Mood and Cognition Adversely Affected by Dopamine in Depressed People with PD

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Mood and Cognition Adversely Affected by Dopamine in Depressed People with PD

A new research study from the University of Kentucky College of Medicine and the Sanders Brown Center on Aging has shown some information about depression and PARKINSON’S DISEASE that was not typically expected.  Lee Blonder, Ph.D. used a small group of 28 subjects, all with PARKINSON’S DISEASE, 10 of whom were depressed and 18 who were not to examine the effects of dopamine replacement on cognitive function and depression.  HIs expectations were that cognitive function would improve for both depressed and non-depressed subjects with the addition of dopamine.  To his surprise, this did not prove to be true.

All of the subjects underwent a baseline series of cognitive testing and tests to measure the severity of their depression.  Then they were all retested both with and without their regular dopamine replacement therapies.  Subjects who were depressed were found to have poorer performance on three measures of the cognitive testing when taking dopamine replacement than without the dopamine.  Mood of the depressed subjects was also worse on dopamine.  For subjects that did not have depression, performance on cognitive testing improved on dopamine therapy and their mood was stable.

The results of this study raise concerns about treatment options that may compromise the mental health and cognitive functioning of depressed patients with PARKINSON’S DISEASE.  Dr. Blonder cautions that this is a very small preliminary study and should not be used to change treatment plans until additional larger studies confirm his findings.  Depression is very common in PARKINSON’S patients, with perhaps 40% of patients affected.

 

Source:

newswise.com/articles/university-of-kentucky-research-on-depression-and-parkinson-s-disease-published-in-psychiatry-research 4/18/2014

 

 

 

Review by Marcia McCall

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http://www.medicalobserver.com.au/news/alarming-number-of-carers-contemplate-suicide

Creativity of People with Parkinson’s Enhanced with Dopamine Therapy

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Creativity of People with Parkinson’s Enhanced with Dopamine Therapy

As she continues to pursue her fascination with the creative process of her Parkinson’s patients treated with dopamine replacement therapies, Dr. Rivka Inzelberg has just published a new paper in the Annals of Neurology journal.  Dr. Inzelberg is associated with the Department of Neurology at the Sheba Medical Center and the Sackler Faculty of Medicine at Tel Aviv University in Israel.  Several years ago, she noticed that at holiday time, when patients brought her small gifts, the gifts were no longer of the chocolates and wine, but small artistic creations produced by the patients themselves.

Her research lead her to the connection between dopamine and behavior and its involvement with the “reward system”.  It is also associated with impulse control disorders (ICD) and stories of how dopamine replacement therapies have triggered destructive bouts of gambling or unrestrained shopping sprees abound.  But there is also a creative impulse in some patients that has been discovered or enhanced by this therapy.  And this artistic creativity spans all creative genres, from painting and drawing, to writing poetry and more.  Dr. Inzelberg speculated that perhaps the loosening of the impulse control helps patients to find the courage to express their talents or helps them express their talents in different ways, but her creative patients did not all fit the impulse control model.  So she designed a study “to identify features of creative thinking in PD patients and examine whether creativity in PD patients treated with dopaminergic therapy is an expression of ICD or a distinct phenomenon.”

Together with her research team, they recruited 27 Parkinson’s patients and 27 healthy, age matched controls.  Both groups met certain education requirements, had similar cognitive testing results and were screened to rule out depression.  Both groups underwent a battery of testing.  Verbal and creativity tests consisted of Verbal Fluency, Remote Association Test, the Tel-Aviv University Creativity Test, and a test of novel metaphors in which they must determine if the meaning of multiple two word expressions is literal, conventional, novel or meaningless.   This test in particular requires a semantic flexibility or a creative sensibility as compared to simple meaning retrieval of words already in the vocabulary.  Subjects were also given tests to evaluate for any symptoms of Impulse Control Disorder.

The subjects in the Parkinson’s side of the study were then further sub-divided into three groups, based on the amount of levodopa (dopamine replacement) they were receiving, from highest, mid level or lowest.  The researchers found a “significantly higher amount of creative responses” among the group with the highest dose of levodopa.

