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Granerus, Ann-Kathrine
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Publications (10 of 29) Show all publications
Palhagen, S., Granerus, A.-K., Walinder, J. & Svenningsson, P. (2010). Biomarker identification in CSF in patients with Parkinsons disease and major depression in EUROPEAN JOURNAL OF NEUROLOGY, vol 17, issue SI, pp 20-20. In: EUROPEAN JOURNAL OF NEUROLOGY (pp. 20-20). Wiley-Blackwell, 17(SI)
Open this publication in new window or tab >>Biomarker identification in CSF in patients with Parkinsons disease and major depression in EUROPEAN JOURNAL OF NEUROLOGY, vol 17, issue SI, pp 20-20
2010 (English)In: EUROPEAN JOURNAL OF NEUROLOGY, Wiley-Blackwell , 2010, Vol. 17, no SI, p. 20-20Conference paper, Published paper (Refereed)
Abstract [en]

n/a

Place, publisher, year, edition, pages
Wiley-Blackwell, 2010
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-70231 (URN)000293331100042 ()
Available from: 2011-08-26 Created: 2011-08-26 Last updated: 2011-08-26
Palhagen, S., Qi, H., Martensson, B., Walinder, J., Granerus, A.-K. & Svenningsson, P. (2010). Monoamines, BDNF, IL-6 and corticosterone in CSF in patients with Parkinsons disease and major depression. JOURNAL OF NEUROLOGY, 257(4), 524-532
Open this publication in new window or tab >>Monoamines, BDNF, IL-6 and corticosterone in CSF in patients with Parkinsons disease and major depression
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2010 (English)In: JOURNAL OF NEUROLOGY, ISSN 0340-5354, Vol. 257, no 4, p. 524-532Article in journal (Refereed) Published
Abstract [en]

The biochemical basis of major depression (MD) in Parkinsons disease (PD) is largely unknown. To increase our understanding of MD in PD patients, the levels of monoamine metabolites (HVA, 5-HIAA and MHPG), BDNF, orexin-A, IL-6 and corticosterone were examined in cerebrospinal fluid. The analyses were performed in MD patients with (n = 11) and without (n = 12) PD at baseline and after 12 weeks of treatment with the antidepressant citalopram, and in patients with solely PD (n = 14) at baseline and after 12 weeks. The major findings were that PD patients with MD had significantly lower baseline levels of MHPG, corticosterone and IL-6 when compared to patients with solely MD. In response to citalopram treatment, patients with solely MD exhibited an expected decrease in 5-HIAA and MHPG levels which was not found in PD patients with MD. Moreover, the levels of BDNF and IL-6 were lower in PD patients with MD compared with patients with solely MD after treatment with citalopram. Thus, the biochemical basis and the response to citalopram differ between PD patients with MD and patients with solely MD.

Place, publisher, year, edition, pages
Springer Science Business Media, 2010
Keywords
Parkinsons disease, Major depression, Cerebrospinal fluid, Biomarker, HVA, 5-HIAA, MHPG, BDNF, Corticosterone, IL-6, Citalopram, SSRI
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-54857 (URN)10.1007/s00415-009-5353-6 (DOI)000276254900004 ()
Available from: 2010-04-16 Created: 2010-04-16 Last updated: 2010-04-16
Palhagen, S. E., Ekberg, S., Walinder, J., Granerus, A.-K. & Granerus, G. (2009). HMPAO SPECT in Parkinsons disease (PD) with major depression (MD) before and after antidepressant treatment. JOURNAL OF NEUROLOGY, 256(9), 1510-1518
Open this publication in new window or tab >>HMPAO SPECT in Parkinsons disease (PD) with major depression (MD) before and after antidepressant treatment
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2009 (English)In: JOURNAL OF NEUROLOGY, ISSN 0340-5354, Vol. 256, no 9, p. 1510-1518Article in journal (Refereed) Published
Abstract [en]

