risk factors found also in healthy populations or have neglectable consequences. They also exhibit various prevalence among different populations. The aim of this paper is to sum up the current knowledge regarding the epidemiology and pathogenicity of LRRK2 mutations, other than the well-established p.Gly2019Ser. We performed a review of the literature using PubMed database. 103 publications met our inclusion criteria. p.Arg1441Cys, p.Arg1441Gly, p.Arg1441His, p.Arg1441Ser are the most common pathogenic mutations in European populations, especially Hispanic. p.Asn1437His is pathogenic and occurs mostly in the Scandinavians. p.A...
Annals of Physical and Rehabilitation Medicine, 2018
in the Norwegian Constraint Induced Movement Therapy trial (NORCIMT). The patients were recruited... more in the Norwegian Constraint Induced Movement Therapy trial (NORCIMT). The patients were recruited 7-28 days' post-stroke and had mild to moderate symptoms. RFD (0-250 ms) and sustained maximal grip force (15 s) were recorded for the paretic and nonparetic hand with a hand dynamometer and a pinchmeter (G/P200, Biometrics Ltd., UK) using the testing positions recommended by the American Society of Hand Therapists. All participants were tested 5 times (at inclusion; 2, 26, 28 and 52 weeks after inclusion). Results At inclusion, mean (SD) RFD from the dynamometer was 25.1 (22.3) and 75.0 (44) kg/s in the affected and non-affected hand respectively (P = 0.003). However, RFD increased and the difference was no longer significant after 2 weeks. Contrary, the ability to sustain maximal grip strength was similar for both hands at inclusion, however it was reduced (P < 0.001) for the affected hand if the values were normalized to maximum voluntary contraction. On the affected side, most of the decrease in strength occurred during the first 3 seconds, while it decreased continuously on the non-affected side. The affected hand approached the capacity of the non-affected hand during the 52-weeks follow-up period. Pinchmeter recordings showed comparable results. Conclusion Although RFD and the ability to sustain maximal grip strength is reduced in the affected hand early after stroke, this study shows that the difference between affected and non-affected hand decreases markedly during the first year after stroke.
Lekarz POZ, 2021
Choroby neurologiCzne w POZ Streszczenie Choroba Alzheimera, która jest najczęstszą przyczyną otę... more Choroby neurologiCzne w POZ Streszczenie Choroba Alzheimera, która jest najczęstszą przyczyną otępienia, dotyczy znacznej i ciągle powiększającej się populacji osób w wieku podeszłym. W większości przypadków zaczyna się od postępujących zaburzeń pamięci świeżej, do których stopniowo dołączają się deficyty innych funkcji poznawczych. Do czynników ryzyka rozwoju choroby Alzheimera należą czynniki ryzyka chorób sercowo-naczyniowych, jak również rzadkie mutacje genetyczne. Osoby cierpiące na chorobę Alzheimera są szczególnie narażone na infekcję SARS-CoV-2. W tej grupie choroba COVID-19 ma zwykle cięższy przebieg i częściej kończy się zgonem. Izolacja od bliskich i konieczność utrzymania reżimu sanitarnego może być dla tej grupy chorych trudna do zrozumienia oraz wywoływać reakcje gniewu i złości lub powodować obniżenie nastroju. Ostre nasilenie zaburzeń poznawczych oraz pojawienie się objawów psychotycznych może być u pacjentów z otępieniem wczesną manifestacją infekcji COVID-19. Każde wystąpienie pobudzenia oraz psychozy u osób z chorobą Alzheimera wymaga wykluczenia przyczyn somatycznych przed włączeniem leczenia farmakologicznego. Pod wpływem pandemii znacznie pogorszył się dostęp do wczesnej diagnostyki i leczenia otępień. Bardzo ważna rola przypadła lekarzom podstawowej opieki zdrowotnej, którzy dzięki bezpośredniemu i częstemu kontaktowi z chorymi mogą wykryć pierwsze, dyskretne objawy otępienia i skierować do właściwego specjalisty.
