acetogenins and Parkinsonian-Disorders

To describe sleep characteristics and rapid eye movement (REM) sleep behavior disorder in patients with Guadeloupean atypical parkinsonism (Gd-PSP), a tauopathy resembling progressive supranuclear palsy that mainly affects the midbrain. It is possibly caused by the ingestion of sour sop (corossol), a tropical fruit containing acetogenins, which are mitochondrial poisons.. Sleep interview, motor and cognitive tests, and overnight videopolysomnography.. Thirty-six age-, sex-, disease-duration- and disability-matched patients with Gd-PSP (n = 9), progressive supranuclear palsy (a tauopathy, n = 9), Parkinson disease (a synucleinopathy, n = 9) and controls (n = 9).. Tertiary-care academic hospital.. REM sleep behavior disorder was found in 78% patients with Gd-PSP (43% of patients reported having this disorder several years before the onset of parkinsonism), 44% of patients with idiopathic Parkinson disease, 33% of patients with progressive supranuclear palsy, and no controls. The percentage of muscle activity during REM sleep was greater in patients with Gd-PSP than in controls (limb muscle activity, 8.3%+/-8.7% vs 0.1%+/- 0.2%; chin muscle activity, 24.3%+/- 23.7% vs 0.7%+/-2.0%) but similar to that of other patient groups. The latency and percentage of REM sleep were similar in patients with Gd-PSP, patients with Parkinson disease, and controls, whereas patients with progressive supranuclear palsy had delayed and shortened REM sleep.. Although Gd-PSP is a tauopathy, most patients experience REM sleep behavior disorder. This suggests that the location of neuronal loss or dysfunction in the midbrain, rather than the protein comprising the histologic lesions (synuclein versus tau aggregation), is responsible for suppressing muscle atonia during REM sleep. Subjects with idiopathic REM sleep behavior disorder should avoid eating sour sop.

Topics: Acetogenins; Aged; Dementia; Diagnosis, Differential; Disability Evaluation; Dreams; Fatty Alcohols; Female; Fruit; Guadeloupe; Humans; Lactones; Male; Mesencephalon; Middle Aged; Motor Activity; Neurologic Examination; Parkinson Disease; Parkinsonian Disorders; Polysomnography; Prospective Studies; REM Sleep Behavior Disorder; Sleep-Wake Transition Disorders; Supranuclear Palsy, Progressive; Tauopathies

Topics: Acetogenins; Adenosine Triphosphate; Alkaloids; Animals; Annonaceae; Brain; Cells, Cultured; Fatty Alcohols; Humans; Lactones; Mitochondrial Diseases; Neurons; Pacific Islands; Parkinsonian Disorders; Rats

Atypical parkinsonism in Guadeloupe has been associated with the consumption of fruit and infusions or decoctions prepared from leaves of Annona muricata L. (Annonaceae), which contains annonaceous acetogenins, lipophilic inhibitors of complex I of the mitochondrial respiratory chain. We have determined the concentrations of annonacin, the major acetogenin in A. muricata, in extracts of fruit and leaves by matrix-assisted laser desorption-ionization mass spectrometry. An average fruit is estimated to contain about 15 mg of annonacin, a can of commercial nectar 36 mg, and a cup of infusion or decoction 140 microg. As an indication of its potential toxicity, an adult who consumes one fruit or can of nectar a day is estimated to ingest over 1 year the amount of annonacin that induced brain lesions in rats receiving purified annonacin by intravenous infusion.

Topics: Acetogenins; Annona; Chromatography, High Pressure Liquid; Fatty Alcohols; Guadeloupe; Humans; Lactones; Molecular Weight; Parkinsonian Disorders; Plant Extracts; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization