Monika Białecka

Pomeranian Medical University in Szczecin, Stettin, West Pomeranian Voivodeship, Poland

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Publications (41)56.52 Total impact

  • Jarosław Sławek · Monika Białecka
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    ABSTRACT: White matter hyperintensities (WMH) and silent infarcts detected in MRI are common findings in elderly. They reflect the pathology of small vessels of different origin. Vascular risk factors typical for stroke are probably also risk factors for WMH; however, their role in pathogenesis of dementia is not completely understood. The role of WMH and silent infarcts differs across the dementia syndromes, being the most prominent in vascular dementia (VaD) and Alzheimer's disease (AD) and less in Lewy body diseases (LBD). In AD, they play an important role, as patients with Alzheimer's pathology and WMH may be more vulnerable to cognitive decline. Proper control and prevention of risk factors such as arterial hypertension earlier in the life span may be one potential mechanism to ameliorate or delay neuropathological brain changes with aging. Cessation of smoking and moderate alcohol intake, as well as physical activity, are well-evidenced recommendations to decrease the WMH burden and the risk of dementia. The same seems to be true for nutrition and diet, as very low and high body mass index (BMI) is a risk factor for AD. The so-called Mediterranean diet seems to be beneficial, but more evidence from clinical studies is needed. The preventive role of vitamin B and folate in cognitively declined patients on levodopa therapy and at the same at risk of hyperhomocysteinemia is not clear.
    No preview · Chapter · Dec 2015

  • No preview · Article · Sep 2015 · Pharmacological reports: PR
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    Full-text · Article · Sep 2015 · Pharmacological reports: PR
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    Mateusz Kurzawski · Monika Białecka · Marek Droździk
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    ABSTRACT: SUMMARY Recently, a lot of progress has been made in the identification of genetic biomarkers of drug response. Efforts to define the role of genetic polymorphisms in optimizing pharmacotherapy of Parkinson's disease were also undertaken. This report presents the current state of knowledge on pharmacogenetics of PD, including genes encoding enzymes involved in drug metabolism, drug transporters and direct targets of antiparkinsonian drugs. In most of cases, available data on pharmacogenetic factors that could turn out to be significant modifiers of therapy with anti-PD drugs is still very incomplete and makes it impossible to reach final conclusion about their usefulness in the clinic. More extensive studies, in more uniform, large patient groups, including genome-wide association studies, should be undertaken to finally confirm or deny the value of genetic tests in PD therapy individualization.
    Full-text · Article · Feb 2015
  • Jarosław Sławek · Monika Białecka
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    ABSTRACT: Homocysteine (Hcy) is regarded as a biomarker and possibly also an important factor contributing to pathogenesis of different forms of dementia. Traditionally it is linked to vascular pathology, but recent studies have shown its direct neurotoxicity via different mechanisms. One of the potential causes of elevated Hcy is the folate and vitamin B deficiency, although genetic factors (gene polymorphisms of enzymes engaged in Hcy metabolism) have to be considered as well. In patients suffering from Parkinson's disease and taking levodopa, Hcy may increase due to the activity of cathechol- O-methyl transferase (COMT). The causal relationship between elevated Hcy and cognitive decline remains unclear, however in many studies dementia was correlated with hyperhomocysteinemia. The results of interventional trials on possible treatment options with folate, vitamin B supplementation and COMT inhibitors are till now inconclusive and there is no clear recommendation on such therapy in terms of cognitive decline prevention. If effective, it should be started early and maintain for long period. In this chapter authors review the possible mechanisms of Hcy toxicity, possible environmental and genetic causes of its elevated serum concentrations in different forms (Alzheimer disease, vascular dementia, Lewy body dementias) of dementia. They also discuss the possible treatment options and limitations of performed studies.
    No preview · Chapter · Jan 2015
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    ABSTRACT: Psoriasis has been considered to involve a specific genetic background (1,2), and epidemiological studies together with genetic analyses have confirmed the significance of HLA-Cw6 as a disease susceptibility marker (3,4). However, the HLA-Cw6 findings did not explain the predisposition to the disease of the 35–40% of people with psoriasis who do not carry this risk variant, and approximately 15% of individuals without psoriasis do carry it (5). Recent genome-wide association studies (GWAS) have revealed new psoriasis predisposition candidates in genes encoding cytokines (6), showing a coincidence between psoriasis development and polymorphisms in genes encoding interleukin (IL)-12 p40, the IL-23 receptor subunit, IL12B, IL-13, and IL-15.This article is protected by copyright. All rights reserved.