Parkinsonism & Related Disorders, 2020
European Journal of Neurology, 2015
Recently, a novel mutation in exon 24 of DNAJC13 gene (p.Asn855Ser, rs387907571) has been reporte... more Recently, a novel mutation in exon 24 of DNAJC13 gene (p.Asn855Ser, rs387907571) has been reported to cause autosomal dominant Parkinson's disease (PD) in a multi-incident Mennonite family. In the present study we have sequenced the mutation containing exon of the DNAJC13 gene in a Caucasian series consisting of 1938 patients with clinical PD and 838 pathologically
Journal of the Neurological Sciences, 2009
Identification of Parkinson's Disease (PD) patients at risk for development of dementia is cr... more Identification of Parkinson's Disease (PD) patients at risk for development of dementia is crucial for early intervention. However, diagnosing dementia in PD patients requires advanced, time-consuming and expensive imaging techniques (such as DaT-SCAN-SPECT). The study aims to prove the usefulness of convolutional neural networks (CNN) for the identification of brain areas related to the progress of cognitive impairment by using standard Magnetic Resonance Imaging (MRI) sequences. T1&T2 sequences of 18 patients were used in the pilot study. Activation maps were generated, and the brain regions most involved in the classification process were identified, showing areas potentially significant in the diagnosis of cognitive impairment severity. The cerebellum was proven significant for distinguishing the above-mentioned classes in relative cerebellum volume (ANOVA p-value=0.0038 with large effect size η2=0.5254) and folding (p-value=0.0031, η2=0.5357), which is consistent with repor...
International Journal of Molecular Sciences
Parkinson’s disease (PD) is generally considered a sporadic disorder, but a strong genetic backgr... more Parkinson’s disease (PD) is generally considered a sporadic disorder, but a strong genetic background is often found. The aim of this study was to identify the underlying genetic cause of PD in two affected siblings and to subsequently assess the role of mutations in Cathepsin B (CTSB) in susceptibility to PD. A typical PD family was identified and whole-exome sequencing was performed in two affected siblings. Variants of interest were validated using Sanger sequencing. CTSB p.Gly284Val was genotyped in 2077 PD patients and 615 unrelated healthy controls from the Czech Republic, Ireland, Poland, Ukraine, and the USA. The gene burden analysis was conducted for the CTSB gene in an additional 769 PD probands from Mayo Clinic Florida familial PD cohort. CTSB expression and activity in patient-derived fibroblasts and controls were evaluated by qRT-PCR, western blot, immunocytochemistry, and enzymatic assay. The CTSB p.Gly284Val candidate variant was only identified in affected family mem...
Parkinsonism & Related Disorders, 2020
Parkinsonism & Related Disorders, 2020
Mild cognitive impairment (MCI) is a risk factor of dementia. Early impairment in epi‐ sodic memo... more Mild cognitive impairment (MCI) is a risk factor of dementia. Early impairment in epi‐ sodic memory is considered to be a predictor of progression to dementia. The goal of the study was to evaluate the utility of baseline cognitive testing of episodic and working memory in the risk assess‐ ment of the dementia development in MCI. We studied 55 MCI patients and 44 controls, assessed annually by a set of neuropsychological tests for four years. The Petersen criteria were used to diag‐ nose MCI, and DSM‐IV criteria were applied to diagnose dementia. Variant analysis revealed signifi‐ cant differences in the results of individual cognitive tests between MCI converters who developed Alzheimer’s disease (AD) at follow up, MCI non‐converters, and controls (p < 0,05). At baseline, MCI converters had significant impairment in all tests comparing to MCI non‐converters. APOE4 status had a significant influence on AD development in our MCI group (p = 0,0022). The study showed that significan...
Neurologia i Neurochirurgia Polska, 2021
This article is available in open access under Creative Common Attribution-Non-Commercial-No Deri... more This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
Human molecular genetics, Sep 11, 2016
Parkinson's disease (PD) is the most common cause of neurodegenerative movement disorder and ... more Parkinson's disease (PD) is the most common cause of neurodegenerative movement disorder and the second most common cause of dementia. Genes are thought to have a stronger effect on age-at-onset of PD than on risk, yet there has been phenomenal success in identifying risk loci but not age-at-onset modifiers. We conducted a genome-wide study for age-at-onset. We analyzed familial and non-familial PD separately, per prior evidence for strong genetic effect on age-at-onset in familial PD. GWAS was conducted in 431 unrelated PD individuals with at least one affected relative (familial PD) and 1544 non-familial PD from the NeuroGenetics Research Consortium (NGRC); an additional 737 familial PD and 2363 non-familial PD were used for replication. In familial PD, two signals were detected and replicated robustly: one mapped to LHFPL2 on 5q14.1 (PNGRC=3E-8, PReplication=2E-5, PNGRC+Replication=1E-11), the second mapped to TPM1 on 15q22.2 (PNGRC=8E-9, PReplication=2E-4, PNGRC+Replication=...
