e24 Abstracts / Parkinsonism and Related Disorders 46 (2018) e23ee27
Conclusions: PMD patients showed more body oscillations compared to
controls, and this effect in- creased over time, possibly due to the
increasing stress.
The change in cortisol for the controls reflected a freeze response (reduced
frequency with increasing stress). Interestingly, the inverse pattern was
observed in the patients, revealing an abnormal motor re- sponse to stress
(impaired freeze reaction).
OP-5-03
MICRORNA-4639 IS A REGULATOR OF DJ-1 EXPRESSION AND A
POTENTIAL DIAGNOSTIC MARKER FOR EARLY PARKINSON’S DISEASE
Y. Chen1,2, J. Ding1, S. Chen1,2. 1 Department of Neurology and Institute of
Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine,
Shanghai, China; 2 Institute of Health Sciences, Shanghai Institutes for
Biological Sciences, Chinese Academy of Sciences, Shanghai, China
Objective: Parkinson’s disease (PD), as the second most common neuro-
degenerative disorder, has pro- found impacts on patients’ daily life.
However, there is a lack of effective biomarkers for early diagno- sis, and
the mechanisms underlying pathogenesis of PD remain obscure. micro-
RNAs (miRNAs) are post- transcriptional gene regulators, which can be
easily detected in plasma, suggesting a promising role as diagnostic
markers. Here, we aimed to explore a peripheral biomarker, which not
only can be applied for accurate early PD diagnosis, but also has the po-
tential to be a therapeutic target.
Methods: miRNA microarray screening followed by quantitative real-time
PCR validation were used to identify abnormal expressed miRNAs in PD
patients. Dual-luciferase reporter assay and western blot were applied to
discover miRNA-target gene. We used CM-H2DCFDA probe and CCK-8
reagent to measure reac- tive oxygen species level and cell viability in
miRNA overexpessed or inhibited cells.
Results: Plasma samples from 169 sporadic PD patients, 170 healthy con-
trols and 60 essential tremor patients were examined, and hsa-miR-4639-
5p was identified to significantly up-regulated in PD patients. It has
adequate sensitivity and specificity to discriminate early PD (disease
duration
2 years or Hoehn & Yahr stage 1) and healthy controls.
Furthermore, preliminary data showed that increased plasma miR- 4639 in
PD patients is mainly derived from central nervous system-exosomes.
Additionally, hsa-miR-4639- 5p was proved to be the post-transcriptional
regulator of DJ-1 (PARK7), a well-known PD-related gene. Abnormal up-
regulation of hsa-miR-4639-5p cause down-regulation of DJ-1 protein
level, leading to se- vere oxidative stress and neuronal death.
Conclusions: hsa-miR-4639-5p has the potential to be a peripheral diag-
nostic biomarker and therapeutic target for early PD.
OP-5-04
CHRONIC MUCUNA PRURIENS IN PARKINSON’S DISEASE: A NON-
INFERIORITY, RANDOMISED, CROSSOVER, PHASE-2B TRIAL
R. Cilia1, J. Laguna2, E. Cassani1, E. Cereda3, B. Raspini1, M. Barichella1, G.
Pezzoli1. 1 Parkinson Institute, ASST Gaetano Pini-CTO, Milan, Italy;
2
Neurology Clinic, Clinica Nin~ o Jesus, Santa Cruz, Bolivia; 3 Nutrition and
Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Objective: Thousands of individuals with Parkinson’s disease (PD) in low-
income countries remain under- treated/untreated due to unaffordability
of marketed levodopa preparations. MP, a levodopa-containing legumi-
nous plant growing in all tropical areas worldwide, may be a sustainable
alternative therapy for indigent patients.
The objective of this study is to investigate safety and efficacy of
daily intake of Mucuna pruriens (MP) pow- der as compared to
marketed levodopa/carbidopa over a 16-week period using a crossover
study design.
Methods: Fourteen out of eighteen patients with advanced PD (mean age
61±10 years, disease duration 9.4±2.7 years), initially included in a phase-
2b trial on the efficacy of acute MP intake (NCT02680977), further received
MP powder (obtained from roasted seeds) and marketed levodopa/carbi-
dopa (LD/CD) in a randomised order and crossover design over a 16-week
period. Efficacy measures were changes in qual- ity of life, activities of daily
living, motor and non-motor symptoms, and time with good mobility
without troublesome dyskinesias. Safety measures were frequency of
adverse events, changes in laboratory indi- ces and electrocardiography.
