Exercise increases caudate dopamine release and ventral striatal activation in Parkinson's disease.

Background: The objective of this study was to examine the effects of aerobic exercise on evoked dopamine release and activity of the ventral striatum using positron emission tomography and functional magnetic resonance imaging in Parkinson's disease (PD).

Methods: Thirty-five participants were randomly allocated to a 36-session aerobic exercise or control intervention. Each participant underwent an functional magnetic resonance imaging scan while playing a reward task before and after the intervention to determine the effect of exercise on the activity of the ventral striatum in anticipation of reward.

Single Inflammatory Trigger Leads to Neuroinflammation in LRRK2 Rodent Model without Degeneration of Dopaminergic Neurons.

Background: Leucine-rich repeat kinase 2 (LRRK2) mutations are the most common genetic risk factor for Parkinson's disease (PD). While the corresponding pathogenic mechanisms remain largely unknown, LRRK2 has been implicated in the immune system.

Objective: To assess whether LRRK2 mutations alter the sensitivity to a single peripheral inflammatory trigger, with ultimate impact on dopaminergic integrity, using a longitudinal imaging-based study design.

Habitual exercisers versus sedentary subjects with Parkinson's Disease: Multimodal PET and fMRI study.

Background: The benefits of exercise in PD have been linked to enhanced dopamine (DA) transmission in the striatum.

Objective: To examine differences in DA release, reward signaling, and clinical features between habitual exercisers and sedentary subjects with PD.

Methods: Eight habitual exercisers and 9 sedentary subjects completed [ C]raclopride PET scans before and after stationary cycling to determine exercise-induced release of endogenous DA in the dorsal striatum.

Win-Concurrent Sensory Cues Can Promote Riskier Choice.

Reward-related stimuli can potently influence behavior; for example, exposure to drug-paired cues can trigger drug use and relapse in people with addictions. Psychological mechanisms that generate such outcomes likely include cue-induced cravings and attentional biases. Recent animal data suggest another candidate mechanism: reward-paired cues can enhance risky decision making, yet whether this translates to humans is unknown.

A before-after study of hospital use in two frail populations receiving different home-based services over the same time in Vancouver, Canada.

Background: As individuals age, they are more likely to experience increasing frailty and more frequent use of hospital services. First, we explored whether initiating home-based primary care in a frail homebound cohort, influenced hospital use. Second, we explored whether initiating regular home care support for personal care with usual primary care, in a second somewhat less frail cohort, influenced hospital use.

Serotonin and dopamine transporter PET changes in the premotor phase of LRRK2 parkinsonism: cross-sectional studies.

Background: People with Parkinson's disease can show premotor neurochemical changes in the dopaminergic and non-dopaminergic systems. Using PET, we assessed whether dopaminergic and serotonin transporter changes are similar in LRRK2 mutation carriers with Parkinson's disease and individuals with sporadic Parkinson's disease, and whether LRRK2 mutation carriers without motor symptoms show PET changes.

Methods: We did two cross-sectional PET studies at the Pacific Parkinson's Research Centre in Vancouver, BC, Canada.

[11C]PBR28 PET imaging is sensitive to neuroinflammation in the aged rat.

Neuroinflammation in the aging rat brain was investigated using [(11)C]PBR28 microPET (positron emission tomography) imaging. Normal rats were studied alongside LRRK2 p.G2019S transgenic rats; this mutation increases the risk of Parkinson's disease in humans.

In vivo dopaminergic and serotonergic dysfunction in DCTN1 gene mutation carriers.

Introduction: We used positron emission tomography (PET) to assess dopaminergic and serotonergic terminal density in three subjects carrying a mutation in the DCT1 gene, two clinically affected with Perry syndrome.

Methods: All subjects had brain imaging using 18F-6-fluoro-l-dopa (FDOPA, dopamine synthesis and storage), (+)-11C-dihydrotetrabenazine (DTBZ, vesicular monoamine transporter type 2), and 11C-raclopride (RAC, dopamine D2/D3 receptors). One subject also underwent PET with 11C-3-amino-4-(2-dimethylaminomethyl-phenylsulfanyl)-benzonitrile (DASB, serotonin transporter).

Retrospective study of the impact of fellowship training on two quality and safety measures in uterine artery embolization.

Rationale And Objectives: To measure the impact of 1-year interventional fellowship training on fluoroscopic time and contrast media utilization in uterine artery embolization (UAE).

Materials And Methods: Retrospective single institution analysis of 323 consecutive UAEs performed by 12 interventional fellows using a standardized protocol. Fluoroscopy time and contrast media volume were recorded for each patient and correlated with stage of fellowship training.

Nursing home characteristics associated with resident transfers to emergency departments.

This study examined how nursing home facility ownership and organizational characteristics relate to emergency department (ED) transfer rates. The sample included a retrospective cohort of nursing home residents in the Vancouver Coastal Health region (n = 13,140). Rates of ED transfers were compared between nursing home ownership types.

The nature of progression in Parkinson's disease: an application of non-linear, multivariate, longitudinal random effects modelling.

Background: To date, statistical methods that take into account fully the non-linear, longitudinal and multivariate aspects of clinical data have not been applied to the study of progression in Parkinson's disease (PD). In this paper, we demonstrate the usefulness of such methodology for studying the temporal and spatial aspects of the progression of PD. Extending this methodology further, we also explore the presymptomatic course of this disease.

Effectiveness of educational interventions on asthma self-management in Punjabi and Chinese asthma patients: a randomized controlled trial.

Background: Asthma tends to be less well controlled among ethnic minority groups, and its prevalence in new immigrants increases significantly the longer they are in Canada; mainly due to their lack of familiarity with English and difficulty understanding information regarding the disease, health literacy, cultural issues, housing conditions, and lack of access to appropriate care services.

Objective: To explore the effectiveness of different formats of culturally relevant information and its impact on asthma patients' self-management within the Punjabi, Mandarin, and Cantonese communities.

Methods: Using a participatory approach, we developed and tested knowledge and community educational videos (with similar information, but used a different approach, i.

Does this patient with liver disease have cirrhosis?

Context: Among adult patients with liver disease, the ability to identify those most likely to have cirrhosis noninvasively is challenging.

Objective: To identify simple clinical indicators that can exclude or detect cirrhosis in adults with known or suspected liver disease.

Data Sources: We searched MEDLINE and EMBASE (1966 to December 2011) and reference lists from retrieved articles, previous reviews, and physical examination textbooks.

Longitudinal evolution of compensatory changes in striatal dopamine processing in Parkinson's disease.

Parkinson's disease is a relentlessly progressive neurodegenerative disease. Breakdown of compensatory mechanisms influencing putaminal dopamine processing could contribute to the progressive motor symptoms. We studied a cohort of 78 subjects (at baseline) with sporadic Parkinson's disease and 35 healthy controls with multi-tracer positron emission tomography scans to investigate the evolution of adaptive mechanisms influencing striatal dopamine processing in Parkinson's disease progression.

Age-specific progression of nigrostriatal dysfunction in Parkinson's disease.

Objective: To investigate in vivo the impact of age on nigrostriatal dopamine dysfunction in Parkinson's disease (PD).

Methods: PD patients (n = 78) and healthy control subjects (n = 35) underwent longitudinal positron emission tomography assessments using 3 presynaptic dopamine markers: (1) [¹¹C](±)dihydrotetrabenazine (DTBZ), to estimate the density of the vesicular monoamine transporter type 2; (2) [¹¹C]d-threo-methylphenidate, to estimate the density of the plasma membrane dopamine transporter; and (3) 6-[¹⁸F]-fluoro-L-dopa, to estimate the activity of the enzyme dopa-decarboxylase.

Results: The study comprised 438 PD scans and 241 control scans (679 scans in total).

Complaints in for-profit, non-profit and public nursing homes in two Canadian provinces.

Background: Nursing homes provide long-term housing, support and nursing care to frail elders who are no longer able to function independently. Although studies conducted in the United States have demonstrated an association between for-profit ownership and inferior quality, relatively few Canadian studies have made performance comparisons with reference to type of ownership. Complaints are one proxy measure of performance in the nursing home setting.

Dopamine turnover increases in asymptomatic LRRK2 mutations carriers.

Increase in dopamine (DA) turnover was found to occur early in symptomatic Parkinson's disease (PD) and to be functionally related to the dopamine transporter (DAT). The objectives of this study were to examine changes in DA turnover in the asymptomatic PD phase; to compare them with changes in other dopaminergic markers, and to investigate a possible relationship between DAT and DA turnover. Eight subjects from families at increased risk of PD due to LRRK2 mutation were investigated.

Influence of the mother's preceding pregnancies on fetal development and postnatal survival of the neonate, in normal pregnancy. An immunological phenomenon?

Objectives: The objective of this study is to test for an association between the sex of conceptuses of the mother's preceding pregnancies and fetal development and early neonatal survival in normal pregnancy.

Methods: A population of 27,243 neonates, including a subsample of 7,773 "newborn/mother/placenta units" were divided into cohorts according to the sex of the neonate and the sex and number of conceptuses of the mother's preceding pregnancies. The average birth weight, placenta weight and early neonatal mortality rate were measured for each cohort and compared.

Levodopa and pramipexole effects on presynaptic dopamine PET markers and estimated dopamine release.

Purpose: Levodopa and dopamine (DA) agonist therapy are two common treatments for Parkinson's disease (PD). There is controversy about the effects of these treatments on disease progression and imaging markers. Here we used multi-tracer positron emission tomography imaging and a unilateral 6-hydroxydopamine (6-OHDA) rat model of PD to evaluate in vivo the effects of chronic levodopa and pramipexole treatments on measurements of vesicular monoamine transporter type 2 (VMAT2), dopamine transporter (DAT) levels, and on levodopa-induced changes in synaptic DA levels [Δ(DA)].

Effects of expectation on placebo-induced dopamine release in Parkinson disease.

Context: Expectations play a central role in the mechanism of the placebo effect. In Parkinson disease (PD), the placebo effect is associated with release of endogenous dopamine in both nigrostriatal and mesoaccumbens projections, yet the factors that control this dopamine release are undetermined.

Objective: To determine how the strength of expectation of clinical improvement influences the degree of striatal dopamine release in response to placebo in patients with moderate PD.

Response to heat pain stimulation in idiopathic Parkinson's disease.

Background: Pain is a prominent nonmotor symptom in Parkinson's disease (PD) but has not been well studied.

Objective: The aim of this study is to assess thermal experience and emotional content, as well as side-to-side sensory differences in PD "off" and "on" dopaminergic therapy following thermal cutaneous stimulation.

Design: Cross-sectional design.

Trials of neuroprotective therapies for Parkinson's disease: problems and limitations.

Since the initial results of the DATATOP study, considerable effort has been devoted over the past 20 years to test neuroprotective therapies for Parkinson's disease (PD). Two trials (CALM-PD-CIT and REAL-PET studies) used neuroimaging dopamine changes as a surrogate marker for PD progression, and concluded that pramipexole and ropinirole could have a neuroprotective effect compared to levodopa. However, it should be recognized that all the presynaptic dopamine markers currently available for SPECT and PET studies are potentially subject to regulatory changes.