Neurology: Genetics, 2015
Objective: To investigate the top late-onset Alzheimer disease (LOAD) risk loci detected or confi... more Objective: To investigate the top late-onset Alzheimer disease (LOAD) risk loci detected or confirmed by the International Genomics of Alzheimer's Project for association with brain gene expression levels to identify variants that influence Alzheimer disease (AD) risk through gene expression regulation. Methods: Expression levels from the cerebellum (CER) and temporal cortex (TCX) were obtained using Illumina whole-genome cDNA-mediated annealing, selection, extension, and ligation assay (WG-DASL) for ;400 autopsied patients (;200 with AD and ;200 with non-AD pathologies). We tested 12 significant LOAD genome-wide association study (GWAS) index single nucleotide polymorphisms (SNPs) for cis association with levels of 34 genes within 6100 kb. We also evaluated brain levels of 14 LOAD GWAS candidate genes for association with 1,899 cis-SNPs. Significant associations were validated in a subset of TCX samples using next-generation RNA sequencing (RNAseq). Results: We identified strong associations of brain CR1, HLA-DRB1, and PILRB levels with LOAD GWAS index SNPs. We also detected other strong cis-SNPs for LOAD candidate genes MEF2C, ZCWPW1, and SLC24A4. MEF2C and SLC24A4, but not ZCWPW1 cis-SNPs, also associate with LOAD risk, independent of the index SNPs. The TCX expression associations could be validated with RNAseq for CR1, HLA-DRB1, ZCWPW1, and SLC24A4. Conclusions: Our results suggest that some LOAD GWAS variants mark brain regulatory loci, nominate genes under regulation by LOAD risk variants, and annotate these variants for their brain regulatory effects.
Neurologia i neurochirurgia polska
Melkersson-Rosenthal syndrome is a rare cause of recurrent facial nerve palsy. The syndrome is cl... more Melkersson-Rosenthal syndrome is a rare cause of recurrent facial nerve palsy. The syndrome is classically characterized by a triad of signs consisting of facial edema, recurrent peripheral facial nerve paralysis, and congenital fissured tongue, although it may also present in a mono- or oligosymptomatic form. The paper presents a 24-year-old woman with right-sided peripheral facial nerve palsy and a history of left-sided episodes of facial nerve palsy. Magnetic resonance angiography of the cerebral vessels suggested compression of the right seventh and eighth cranial nerves by a vascular loop. The authors describe the patient with a complete picture of Melkersson-Rosenthal syndrome and discuss the diagnosing process and treatment.
Frontiers in Neuroscience
Parkinson’s disease (PD) is a heterogenous neurodegenerative disorder. Genetic factors play a sig... more Parkinson’s disease (PD) is a heterogenous neurodegenerative disorder. Genetic factors play a significant role, especially in early onset and familial cases. Mutations are usually found in the LRRK2 gene, but their importance varies. Some mutations, such as p.Arg1441Cys or other alterations in the 1441 codon, show clear correlation with PD, whereas others are risk factors found also in healthy populations or have neglectable consequences. They also exhibit various prevalence among different populations. The aim of this paper is to sum up the current knowledge regarding the epidemiology and pathogenicity of LRRK2 mutations, other than the well-established p.Gly2019Ser. We performed a review of the literature using PubMed database. 103 publications met our inclusion criteria. p.Arg1441Cys, p.Arg1441Gly, p.Arg1441His, p.Arg1441Ser are the most common pathogenic mutations in European populations, especially Hispanic. p.Asn1437His is pathogenic and occurs mostly in the Scandinavians. p.A...
