Substantia Nigra Depigmentation and Birth Cohorts: Remote Effect of Encephalitis Lethargica? (S42.006)

Abstract

Objective: Evaluate the association of Parkinson9s disease (PD) with the encephalitis lethargica (EL) epidemic in the early 19009s. Background The etiology of idiopathic PD remains a conundrum. Parkinsonism has been well characterized as a complication of some infectious diseases. The present study examines the clinical and pathological correlates of Parkinsonism across birth cohorts in relation to critical exposure to the encephalitis lethargica epidemic in the early 19009s. Design/Methods: The study population consisted of 678 participants in the Nun Study, of whom 432 died and donated their brains for neuropathologic research. Qualitative indices of SN depigmentation were verified in a subset of 40 randomly selected subjects using quantitative stereological techniques. Substantia nigra (SN) depigmentation, detected neuropathologically, was correlated with clinical parameters of PD, age, and birth cohort. Results: 432 women ranging in age from 76 to 107 years that had participated in the Nun Study came to autopsy. SN depigmenation was detected in 57 (13.2%) of the cohort. Quantitative measures of SN depigmentation were increased in this birth cohort compared to age matched subjects from flanking birth cohorts 1890-1894 and 1900-1904 (p Conclusions: Subjects in the birth cohort 1895-1899 would have been in their late teens and 20s at the onset and during the peak of the encephalitis lethargica epidemic. These were precisely the age ranges of persons that were most often affected by the illness. These data suggest the possibility that the coexistence of Parkinsonism and SN depigmentation in this birth cohort may have resulted from the yet undetermined infectious agent responsible for encephalitis lethargica. Supported by: University of Kentucky Neurology Department. Disclosure: Dr. Hack has nothing to disclose. Dr. Jicha has received personal compensation for activities with Pfizer Inc, Janssen Immunotherapy, and Eli Lilly & Company. Dr. Jicha has received research support from Baxter, Janssen, Pfizer Inc, Medivation, and Danone. Dr. Abell has nothing to disclose. Dr. Dawson has nothing to disclose. Dr. Berger has received personal compensation for activities with Bayer Pharmaceuticals Corporation, Biogen Idec, Millenium, Eisai, Inc., GlaxoSmithKline, Inc., Genentech, Inc., Novartis, Pfizer Inc, Teva Neuroscience, and Serono, Inc. as a consultant and/or speaker. Dr. Berger has received research support from Serono, Inc. and Biogen-Idec.