Considering the limited sample size and exploratory nature of this study,
we used an arbitrary cut-off of p-value >0.5 to set the margin for non-
inferiority.
Results: In the intention-to-treat population, MP was non-inferior to LD/
CD in all efficacy measures, in- cluding quality of life. Seven discontinued
MP treatment due to either reduced tolerability (n¼4/7) or pro- gressive
worsening of motor performance (n¼3/7). At baseline, patients who dis-
continued MP had more depressive symptoms and lived alone, while
motor symptoms were milder than those who completed the protocol. At
per-protocol analysis, MP showed a trend for better outcome than LD/CD in
all efficacy measures.
Conclusion: In this pilot study, chronic MP was non-inferior to marketed
LD/CD in terms of efficacy. Further studies are warranted to improve MP
tolerability in the long-term and to identify appropriate titra- tion schemes
minimizing drug tolerance.
OP-5-05
VISUAL SPATIAL DYSFUNCTION AND RETINAL NERVE FIBER LAYER
THICKNESS IN PATIENTS WITH PARKINSON DISEASE
P.C. Teh1, W.A. Wan Zaidi2, N. Mohamed Ibrahim2, N. Abdul Kadir2, B.M.-L.
Catherine3, S. Azhar Shah4, N.A. Mohd Fauzi5, C.S. Khoo2, C.F.
Ng2. 1 Department of Neurology, Hospital Kuala Lumpur, Kuala Lumpur,
Malaysia; 2 Department of Medicine, Pusat Perubatan Universiti Kebangsaan
Malaysia, Kuala Lumpur, Malaysia; 3 Department of Ophthalmology, Pusat
Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 4 Public
Health Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala
Lumpur, Malaysia; 5 Department of Medicine, Faculty of Medicine, Universiti
Teknologi MARA (UiTM), Sungai Buloh, Malaysia
Objectives: To explore the retinal nerve fiber layer (RNFL) thickness and
visual spatial dysfunction in pa- tients with Parkinson disease (PD). To
establish correlation between visual spatial dysfunction and RNFL thick-
ness and their association with age, PD duration and baseline cognitive
status (MoCA).
Methods: This is a case control study involving two controls. Cases were
idiopathic PD patients without DM, while control 1 were idiopathic PD
patients without DM and control 2 were normal patients without PD or
DM. Baseline demographics data, disease severity, duration of illness and
Montreal Cognitive as- sessment (MoCA) scores were recorded. Visual
Object Space Perception battery (VOSP) was administered. Retinal Nerve
Fiber Layer Thickness was measured by Optical Coherence Tomography
(OCT).
Results: A total of 44 patients were recruited; 14 PD patients without
DM, 14 PD patients with DM and 15 normal controls. Results revealed vi-
sual spatial dysfunction was highest in PD patients with DM (64.2%; n¼9)
followed by PD patients without DM (53.3%, n¼8), and lowest in non-PD
non DM controls (46.7%, n¼7). There were no significant differences in
the RNFL thickness between case and controls. Of the 8 subtest of the
VOSP, only the number location subtest correlated with left nasal
quadrant retinal thinning in PD patients with DM. No correlation between
VOSP or RNFL thickness with age, duration of disease and baseline MoCA
scores.
Conclusions: Visual spatial dysfunction is prominent among PD patients
with or without DM. Concomitant DM possibly augment the visual spatial
dysfunction by causing selective regional retinal thinning. Retinal thinning
was not a prominent feature in our PD patients. There was also no corre-
lation between VOSP and RNFL, implying that retinal thinning may not be
an accurate reflection of retinal dopaminergic function. We believe that
OCT is a potential tool to evaluate the progression of Parkinson’s disease
but need further exploration.
OP-5-06
TURN CRANIO-CAUDAL SIGNATURE ASSESSMENT FROM INERTIAL
SYSTEMS FOR MOBILITY DEFICIT IDENTIFICATION IN PARKINSON’S
DISEASE PATIENTS
K. Lebel1, 2, C. Duval3, 4, H. Nguyen3, 4, R. Plamondon5, P.
Boissy1, 2. 1 Department of Surgery, orthopaedic service, Universit
e de