Further analysis of the results showed a significantly enhanced creativity among the Parkinson’s patients compared to the healthy controls.  There was also no correlation between creativity and impulse control disorder, which was one of the main questions this study sought to resolve.

The results suggest that the creative process that requires originality and flexibility is supported by a distinct neurological process, and that dopamine is involved in enhancing verbal flexibility and visual creativity.  The researchers suggest that the role of dopamine in the creative process may enable the brain to filter out unnecessary or irrelevant stimuli while at the same time improving divergent thinking and creating more associated meanings.

The authors of this study stress that it was done on a small population of Parkinson’s patients who were already receiving dopamine therapy.  Further studies could follow subjects from early stages without dopamine replacement to later stages with dopamine replacement and monitor changes in creativity related to dosage changes.  They also feel that it is perhaps only a subset of the Parkinson’s population that has a strong creativity process.

 

The Awakening of Artistic Creativity and Parkinson’s Disease.

Rivka Inzelberg

Behavioral Neuroscience (Impact Factor: 2.63). 01/2013; DOI:10.1037/a0031052

Source: PubMed

 

Enhanced Creative Thinking under Dopaminergic Therapy in Parkinson’s Disease

A Faust-Socher, YN Kenett, OS Cohen, S Hassin-Baer and R Inzelberg

Accepted manuscript online: 10 MAY 2014 03:33AM EST | DOI: 10.1002/ana.24181

 

 

Review by Marcia McCall

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http://chrispalbicki.com/blog/2012/02/it-all-begins-with-a-blank-canvas/

Daytime Sleepiness in PD Helped by Bright Light Therapy

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Daytime Sleepiness in PD Helped by Bright Light Therapy

According to Aleksander Videnovic, M.D., from the Clinical Neurological Research Institute, Massachusetts General Hospital and Harvard Medical School in Boston, “Sleep disturbances are among the most common and disabling non-motor manifestations of PARKINSON’S DISEASE, affecting as many as 90% of patients.”

Sleep disturbance definitely changes the quality of life, leading to mood changes, depression, and irritability.  Lack of sleep can hamper one’s awareness and lead to accidents and falls.  And it is not only the patient who suffers…the caregiver’s life is turned upside down, too.

The biological clock plays an important role in other aspects of our daily lives besides affecting sleep patterns. It sets the rhythm for the hormones responsible for hunger and metabolism. It impacts heart function and can even affect the body’s immune response and how it fights infection. When sleep patterns are disrupted mood can be affected by the response of serotonin to the relation to light-dark cycles. People with seasonal affective disorder (SAD) become depressed when the days become shorter but improve when serotonin levels increase due to more available light during longer days.

Light therapy, using bright lights, has been effective in helping to relieve depression and seasonal affective disorder. Light therapy, using infrared light has also shown some effectiveness in relieving chronic pain.  Because there is much clinical evidence showing positive beneficial benefit of exposure to light in both animal and human models, Dr. Videnovic designed a study for people with PARKINSON’S to evaluate their responses to light therapy.

He chose a group of 30 PARKINSON’S patients, 13 men and 17 women, who were experiencing daytime sleepiness and randomly assigned them to either a bright light therapy or a red light therapy.  Sessions for both light therapy groups consisted of exposure to either bright light or red light for one hour twice a day for a period of two weeks.  Subjects received their usual medications during the study.  At baseline before treatment and then at the end of two weeks of treatment they were evaluated using several sleep study scales including the Epworth Sleepiness Scale (ESS) as well as the United Parkinson’s Disease Rating Scale (UPDRS) and test to measure depression.  Two weeks after the end of the treatment, they were also re-evaluated.

Both groups showed only modest improvement, but the bright light therapy group showed a statistically significant improvement with average ESS score of 4.75 to the red light group score of 1.79.  The bright light group also showed an improvement in the UPDRS score, which continued a small upward improvement even after two weeks.

This is a rather small study, but the results are definitely encouraging.  This is a very early investigation and there may be other methods of bright light treatment that might bring more improvement.  Any improvement in sleep that helps the body clock also has positive benefits on neurological functions.  Further study is needed to optimize the benefits of light therapy for people with PARKINSON’S who have sleep problems and excessive daytime sleepiness.

