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Vol. 50.
Pages 12-22 (July - December 2019)
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Vol. 50.
Pages 12-22 (July - December 2019)
Original article
Stress in Parkinson's disease. Cortisol and amylase biomarkers. Systematic review
El estrés en la enfermedad de Parkinson. Biomarcadores cortisol y amilasa. Revisión sistemática
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David Sancho Cantusa,
Corresponding author
david.sancho@ucv.es

Corresponding author.
, Natalia Santiesteban Lópeza, María Cuerda Ballestera, Silvia Solera Gómezb, José Enrique de la Rubia Ortía
a Facultad de Enfermería, Nuestra Señora de los Desamparados, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
b Centro de Salud integrado de Tavernes de la Valldigna, Tavernes de la Valldigna, Valencia, Spain
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Tables (2)
Table 1. Results of the bibliographical search.
Table 2. Classification of the studies included in this review. Source: self-prepared.
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Abstract
Objective

To determine whether salivary alpha-amylase and salivary cortisol are adequate as biomarkers to evaluate the level of stress in patients suffering from Parkinson's disease.

Method

A systematic review was carried out on studies published in different databases on stress and both biomarkers. Seventeen analytical studies, including quasi-experimental and case–controls, were analysed. The population age was between 20 and 80 years, approximately, and the distribution between genders was fairly equitable.

Results

The results obtained in terms of biomarkers were different from those expected. Theoretically, cortisol is more associated with biomarker of stress, but in this literature review it is concluded that salivary alpha-amylase was a more reliable biomarker for stress measurement. This is a less studied biomarker, but a great candidate for future research.

In addition, stress has been shown to favour neurodegeneration, with the dopaminergic system being especially sensitive.

Conclusions

Both salivary alpha-amylase and cortisol are valid biomarkers for stress measurement in patients with PD, with salivary alpha-amylase being more reliable. It is essential to reduce stress levels in patients with PD in order to reduce its incidence, as well as the prodromal and motor symptoms, and to reduce pharmacological treatments by replacing them with anti-stress therapies.

Keywords:
Neurodegeneration
Neurodegenerative disease
Parkinson's disease
Salivary cortisol
Salivary alpha-amylase
Stress
Chronic stress
Psychosocial stress
Resumen
Objetivo

Identificar si los biomarcadores cortisol salival y alfa-amilasa salival son adecuados para evaluar el grado de estrés de pacientes que presentan EP.

Método

Revisión sistemática realizada de estudios publicados en diferentes bases de datos sobre el estrés y ambos biomarcadores. Se analizaron 17 estudios mayoritariamente analíticos: cuasiexperimentales y casos-controles. La población comprendía las edades de entre 20 y 80 años, aproximadamente, y el reparto entre sexos fue bastante equitativo.

Resultados

Los resultados obtenidos en cuanto a biomarcadores fueron distintos de los esperados, teóricamente se relaciona más al cortisol como biomarcador del estrés, pero en esta revisión bibliográfica se concluye que la alfa-amilasa salival es un biomarcador más fiable para la medición del estrés. Es un biomarcador menos estudiado pero un gran candidato para líneas futuras de investigación.

Además, se ha demostrado que el estrés favorece la neurodegeneración, siendo especialmente sensible el sistema dopaminérgico.

Conclusiones

Tanto la alfa-amilasa salival como el cortisol son biomarcadores válidos para la medición del estrés en pacientes con EP, siendo más fiable la alfa-amilasa salival. Es fundamental reducir los niveles de estrés en pacientes con EP tanto para reducir su incidencia y su sintomatología prodrómica y motora, como para poder reducir los tratamientos farmacológicos sustituyéndolos por terapias antiestrés.

Palabras clave:
Neurodegeneración
Enfermedad neurodegenerativa
Enfermedad de Parkinson
Cortisol salival
Alfa-amilasa salival
Estrés
Estrés crónico
Estrés psicosocial

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