Previously we suggested that major depression (MD) in Parkinsons disease (PD) could be an indication of a more advanced and widespread neurodegenerative process, as PD symptoms were more severe in those with depression. We also found a different antidepressant response with SSRI medication in PD patients with depression compared to depressed patients without PD. This indicates diverse underlying pathophysiological mechanisms. Investigations using single-photon emission computed tomography (SPECT), measuring regional cerebral blood flow (rCBF), may contribute to enlighten the neurobiological substrates linked to depressive symptoms. SPECT was performed in order to compare rCBF in MD patients with and without PD. The study included 11 MD patients with PD, 14 nondepressed PD patients and 12 MD patients without PD. All patients were followed for 12 weeks with repeated evaluation of depressive as well as PD symptoms. Anti-Parkinsonian treatment remained unchanged during the study. Antidepressant treatment with SSRI (citalopram) was given to all patients with MD. SPECT was performed before and after 12 weeks of antidepressant treatment. rCBF was found to differ between PD patients with and without MD, as well as between MD patients with and without PD, both at baseline and concerning the response to treatment with SSRI (citalopram). In patients with PD the rCBF was found to be decreased in preoccipital and occipital regions, a finding more common when PD was combined with MD. In summary, larger cortical areas were found to be involved in depressed PD patients, both with hyperactivity (reciprocal to basal degeneration in PD and maybe dopaminergic treatment) and with hypoactivity (probably due to organic lesions leading to hypoperfusion). These observations support our hypothesis that PD combined with MD is an expression of a more advanced and widespread neurodegenerative disorder.

Keywords
rCBF, HMPAO SPECT, Parkinsons disease, Major depression, SSRI
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-20593 (URN)10.1007/s00415-009-5155-x (DOI)
Available from: 2009-09-15 Created: 2009-09-15 Last updated: 2009-09-15
Lorefält, B., Toss, G. & Granerus, A.-K. (2009). Weight Loss, Body Fat Mass, and Leptin in Parkinsons Disease. MOVEMENT DISORDERS, 24(6), 885-890
Open this publication in new window or tab >>Weight Loss, Body Fat Mass, and Leptin in Parkinsons Disease
2009 (English)In: MOVEMENT DISORDERS, ISSN 0885-3185, Vol. 24, no 6, p. 885-890Article in journal (Refereed) Published
Abstract [en]

Weight loss is a common problem in Parkinsons disease (PD), but the causative mechanisms behind this weight loss are unclear. We compared 2( PD patients with sex and age matched healthy controls. Examinations were repeated at baseline, after one and after two years. Body fat mass was measured by Dual X-ray Absorptiometry (DXA). Seventy three per cent of the PD patients lost body weight. Loss of body fat mass constituted a considerable part of the loss of body weight. In the patients who lost weight, serum leptin levels were lower than in those who did not lose weight. The relationship between low body fat mass and low leptin levels seems to be relevant, at least for female PD patients. It is reasonable to believe that low leptin levels in these patients could be secondary to the decreased body fat mass.

Keywords
Parkinsons disease, body weight, body fat mass, leptin
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-18270 (URN)10.1002/mds.22466 (DOI)
Available from: 2009-05-16 Created: 2009-05-15 Last updated: 2009-08-19
Palhagen, S., Carlsson, M., Curman, E., Walinder, J. & Granerus, A.-K. (2008). Depressive illness in Parkinson's disease - Indication of a more advanced and widespread neurodegenerative process?. Acta Neurologica Scandinavica, 117(5), 295-304
Open this publication in new window or tab >>Depressive illness in Parkinson's disease - Indication of a more advanced and widespread neurodegenerative process?
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2008 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 117, no 5, p. 295-304Article in journal (Refereed) Published
Abstract [en]

Objective - The aims were to study if the type and complexity of Parkinsonian symptoms, as well as treatment, could be related to the occurrence and severity of later depressive symptoms. Furthermore, the aim was to study if there is a different depressive symptomatology in Parkinson's disease (PD) patients compared with depressive illness in an age-matched group of patients with major depression but without Parkinson's disease. Methods - Eleven PD-patients with major depression (MD) were compared to 14 PD-patients without depression and to 12 MD patients without PD. Results - PD patients who later developed a depressive illness were younger at the debut of PD than patients without depression (P < 0.05). At inclusion the depressed PD patients were more disabled than PD patients without depression with higher level in the H&Y scale (P<0.05), and they had more involuntary movements according to Unified Parkinson's Disease Rating Scale (UPDRS IV) (P < 0.01). A family history of depression was found in one third of the depressed non-parkinsonian patients but in none of the PD groups. Sleep disturbances were significantly more common among depressed PD patients than in PD patients without depression but even more common in depressed patients without PD. Conclusions - Depressed PD patients had a longer duration of PD and more severe motor symptoms than PD patients without depression, although tremor as an initial symptom seemed to be more common in PD without a later depression. It cannot be excluded that depression in PD reflects a more advanced and widespread neurodegeneration, including serotonergic as well as dopaminergic neurons. Sleep disturbances is common and could be overlooked as an expression of depression. © 2008 The Authors.

