Age and Ageing 2018; 0: 1 © The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: firstname.lastname@example.org Letter to the Editor routine ECG, stress tests, long-term ECG recordings, echo- Sudden Unexpected Death in Parkinson’s cardiography, cardiac MRI and myocardial scintigraphy. The Disease (SUDPAR): a fatal event that goal of all these measures should be the reduction of the fre- James Parkinson did not address quency of SUDPAR. 1 2 1 FULVIO A. SCORZA ,ANA C. FIORINI ,CARLA A. SCORZA , Dear Sir, JOSEF FINSTERER We read with interest the stimulating article by McDonald Disciplina de Neurociência. Escola Paulista de Medicina/ et al. who have elegantly reviewed the scientiﬁc advances of Universidade Federal de São Paulo/. (EPM/UNIFESP) Parkinson’s Disease (PD) since James Parkinson’soriginal Programa de Estudos Pós-Graduado em Fonoaudiologia. Pontifícia Universidade Católica de São Paulo (PUC-SP). Departamento de description . In the last decades, signiﬁcant advances have Fonoaudiologia. Escola Paulista de Medicina/Universidade Federal been achieved regarding pathophysiology and symptomatic de São Paulo (EPM/UNIFESP) treatments, but critically important issues are still under dis- Krankenanstalt Rudolfstiftung cussion, such as the need to modify disease progression [1, 2]. Address correspondence to: Josef Finsterer, Postfach 20, 1180 Vienna, Austria, Europe. Tel: +43-1-71165-92085; Another important aspect, not frequently discussed in the lit- Fax: +43-1-4781711. Email: ﬁﬁgs1@yahoo.de erature, that should also be addressed, is the mortality in PD . Mortality rates among patients with PD are higher when compared with the general population . Interestingly, mor- Funding tality is not increased in the ﬁrst decade after disease onset, but increases only thereafter . It is well established that the Our studies are supported by the following grants: FAPESP leading causes of death in PD are pneumonia, cerebrovascular (Fundação de Amparo à Pesquisa do Estado de São Paulo); complications and cardiovascular diseases [3, 4]. However, CNPq (Conselho Nacional de Desenvolvimento Cientíﬁco e neuroscientists are recognising the increasing number of PD Tecnológico); Coordenação de Aperfeiçoamento de Pessoal patients who die suddenly and unexplained, referred as de Nível Superior (CAPES) and FAPESP/CNPq/MCT Sudden Unexpected Death in Pakinson’sDisease (SUDPAR) (Instituto Nacional de Neurociência Translacional). . Didactically, SUDPAR could be deﬁned as an unexpected death in a patient with PD without any satisfactory explan- ation of death as determined by autopsy studies . From the Conﬂicts of interest epidemiological point of view, there are still only few studies The authors report no conﬂicts of interest. providing ﬁgures about the prevalence and incidence of SUDPAR in the main research centres of PD. Accordingly, an interesting study by Matsumoto et al.  evaluated the causes References of death in16patientswithPDinanautopsy study. The authors found that 25% of the individuals with PD had died 1. McDonald C, Gordon G, Hand A, Walker RW, Fisher JM. suddenly, suggesting that a non-negligible number of PD 200 years of Parkinson’s disease: what have we learnt from patients diefromsuddendeath. SUDPAR does not have a James Parkinson? Age Ageing 2018; 47: 209–14. doi:10. deﬁnite cause, but cardiovascular events may play an import- 1093/ageing/afx196. ant pathogenetic role . Despite being considered a rare 2. Obeso JA, Stamelou M, Goetz CG et al. Past, present, and future of Parkinson’s disease: a special essay on the 200th Anniversary event, much still needs to be discovered about SUDPAR and of the Shaking Palsy. Mov Disord 2017; 32: 1264–1310. a number of questions remain unanswered. How to deﬁne 3. Scorza FA, do Carmo AC, Fiorini AC et al. Sudden unex- sudden death of patients with PD? How many individuals pected death in Parkinson’s disease (SUDPAR): a review of with PD die annually? What is the main cause or causes of publications since the decade of the brain. Clinics 2017; 72: SUDPAR? Are there speciﬁcriskfactors forSUDPAR? In 649–51. case speciﬁcriskfactors forSUDPARcan be identiﬁed, pre- 4. Pinter B, Diem-Zangerl A, Wenning GK et al. Mortality in ventive actions need to be taken by neurologists. While Parkinson’s disease: a 38-year follow-up study. Mov Disord answers to these questions are not extensively discussed in the 2015; 30: 266–9. literature, caution with PD patients is necessary. Therefore, a 5. Matsumoto H, Sengoku R, Saito Y, Kakuta Y, Murayama S, close cooperation between neurologists and cardiologists Imafuku I. Sudden death in Parkinson’s disease: a retrospect- should be pursued in PD research centres. Cardiac surveil- ive autopsy study. J Neurol Sci 2014; 343: 149–52. lance of PD patients considered at high risk, should follow comprehensive cardiovascular screening protocols, including doi: 10.1093/ageing/afy064 Downloaded from https://academic.oup.com/ageing/advance-article-abstract/doi/10.1093/ageing/afy064/4985485 by Ed 'DeepDyve' Gillespie user on 08 June 2018
Age and Ageing – Oxford University Press
Published: Apr 25, 2018
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