Annals of Physical and Rehabilitation Medicine, 2018
in the Norwegian Constraint Induced Movement Therapy trial (NORCIMT). The patients were recruited... more in the Norwegian Constraint Induced Movement Therapy trial (NORCIMT). The patients were recruited 7-28 days' post-stroke and had mild to moderate symptoms. RFD (0-250 ms) and sustained maximal grip force (15 s) were recorded for the paretic and nonparetic hand with a hand dynamometer and a pinchmeter (G/P200, Biometrics Ltd., UK) using the testing positions recommended by the American Society of Hand Therapists. All participants were tested 5 times (at inclusion; 2, 26, 28 and 52 weeks after inclusion). Results At inclusion, mean (SD) RFD from the dynamometer was 25.1 (22.3) and 75.0 (44) kg/s in the affected and non-affected hand respectively (P = 0.003). However, RFD increased and the difference was no longer significant after 2 weeks. Contrary, the ability to sustain maximal grip strength was similar for both hands at inclusion, however it was reduced (P < 0.001) for the affected hand if the values were normalized to maximum voluntary contraction. On the affected side, most of the decrease in strength occurred during the first 3 seconds, while it decreased continuously on the non-affected side. The affected hand approached the capacity of the non-affected hand during the 52-weeks follow-up period. Pinchmeter recordings showed comparable results. Conclusion Although RFD and the ability to sustain maximal grip strength is reduced in the affected hand early after stroke, this study shows that the difference between affected and non-affected hand decreases markedly during the first year after stroke.
Lekarz POZ, 2021
Choroby neurologiCzne w POZ Streszczenie Choroba Alzheimera, która jest najczęstszą przyczyną otę... more Choroby neurologiCzne w POZ Streszczenie Choroba Alzheimera, która jest najczęstszą przyczyną otępienia, dotyczy znacznej i ciągle powiększającej się populacji osób w wieku podeszłym. W większości przypadków zaczyna się od postępujących zaburzeń pamięci świeżej, do których stopniowo dołączają się deficyty innych funkcji poznawczych. Do czynników ryzyka rozwoju choroby Alzheimera należą czynniki ryzyka chorób sercowo-naczyniowych, jak również rzadkie mutacje genetyczne. Osoby cierpiące na chorobę Alzheimera są szczególnie narażone na infekcję SARS-CoV-2. W tej grupie choroba COVID-19 ma zwykle cięższy przebieg i częściej kończy się zgonem. Izolacja od bliskich i konieczność utrzymania reżimu sanitarnego może być dla tej grupy chorych trudna do zrozumienia oraz wywoływać reakcje gniewu i złości lub powodować obniżenie nastroju. Ostre nasilenie zaburzeń poznawczych oraz pojawienie się objawów psychotycznych może być u pacjentów z otępieniem wczesną manifestacją infekcji COVID-19. Każde wystąpienie pobudzenia oraz psychozy u osób z chorobą Alzheimera wymaga wykluczenia przyczyn somatycznych przed włączeniem leczenia farmakologicznego. Pod wpływem pandemii znacznie pogorszył się dostęp do wczesnej diagnostyki i leczenia otępień. Bardzo ważna rola przypadła lekarzom podstawowej opieki zdrowotnej, którzy dzięki bezpośredniemu i częstemu kontaktowi z chorymi mogą wykryć pierwsze, dyskretne objawy otępienia i skierować do właściwego specjalisty.
Parkinsonism & Related Disorders, 2020
European Journal of Neurology, 2015
Recently, a novel mutation in exon 24 of DNAJC13 gene (p.Asn855Ser, rs387907571) has been reporte... more Recently, a novel mutation in exon 24 of DNAJC13 gene (p.Asn855Ser, rs387907571) has been reported to cause autosomal dominant Parkinson's disease (PD) in a multi-incident Mennonite family. In the present study we have sequenced the mutation containing exon of the DNAJC13 gene in a Caucasian series consisting of 1938 patients with clinical PD and 838 pathologically
Journal of the Neurological Sciences, 2009
Identification of Parkinson's Disease (PD) patients at risk for development of dementia is cr... more Identification of Parkinson's Disease (PD) patients at risk for development of dementia is crucial for early intervention. However, diagnosing dementia in PD patients requires advanced, time-consuming and expensive imaging techniques (such as DaT-SCAN-SPECT). The study aims to prove the usefulness of convolutional neural networks (CNN) for the identification of brain areas related to the progress of cognitive impairment by using standard Magnetic Resonance Imaging (MRI) sequences. T1&T2 sequences of 18 patients were used in the pilot study. Activation maps were generated, and the brain regions most involved in the classification process were identified, showing areas potentially significant in the diagnosis of cognitive impairment severity. The cerebellum was proven significant for distinguishing the above-mentioned classes in relative cerebellum volume (ANOVA p-value=0.0038 with large effect size η2=0.5254) and folding (p-value=0.0031, η2=0.5357), which is consistent with repor...