    No preview · Article · Oct 2014 · Experimental Dermatology
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    ABSTRACT: Background: According to recent investigations, the eradication of Helicobacter pylori (H. pylori) may influence levodopa (LD) pharmacokinetics (PK) and improve the motor function of infected patients with Parkinson disease (PD). The aim of this study was to compare PK of LD and its metabolite 3-O-methyldopa (3-OMD), between H. pylori-positive (HP+) and -negative (HP-) patients with PD and motor fluctuations. Materials and methods: Patients with the clinical diagnosis of PD, under stable LD therapy, reporting daily motor fluctuations and who had no history of previous eradication treatment were screened for the H. pylori infection with an antigen stool test. Two groups of patients-bacteria-infected and noninfected-matched demographically and clinically, were selected for the examination of PK values. Blood samples were collected after morning oral LD dose. Noncompartmental PK parameters were computed from the LD and 3-OMD plasma concentration-time data. Results: Interindividual variability was seen in LD absorption curve in both groups. There were no clinically significant differences in PK parameters of LD and 3-OMD. Changes of small magnitude but with possible clinical impact were found according to tmax and Cmax that tended to be lower in HP- patients and AUC0-t that was larger in the HP+ group. The Cmax value of 3-OMD was almost identical in both groups. The HP- group had smaller AUC0-∞t of 3-OMD. Conclusions: The H. pylori infection in PD patients with motor fluctuations, despite not significantly influencing PK parameters of LD and 3-OMD, may still have important clinical implications.
    No preview · Article · Jul 2014 · Clinical Neuropharmacology
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    ABSTRACT: Some of the risk factors of ischaemic stroke influence the development of atherosclerosis, which is a significant cause of vascular incidents. An inflammatory component plays a role in pathogenesis of both atherosclerosis and atrial fibrillation, the most important risk factor of embolic strokes. C-reactive protein (CRP) concentration in blood reflects the inflammatory process. Concentration of this protein depends on the CRP gene polymorphism. The aim of the study was to assess the relationship between selected risk factors of stroke and variant of -717A>G (rs2794521) CRP gene polymorphism in population of West Pomerania Province of Poland. There were 125 consecutive patients with ischaemic stroke analysed, who met the inclusion and exclusion criteria. In all patients, -717A>G CRP gene polymorphism was genotyped and analysed in relation to selected stroke risk factors. Prevalence of type 2 diabetes was lower in patients with AA genotype of -717A>G CRP gene polymorphism than in patients with other alleles (p=0.017). Subjects with GG genotype had significantly higher concentration of CRP comparing to AG genotype (p=0.023). No correlation was found between -717A>G CRP gene polymorphism and the lipid profile and other selected risk factors of stroke. In patients with ischaemic stroke in West Pomerania Province, the GG genotype of -717A>G CRP gene polymorphism is associated with significantly higher CRP concentration in relation to AG genotype. Patients with AA genotype may be characterised by lower prevalence of type 2 diabetes.
    No preview · Article · Mar 2014 · Neurologia i neurochirurgia polska
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    ABSTRACT: Brain-derived neurotrophic factor (BDNF) is a neurotrophin widely expressed in the mammalian brain, regulating neuronal survival and known to influence dopaminergic neurons and cognitive processes. The present study investigated the BDNF Val66Met polymorphism associations with PD risk, and cognitive impairment in PD. A total of 486 study subjects (244 PD and 242 age and sex matched controls) were included in the study. UPDRS score, Hoehn-Yahr staging and the Schwab-England scale were used to assess motor abilities and activity during daily life. The patients were classified into groups with dementia (PDD, n=69) and without it (nPDD, n=166) on the basis of neuropsychological assessment. The most common functional polymorphism in BDNF Val66Met (rs6265, G196A) gene was determined using TaqMan real-time PCR assay. Frequencies of evaluated BDNF alleles and genotypes were similar in PD and the controls. The mean age of disease onset among BDNF Met/Met carriers was later (65.00±6.13) in comparison to Val/Val (57.45±10.68) and Val/Met (56.33±10.91) subjects (p=0.077). The studied BDNF polymorphism was not associated with cognitive status in PD patients. However, patients with Met/Met alleles demonstrated better delayed recall of information than patients with Val/Val alleles. The results of multivariate logistic regression analysis revealed age (p=0.0003) and the disease stage (p=0.002) as independent risk factors predisposing to PD dementia.
