title: Cortisol is higher in parkinsonism and associated with gait deficit.
abstract: BACKGROUND
  We propose an active pathogenic mechanism, involving circulating cortisol, in parkinsonism.
  
  
  METHODS
  Serum cortisol was measured in 96 subjects with idiopathic parkinsonism, 170 without, and in 17 spouses and 36 siblings of elderly sufferers with double the number of controls, all obeying inclusion/exclusion criteria.
  
  
  RESULTS
  Cortisol, adjusted for sampling time, was greater (17%, on average, P<0.001) in parkinsonians, but not in relatives. The central cortisol lowering effect of anti-muscarinics was seen (P=0.025). Selegiline may attenuate the disease, and parkinsonism is less frequent in tobacco smokers. Selegiline was associated with a lower cortisol (P=0.03): chronic smoking appeared (P=0.08) to be, irrespective of parkinsonism. Bowel stasis has been implicated in the pathogenesis: cortisol was higher in parkinsonians requiring laxatives (P=0.05). In controls, cortisol was lower, the longer the stride (P=0.02): in parkinsonians, this relationship was numerically reversed. A similar (P=0.01) group performance interaction was seen for deterioration, over 4 years, in gait.
  
  
  CONCLUSIONS
  Cortisol is doing harm or mirroring something which is. A common pathway for neuronal protection/rescue emerges.
authors.affiliation: Statistics Unit, Public Health Laboratories Service, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Charlett
authors.forename: R J
authors.initials: RJ
authors.lastname: Dobbs
authors.forename: A G
authors.initials: AG
authors.lastname: Purkiss
authors.forename: D J
authors.initials: DJ
authors.lastname: Wright
authors.forename: D W
authors.initials: DW
authors.lastname: Peterson
authors.forename: C
authors.initials: C
authors.lastname: Weller
authors.forename: S M
authors.initials: SM
authors.lastname: Dobbs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects / Q000503:physiopathology; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use; D003248:Constipation / Q000503:physiopathology; D005260:Female; D005684:Gait / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012307:Risk Factors; D012642:Selegiline / Q000009:adverse effects / Q000627:therapeutic use; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology
chemical_list: D000978:Antiparkinson Agents; D012642:Selegiline; D006854:Hydrocortisone