International Journal of Molecular Sciences
Parkinson’s disease (PD) is generally considered a sporadic disorder, but a strong genetic backgr... more Parkinson’s disease (PD) is generally considered a sporadic disorder, but a strong genetic background is often found. The aim of this study was to identify the underlying genetic cause of PD in two affected siblings and to subsequently assess the role of mutations in Cathepsin B (CTSB) in susceptibility to PD. A typical PD family was identified and whole-exome sequencing was performed in two affected siblings. Variants of interest were validated using Sanger sequencing. CTSB p.Gly284Val was genotyped in 2077 PD patients and 615 unrelated healthy controls from the Czech Republic, Ireland, Poland, Ukraine, and the USA. The gene burden analysis was conducted for the CTSB gene in an additional 769 PD probands from Mayo Clinic Florida familial PD cohort. CTSB expression and activity in patient-derived fibroblasts and controls were evaluated by qRT-PCR, western blot, immunocytochemistry, and enzymatic assay. The CTSB p.Gly284Val candidate variant was only identified in affected family mem...
Parkinsonism & Related Disorders, 2020
Parkinsonism & Related Disorders, 2020
Mild cognitive impairment (MCI) is a risk factor of dementia. Early impairment in epi‐ sodic memo... more Mild cognitive impairment (MCI) is a risk factor of dementia. Early impairment in epi‐ sodic memory is considered to be a predictor of progression to dementia. The goal of the study was to evaluate the utility of baseline cognitive testing of episodic and working memory in the risk assess‐ ment of the dementia development in MCI. We studied 55 MCI patients and 44 controls, assessed annually by a set of neuropsychological tests for four years. The Petersen criteria were used to diag‐ nose MCI, and DSM‐IV criteria were applied to diagnose dementia. Variant analysis revealed signifi‐ cant differences in the results of individual cognitive tests between MCI converters who developed Alzheimer’s disease (AD) at follow up, MCI non‐converters, and controls (p < 0,05). At baseline, MCI converters had significant impairment in all tests comparing to MCI non‐converters. APOE4 status had a significant influence on AD development in our MCI group (p = 0,0022). The study showed that significan...
Neurologia i Neurochirurgia Polska, 2021
This article is available in open access under Creative Common Attribution-Non-Commercial-No Deri... more This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
Human molecular genetics, Sep 11, 2016
Parkinson's disease (PD) is the most common cause of neurodegenerative movement disorder and ... more Parkinson's disease (PD) is the most common cause of neurodegenerative movement disorder and the second most common cause of dementia. Genes are thought to have a stronger effect on age-at-onset of PD than on risk, yet there has been phenomenal success in identifying risk loci but not age-at-onset modifiers. We conducted a genome-wide study for age-at-onset. We analyzed familial and non-familial PD separately, per prior evidence for strong genetic effect on age-at-onset in familial PD. GWAS was conducted in 431 unrelated PD individuals with at least one affected relative (familial PD) and 1544 non-familial PD from the NeuroGenetics Research Consortium (NGRC); an additional 737 familial PD and 2363 non-familial PD were used for replication. In familial PD, two signals were detected and replicated robustly: one mapped to LHFPL2 on 5q14.1 (PNGRC=3E-8, PReplication=2E-5, PNGRC+Replication=1E-11), the second mapped to TPM1 on 15q22.2 (PNGRC=8E-9, PReplication=2E-4, PNGRC+Replication=...
