title: Excessive Iron and α-Synuclein Oligomer in Brain are Relevant to Pure Apathy in Parkinson Disease.
abstract: To investigate the demographic features, clinical features, and potential mechanism in patients with Parkinson disease (PD) with pure apathy.
  
  
  
  A total of 145 patients with PD without depression and dementia and 30 age-matched controls were consecutively recruited. Patients with PD were evaluated by Apathy Scale (AS), scales for motor symptoms and quality of life. The levels of iron, oxidative and neuroinflammatory factors, α-synuclein oligomer, and dopamine in cerebrospinal fluid (CSF) from patients with PD and controls were detected by enzyme-linked immunosorbent assay, chemical colorimetric method, and high-performance liquid chromatography. Comparisons between PD with pure apathy and with no pure apathy groups and correlation between AS score and the levels of above factors were analyzed.
  
  
  
  There were 64 (44.14%) cases in PD-apathy group. The PD-apathy group had older age, (97.81 ± 10.82) years versus (61.86 ± 10.80) years, and severer quality of life (P < .05). The PD-apathy and PD without apathy groups presented no remarkable differences in motor symptoms (P > .05). The levels of iron, hydroxyl radical (·OH), hydrogen peroxide (H2O2), and α-synuclein oligomer in CSF in PD-apathy group were significantly higher than that in PD without the apathy group (P < .05). In patients with PD, the AS score was positively correlated with the levels of iron, ·OH, H2O2 and α-synuclein oligomer in CSF (r = 19.838, .063, 1.046, and 0.498, respectively, P < .05). In PD-apathy group, iron level was positively correlated with ·OH level (r = .011, P < .05), and H2O2 level was positively correlated with α-synuclein oligomer level in CSF (r = .045, P < .05).
  
  
  
  Patients with PD had high prevalence of pure apathy. Patients with PD having pure apathy had older age. Pure apathy reduced quality of life for patients without worsening motor function. Excessive iron and α-synuclein oligomer in brain commonly contributed to pure apathy of PD through potential mechanism of oxidative stress.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Shu-Yang
authors.initials: SY
authors.lastname: Yu
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Zuo
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Chen-Jie
authors.initials: CJ
authors.lastname: Cao
authors.affiliation: Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Ze-Jie
authors.initials: ZJ
authors.lastname: Chen
authors.affiliation: Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Ying-Shan
authors.initials: YS
authors.lastname: Piao
authors.affiliation: Core Laboratory for Clinical Medical Research, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Ya-Jie
authors.initials: YJ
authors.lastname: Wang
authors.affiliation: Department of Physiology, Capital Medical University, Beijing, China.
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Wang
authors.affiliation: Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Sheng-Di
authors.initials: SD
authors.lastname: Chen
authors.affiliation: Department of Neurology, Beijing Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Piu
authors.initials: P
authors.lastname: Chan
authors.affiliation: Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China Center of Parkinson's Disease, Beijing Institute for Brain Disorders, Beijing, China Beijing Key Laboratory on Parkinson's Disease, Beijing, China ttyyzw@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D057565:Apathy; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001921:Brain / Q000378:metabolism; D016022:Case-Control Studies; D002853:Chromatography, Liquid; D004298:Dopamine / Q000134:cerebrospinal fluid*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide / Q000134:cerebrospinal fluid; D007501:Iron / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D010300:Parkinson Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000378:metabolism; D011788:Quality of Life; D051844:alpha-Synuclein / Q000134:cerebrospinal fluid*
chemical_list: D015415:Biomarkers; D051844:alpha-Synuclein; D006861:Hydrogen Peroxide; D007501:Iron; D004298:Dopamine
keywords: Parkinson disease; iron; oxidative stress; pure apathy; α-synuclein oligomer