    No preview · Article · Jan 2014 · Neuroscience Letters
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    Marek Droździk · Monika Białecka · Mateusz Kurzawski
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    ABSTRACT: In the last years due to development of molecular methods a substantial progress in understanding of genetic associations with drug effects in many clinical disciplines has been observed. The efforts to define the role of genetic polymorphisms in optimizing pharmacotherapy of Parkinson’s disease (PD) were also undertaken. So far, some promising genetic loci for PD treatment were determined. In the review pharmacogenetic aspects of levodopa, dopamine agonists and COMT inhibitors are discussed.
    Full-text · Article · Dec 2013 · Current Genomics
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    ABSTRACT: This study was aimed at the evaluation of the relationship between genetic polymorphisms of catechol-O-methyltransferase (COMT) (rs4680:A > G-Val158Met, rs6269:A > G, rs4633:C > T, rs4818:C > G) and pain sensitivity after lumbar discectomy. All patients had one-level symptomatic disc herniation from L3 to S1. The primary data recorded included visual analogue pain scales assessing back and leg pain, Oswestry Disability Questionnaire assessing quality of life and pain intensity, received/filled pre- and postoperatively. Each subject was genotyped for single-nucleotide polymorphism in the COMT gene. Clinical outcome was measured by difference between pre- and postoperative values and those results were analyzed with genetics findings. Pain intensity was associated with the COMT polymorphism. Carriers of rs6269 AA, rs4633 TT, rs4818 CC, and rs4680 AA genotypes were characterized by the lowest preoperative scores related to pain intensity and lower pain intensity at 1 year after the surgery. The rs4633 CC, rs4680 GG genotypes demonstrated significant clinical improvement in VASBACK score at 1 year after the surgery. Patients with COMT haplotype associated with low metabolic activity of enzyme (A_C_C_G) showed better clinical outcome measured by ODI score and VASBACK score 1 year after surgery. We did not observe any significant correlation between leg pain and single-nucleotide polymorphisms in the COMT gene. The results of our study indicate that polymorphism in the COMT gene may play an important role in the mechanism of pain perception, which may have a potential implication for clinical decision-making in the future.
    Full-text · Article · Nov 2013 · Acta Neurochirurgica

  • No preview · Article · Oct 2013
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    ABSTRACT: Hemiparkinsonism-hemiatrophy (HPHA) is a rare neurological syndrome. The main clinical features of HPHA consist of atrophy of one side of the body (face, trunk, limbs), ipsilateral hemiparkinsonism (bradykinesia, rigidity, tremor) and in many cases dystonia. There are no data on prevalence of HPHA as the condition is rare. The mean age of parkinsonism onset is earlier than in idiopathic Parkinson disease (43.7 years, range: 15-63). Changes in magnetic resonance imaging (MRI) (cortical, basal ganglia atrophy contralaterally to the side of clinical presentation) are described in 30% of patients. The pathogenesis of HPHA is unknown, but in many cases a history of prenatal injuries was reported. We present two male patients with HPHA - 45 and 55 years old, with left-sided parkinsonism, dystonia and hemiatrophy (to our knowledge, the first Polish cases). Both patients had no atrophic changes in MRI and levodopa treatment was ineffective. In the discussion the authors review current literature on HPHA.
    No preview · Article · Aug 2013 · Neurologia i neurochirurgia polska
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    ABSTRACT: Inflammatory components play an important role in the pathogenesis of arteriosclerosis, one of the main causes of stroke. Blood C-reactive protein (CRP) level is connected with the severity of neurological deficit and disability after stroke. Production of CRP depends on CRP gene polymorphism. This study enrolled 125 patients with ischemic stroke. CRP 717A/G polymorphism was tested in all patients along with an assay of CRP levels measured on the first and tenth day after stroke onset. Neurological deficit on admission and before discharge from hospital was evaluated according to National Institutes of Health Stroke Scale (NIHSS), and then associated with CRP levels and the CRP polymorphism. The CRP 717AA genotype was the most frequent, observed in 53.6% of patients; AG genotype in 40%, and GG genotype in 6.4%. Carriers of the 717GG genotype had a significantly higher CRP level on the first day after stroke versus heterozygotes (p=0.023). The improvement in neurological state evaluated with the NIHSS was significantly better in CRP 717AA patients in comparison with other CRP 717 genotypes (p=0.035). A higher level of CRP on the first day after ischemic stroke was slightly associated with the CRP 717AG genotype. The CRP 717AA genotype promotes improvement of neurological state in patients with ischemic stroke.