Neurology: Genetics, 2015
Objective: To investigate the top late-onset Alzheimer disease (LOAD) risk loci detected or confi... more Objective: To investigate the top late-onset Alzheimer disease (LOAD) risk loci detected or confirmed by the International Genomics of Alzheimer's Project for association with brain gene expression levels to identify variants that influence Alzheimer disease (AD) risk through gene expression regulation. Methods: Expression levels from the cerebellum (CER) and temporal cortex (TCX) were obtained using Illumina whole-genome cDNA-mediated annealing, selection, extension, and ligation assay (WG-DASL) for ;400 autopsied patients (;200 with AD and ;200 with non-AD pathologies). We tested 12 significant LOAD genome-wide association study (GWAS) index single nucleotide polymorphisms (SNPs) for cis association with levels of 34 genes within 6100 kb. We also evaluated brain levels of 14 LOAD GWAS candidate genes for association with 1,899 cis-SNPs. Significant associations were validated in a subset of TCX samples using next-generation RNA sequencing (RNAseq). Results: We identified strong associations of brain CR1, HLA-DRB1, and PILRB levels with LOAD GWAS index SNPs. We also detected other strong cis-SNPs for LOAD candidate genes MEF2C, ZCWPW1, and SLC24A4. MEF2C and SLC24A4, but not ZCWPW1 cis-SNPs, also associate with LOAD risk, independent of the index SNPs. The TCX expression associations could be validated with RNAseq for CR1, HLA-DRB1, ZCWPW1, and SLC24A4. Conclusions: Our results suggest that some LOAD GWAS variants mark brain regulatory loci, nominate genes under regulation by LOAD risk variants, and annotate these variants for their brain regulatory effects.
Neurologia i neurochirurgia polska
Melkersson-Rosenthal syndrome is a rare cause of recurrent facial nerve palsy. The syndrome is cl... more Melkersson-Rosenthal syndrome is a rare cause of recurrent facial nerve palsy. The syndrome is classically characterized by a triad of signs consisting of facial edema, recurrent peripheral facial nerve paralysis, and congenital fissured tongue, although it may also present in a mono- or oligosymptomatic form. The paper presents a 24-year-old woman with right-sided peripheral facial nerve palsy and a history of left-sided episodes of facial nerve palsy. Magnetic resonance angiography of the cerebral vessels suggested compression of the right seventh and eighth cranial nerves by a vascular loop. The authors describe the patient with a complete picture of Melkersson-Rosenthal syndrome and discuss the diagnosing process and treatment.
Background and Objectives: A growing number of studies correlated higher levels of serum uric aci... more Background and Objectives: A growing number of studies correlated higher levels of serum uric acid (UA) with both: lower risk of Parkinson’s Disease (PD) occurrence and slower progression of the disease. Similar conclusions were made where studies correlated UA with atypical Parkinsonisms (AP) progression. A few researchers have studied the issue of the influence of serum UA on the occurrence of non-motor symptoms (NMS) in PD and AP. Our systematic review is the first review completely dedicated to this matter. Materials and Methods: A comprehensive evaluation of the literature was performed to review the relationship between UA and NMS in PD and AP. The systematic review was conducted according to PRISMA Statement guidelines. The following databases were searched starting in April 2021: MEDLINE via PubMed, Embase, and Scopus. During the research, the following filters were used: >2010, articles in English, concerning humans. The study was not registered and received no external funding. Results: Seven articles meeting all inclusion criteria were included in this study. Collectively, data on 1104 patients were analyzed. A correlation between serum UA concentration and a few NMS types has been provided by the analyzed studies. In four papers, sleep disorders and fatigue were related to UA for both advanced and early PD. Other commonly appearing NMS domains were Attention/memory (4 studies), Depression/anxiety (3 studies), Cardiovascular (3 studies), Gastrointestinal (1 study), Perceptual (1 study), and Miscellaneous (1 study). For AP, no significant correlation between UA and worsening of NMS has been found. Conclusions: Based on the analyzed studies, a correlation between serum UA level and the occurrence and worsening of NMS in PD and APs cannot be definitively determined. Large-scale studies with a more diverse patient population and with more accurate methods of NMS assessment in Parkinsonism are needed.