Keywords
Major depression, Neurodegenerative disorders, Parkinson's disease
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-46377 (URN)10.1111/j.1600-0404.2007.00986.x (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
Lorefält, B., Toss, G. & Granerus, A.-K. (2007). Bone mass in elderly patients with Parkinson's disease. Acta Neurologica Scandinavica, 116(4), 248-254
Open this publication in new window or tab >>Bone mass in elderly patients with Parkinson's disease
2007 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 116, no 4, p. 248-254Article in journal (Refereed) Published
Abstract [en]

Objective - The objective of the present study was to find risk factors for low bone mineral density (BMD) in patients with Parkinson's disease (PD). Material and methods - Twenty-six PD patients and 26 age-and sex-matched healthy controls were assessed twice within a 1-year period. PD symptoms, body weight, body fat mass, BMD, physical activity, smoking and serum concentrations of several laboratory analyses were investigated. Results - BMD in different locations was lower in PD patients compared with their controls and decreased during the investigated year. BMD was lower in PD patients with low body weight. BMD Z-score of trochanter in the PD group was directly correlated to the degree of physical activity and indirectly to the length of recumbent rest. Total body BMD Z-score in the PD group was directly correlated to the degree of rigidity. Serum 25-hydroxy-vitamin D was slightly lower in PD patients. Conclusion - Low body weight and low physical activity were risk factors for low BMD in PD, while rigidity seemed to be protective. © 2007 The Authors.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-38780 (URN)10.1111/j.1600-0404.2007.00875.x (DOI)45629 (Local ID)45629 (Archive number)45629 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Wressle, E., Engstrand, C. & Granerus, A.-K. (2007). Living with Parkinson´s disease: Elderly patients´ and relatives´ perspective on daily living. Australian Occupational Therapy Journal, 54, 131-139
Open this publication in new window or tab >>Living with Parkinson´s disease: Elderly patients´ and relatives´ perspective on daily living
2007 (English)In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 54, p. 131-139Article in journal (Refereed) Published
Abstract [en]

Background/aim: Parkinson's disease is a progressive neurodegenerative disorder resulting in significant disability. We examined how Parkinson's disease affects daily living from the perspective of both patients and relatives. Methods: Qualitative interviews were performed with seven patients with Parkinson's disease and nine relatives from families other than those of the interviewed patients. Patients and relatives were recruited from an outpatient geriatric unit at a university hospital in Sweden. The interviews were transcribed and analysed qualitatively. Results: A conceptual framework encompassing aggravating factors, consequences in daily living and facilitating factors is presented. Patients perceived activity restrictions, changed habits, decreased socialisation and anxiety. Relatives reported changed roles and habits, decreased socialisation, strain and anxiety about the future. Facilitating factors included accessibility, strategies and psychological support for both patients and relatives. Conclusions: The results show that Parkinson's disease affects daily living not only for patients but also for relatives. They need to be seen, heard and supported in this burden. Services must be adapted to the needs of both patients and relatives with accessibility to health-care facilities with deep knowledge about the disease and its consequences. The identified factors are areas of concern in occupational therapy.

Keywords
Activities of daily living, aged, Parkinson´s desease, relatives
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-39355 (URN)10.1111/j.1440-1630.2006.00610.x (DOI)47967 (Local ID)47967 (Archive number)47967 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Wallin, A., Ekberg, S., Lind, K., Milos, V., Granérus, A.-K. & Granerus, G. (2007). Posterior cortical brain dysfunction in cognitively impaired patients with Parkinson´s disease - an rCBF scintigraphy study. Acta Neurologica Scandinavica, 116(6), 347-354
Open this publication in new window or tab >>Posterior cortical brain dysfunction in cognitively impaired patients with Parkinson´s disease - an rCBF scintigraphy study
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2007 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 116, no 6, p. 347-354Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of the study was to visualize cortical function in Parkinson's patients with various degrees of cognitive impairment.

Materials and methods: Thirty-seven patients with Parkinson's disease and three with Parkinson plus syndromes underwent cognitive assessment and rCBF using 99mTC-HMPAO-SPECT.

Results: Almost no regional reductions in cerebral blood flow were seen in patients without cognitive impairment (n = 16). Limited, mainly posterior, blood flow reductions were seen in patients with mild cognitive impairment (n = 14), whereas the reductions were extensive and bilaterally symmetric, involving both anterior and posterior brain regions in patients with dementia (n = 10).

Conclusions: The findings suggest a widespread cortical, mainly posterior type of dysfunction and a relationship between the degree of cognitive impairment and the magnitude of the dysfunction.