    No preview · Article · Aug 2013 · Journal of Clinical Neuroscience
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    ABSTRACT: Elevated plasma homocysteine (Hcy) concentration is an independent risk factor for cardiovascular disease, and its involvement in endothelial cell dysfunction is well established. However, the role of Hcy and folate in the pathogenesis of Parkinson's disease (PD) remains controversial. The study was aimed at evaluating the relationships between Hcy, vitamin B12, and folic acid levels in the blood and cognitive status in PD patients with the genetic polymorphisms of MTHFR (rs1801133: C>T-677C>T, rs1801131: A>C-1298A>C), COMT (rs4680: A>G-Val158Met, rs6269: A>G, rs4633: C>T, rs4818: C>G), or SLC19A1 (rs1051266: G>A-80G>A). A total of 502 participants (248 with PD and 254 age-matched and sex-matched controls) were included in the study. The Unified Parkinson's Disease Rating Scale score, Hoehn-Yahr staging, and the Schwab-England scale were used to assess motor abilities and activity during daily life. Complex psychological examination with a battery of tests was used to classify patients into groups with (PDD) and without (nPDD) dementia. Blood samples were examined for Hcy, vitamin B12, and folic acid levels, as well as polymorphisms in genes related to Hcy metabolism, such as COMT, MTHFR, and SLC19A1(RFC-1). The frequency of homozygous COMT rs4680G and rs4633C allele carriers was significantly decreased in PD patients in comparison with the controls (P=0.015; odds ratio=0.60; 95% confidence interval 0.41-0.90 and P=0.020; odds ratio=0.619; 95% confidence interval 0.42-0.92, respectively). No significant differences in the distribution of MTHFR 677C>T, 1298A>C, and SLC19A1 80G>A alleles and genotypes between PD patients and the controls were found. Hcy levels were significantly increased in PD patients (18±7.8 μmol/l) as compared with the controls (14.0±9.6 μmol/l, P=10) and were significantly associated with the MTHFR 677C>T polymorphism both in PD patients and controls, in which T allele carriers were characterized by markedly elevated Hcy plasma concentrations. No association was observed between Hcy plasma level and COMT and SLC19A polymorphisms. The results of multivariate logistic regression analysis revealed age (P=0.0003) and Hcy plasma levels (P=0.07) as independent risk factors predisposing individuals to PD dementia. The studied polymorphisms were not associated with cognitive status in PD patients. The genetic factors studied were not associated with cognitive status in PD patients. Only age and Hcy plasma levels were found to be independent risk factors predisposing individuals to PD dementia. However, COMT: rs4680: A>G and rs4633: C>T polymorphisms were found to significantly affect PD risk, and the MTHFR 677C>T polymorphism helped determine plasma Hcy concentrations.
    Full-text · Article · Aug 2012 · Pharmacogenetics and Genomics
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    ABSTRACT: Background: The role of white matter hyperintensities (WMH) and homocysteine (Hcy) and other vascular risk factors in the pathogenesis of Parkinson's disease (PD) dementia (PDD) remains unclear. Objective: The aim of the study was to assess the impact of WMH, Hcy and other biochemical and vascular risk factors on PDD. Methods: A total of 192 patients with PD and 184 age- and sex-matched healthy controls were included. A semistructured interview was used to assess demographic and clinical variables with respect to vascular risk factors (arterial hypertension, diabetes mellitus, atrial fibrillation, ischemic heart disease, obliterative atherosclerosis, hypercholesterolemia, smoking, alcohol intake). Unified Parkinson's Disease Rating Scale score, Hoehn-Yahr staging and the Schwab-England activities of daily living scale were used to assess motor abilities and activities of daily living. A complex neuropsychological examination with a battery of tests was used to classify patients into a group with dementia (PDD) and a group without dementia (PD). Neuroradiological examination of MRI scans included visual rating scales for WMH (according to the Wahlund and Erkinjunntti rating scales) and the Scheltens scale for hippocampal atrophy. Blood samples for Hcy, folate, vitamin B12, fibrinogen, lipids, glucose, creatinine, transaminases and thyroid stimulating hormone (TSH) were examined. Results: Among all patients, 57 (29.7%) fulfilled the diagnostic criteria for dementia. Significantly higher Hcy plasma levels were noted in PD and PDD groups compared to controls (p Conclusions: WMH along with Hcy, folate and vitamin B12 may impact cognition in PD. Therapy with vitamin B12, folate and catechol-O-methyltransferase inhibitors may play a potential protective role against PDD.