Keywords
Parkinson's disease, cognitive impairment, SPECT, blood flow, Alzheimer's disease
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-17715 (URN)10.1111/j.1600-0404.2007.00887.x (DOI)
Available from: 2009-04-16 Created: 2009-04-16 Last updated: 2017-12-13
Lorefält, B., Granerus, A.-K. & Unosson, M. (2006). Avoidance of solid food in weight losing older patients with Parkinson's disease. Journal of Clinical Nursing, 15(11), 1404-1412
Open this publication in new window or tab >>Avoidance of solid food in weight losing older patients with Parkinson's disease
2006 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, no 11, p. 1404-1412Article in journal (Refereed) Published
Abstract [en]

Aim.  The aim of this paper was to investigate to what extent parkinsonian symptoms, including mild dysphagia and other eating problems, could influence the choice of consistency and the amount of food intake and if this could be related to weight loss as an expression of the underlying neurodegenerative process.

Background.  Previous studies show that patients with Parkinson's disease tend to lose body weight even early during the disease.

Design.  The design was a longitudinal prospective study.

Methods.  Twenty-six free-living Parkinson's disease patients and 26 age- and sex-matched controls were investigated twice, with one-year apart, with focus on Parkinson's disease symptoms, as well as swallowing function. Intake of food items and food consistency were assessed by food records, completed over three consecutive days at each investigation.

Results.  In patients with weight loss, motor symptoms, problems with activities of daily living and problems with eating, related to motor symptoms, increased and they had more dysphagia compared with their controls. They consumed lower amounts of fluid and solid food on both investigated occasions, compared with their controls. Multiple regression analysis showed that weight loss was associated with female gender, eating difficulties related to activities of daily living and preference towards soft food, but negatively correlated with age.

Conclusion.  Parkinson's disease patients with weight loss seemed to avoid solid food, partly because of eating difficulties. Eating problems, as well as weight loss, could be because of the underlying disease, even when it is not at an advanced stage.

Relevance to clinical practice.  Caring for patients with Parkinson's disease should not only include medical treatment, but also support for adequate food intake to prevent weight loss.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-35214 (URN)10.1111/j.1365-2702.2005.01454.x (DOI)25685 (Local ID)25685 (Archive number)25685 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13Bibliographically approved
Lorefält, B., Ganowiak, W., Wissing, U., Granerus, A.-K. & Unosson, M. (2006). Food habits and intake of nutrients in elderly patients with Parkinson's disease. Gerontology, 52(3), 160-168
Open this publication in new window or tab >>Food habits and intake of nutrients in elderly patients with Parkinson's disease
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2006 (English)In: Gerontology, ISSN 0304-324X, E-ISSN 1423-0003, Vol. 52, no 3, p. 160-168Article in journal (Refereed) Published
Abstract [en]

Background: Weight loss is reported frequently in patients with Parkinson´s disease also early during the disease.

Objective: To investigate food habits and nutrient intake in elderly Parkinson´s disease patients compared with matched controls, as well as to compare PD patients with and without weight loss.

Methods: Twenty-six elderly free-living patients with PD, and 26 sex- and age-matched healthy controls, were assessed twice with one year interval between. All food consumed was recorded over 3 consecutive days. Food habits were assessed with the Food Based Concept for Classification of Eating Episodes and intakes of energy and nutrients were calculated. PD symptoms, olfaction, swallowing function, daily activities and serum concentration of different nutri ents were investigated.

Results: After 1 year, the PD patients decreased their intakes of daily high quality snacks from 0.5 ± 0.7 to 0.3 ± 0.3 (p < 0.05) and their prepared complete meals from 0.8 ± 0.3 to 0.6 ± 0.3 (p < 0.05), while their daily number of prepared incomplete meals increased from 0.2 ± 0.2 to 0.3 ± 0.3 (p < 0.01). PD patients with weight loss increased their daily intakes of fat by 12 ± 34 g and their energy intake per kg body weight increased by 21 ± 31 kJ (p < 0.05), respectively, and this was higher than in those without weight loss (p < 0.01). PD patients required more help with buying and cooking food compared with the controls.

Conclusions: PD patients’ food habits changed so that they consumed a lower number of prepared complete meals. PD patients with weight loss had a higher intake of fat and energy than those without weight loss, although this was obviously not sufficient to prevent weight loss. Impaired absorption of fat in PD should be discussed.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-34088 (URN)10.1159/000091825 (DOI)20789 (Local ID)20789 (Archive number)20789 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13Bibliographically approved
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