    No preview · Article · Jul 2012 · Neurodegenerative Diseases
  • Monika Białecka · Mateusz Kurzawski · Eng-King Tan · Marek Drozdzik
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    ABSTRACT: Recently, a variant in LINGO1 (also denominated as LRRN6A) rs9652490:A>G gene has been found to associate with increased risk of essential tremor (ET). Because ET and Parkinson's disease (PD) may be ethiologically related, we proceeded to conduct an analysis of the SNP in PD population. In the current study LINGO1 rs9652490:A>G polymorphism was evaluated in a cohort of 162 Polish patients diagnosed with PD and 177 controls by means of MALDI-TOF mass spectrometry. Any significant differences in rs9652490 genotype or allele frequencies between the studied groups were noted. Our findings demonstrate that LINGO1 SNP (rs9652490) is not associated with sporadic PD in our Polish cohort. A meta-analysis of the available data suggests protective role of rs9652490GG genotype (OR 0.70, 95% CI: 0.51-0.96, p=0.028).
    No preview · Article · Mar 2010 · Neuroscience Letters
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    ABSTRACT: Parkinson's disease (PD) is a chronic progressive neurodegenerative disorder of the central nervous system. It has a high prevalence, which significantly increases with age. This disease significantly deteriorates the quality of life and, despite treatment, may lead to disability. For these reasons, PD is not only a medical problem, but also a social one. The neuropathological basis of Parkinson's disease is selective degeneration of dopaminergic neurons in the brain's substantia nigra, which results in an imbalance between neurotransmitters in the central nervous system, mainly between dopamine and acetylcholine. The basic symptoms of PD are tremor at rest, extrapyramidal rigidity, bradykinesia, and disturbances of postural reflexes. PD is described as a hypertonic- hypokinetic syndrome. It is also characterized by coexisting vegetative and psychopathological disturbances. In spite of considerable advances in knowledge about the mechanisms of dopaminergic neuron injury, the etiology and pathogenesis of PD are not yet well established. In this paper the authors briefly review agents which influence neurodegenerative processes of the extrapyramidal system based on available literature concerning clinical trials in Parkinson's disease. Since it is known that female sex hormones also influence dopaminergic transmission, special attention is paid to the potential role of estrogens as agents modulating the risk of PD occurrence and their neuroprotective action.
    No preview · Article · Dec 2009 · Postępy Higieny i Medycyny Doświadczalnej (Advances in Hygiene and Experimental Medicine)

  • No preview · Article · Dec 2009 · Parkinsonism & Related Disorders
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    ABSTRACT: It was shown that high levels of alpha-synuclein in substantia nigra are essential in pathogenesis of Parkinson disease (PD), and SNCA expression in neurons is controlled by GATA-2 transcription factor, which plays also crucial role in central nervous system development, and erythroid cells differentiation. Recently, significant association of two GATA2 SNPs with early-onset coronary artery disease has been presented. In this case-control study we tested a hypothesis that polymorphism of GATA2 gene may be associated with sporadic PD. Five tag SNPs within GATA2 gene (rs2860228:G > A, rs2335052:G > A, rs11717152:A > C, rs2713604:G > A, and rs3803:C > T) were investigated in 368 PD patients and 349 controls of Caucasian origin from Poland. We did not find any significant differences in the GATA2 allele and genotype frequencies between PD cases and controls, for individual SNPs, neither in haplotype analysis. Elevated frequency of rs3803T allele was observed in early-onset PD patients (vs. controls and vs. late-onset PD), but this difference was not significant (0.05 < p < 0.1). We conclude that GATA2 polymorphism is not an important risk factor for sporadic PD in Caucasians.
    Full-text · Article · Oct 2009 · Parkinsonism & Related Disorders