The authors of this study presented their research results at the Annual Meeting of the American Academy of Neurology (AAN) as Abstract 13-2.004 on April 28, 2014.

“Light Therapy Effective for Daytime Sleepiness in PD” Medscape. Apr 29, 2014

 

 

Review by Marcia McCall

 

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http://www.sad-lighthire.co.uk/product/innosol-mesa-bright-mesa-160-sad-light-therapy-box-lamp-/125

Can PARKINSON’S Be Helped with Acupuncture?

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Can PARKINSON’S Be Helped with Acupuncture?  Several studies have been undertaken to measure the improvement of PARKINSON’S DISEASE symptoms using acupuncture.  They all report some benefit, but perhaps measuring results of Chinese medical philosophy by the standards of Western medical philosophy is a bit like comparing apples and oranges!

Chinese medicine, from which acupuncture is derived, sees human disease as an issue of imbalance of internal flows of energy within the body.  When there is an imbalance, there will be multi-organ disharmonies.  Chinese medicine attempts to restore balance to organs and organ relationships and to regain normal function and not simply treat the symptoms.  Acupuncture is only one way of helping to restoring balance.

Western medicine, and in movement disorders especially, looks at symptoms in an objective manner, developing scales by which to measure the way symptoms manifest. The Unified Parkinson’s Disease Rating Scale (UPDRS) consists of several rating scales covering multiple aspects of PARKINSON’S symptoms, and is used to help neurologists determine the severity or progression of the disease symptoms.  While it attempts to be objective, it requires training and experience and is based on the physicians’ observations and the patients’ responses.

In all the studies, subjects who received acupuncture reported positive responses and felt some improvement in some of their symptoms.  Sleep was improved and pain decreased, and swallowing issues were sometimes improved.  The feelings of fatigue that plague so many people with PARKINSON’S DISEASE were reduced significantly, leading to better energy and improved enjoyment of life. While Western neurologists may consider these reports to be subjective and not objective, to the people with PARKINSON’S, the relief is very real.

A new study from the University of Arizona has published the results in Neurology, the journal of the American Academy of Neurology.  This time, the research team was able to measure objective improvements in balance and gait.  These researchers used electroacupuncture, which places the acupuncture needles in the same meridians but uses a small electrical current passed between two needles.  Subjects in this trial were divided into two groups, one receiving actual treatment and the other receiving sham treatment.  Subjects in each group received treatment that lasted for 30 minutes once a week for three weeks.  Multiple measurements of balance and gait were measured under various conditions.  The control group did not show any improvement but the acupuncture group showed an improvement of 31% in balance, gait speed increased by 10% and length of stride improved 5%

Hopefully, more studies similar to this will be done soon to verify the results.  Acupuncture may be a good alternative treatment for people with PARKINSON’S DISEASE, to be used in addition to medications and therapies prescribed by their neurologists.  Patients should always discuss any alternative treatments they are interested in trying with their doctors and keep them informed of supplements or herbal preparations they are using in addition to their prescribed medications.

Source:

Lei, Hohg, Nima Toosizadeh, Michael Schwenk, Scott Sherman, Stephen Karp, Saman Parvanish, Esther Esternberg, and Bijan Najali. “Objective Assessment of Electro-acupuncture Benefit for Improving Balance and Gait in Patients with Parkinson’s Disease (P3.074). “Neurology 82, no. 10 Supplement (2014): P3-074.

 

 

Article and review by Marcia McCall

 

Picture Credit:

http://www.envita.com/eimmunotherapy/2013/11/01/using-traditional-chinese-and-western-medicine-to-treat-cancer/

A Look At Vision Issues in PARKINSON’S DISEASE

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A Look At Vision Issues in PARKINSON’S DISEASE

A lesion in the visual cortex renders some people technically blind. While their actual eyes are still functional and can perceive the source of light or even discern and emotional expression on someone’s face, they are still considered legally blind.  A person with PARKINSON’S DISEASE, may have intact eye function and no lesion in the visual cortex, but may be unable to perceive the emotion on another’s face or grasp an object that is moving.

Dr. Nico Diederich has been studying vision deficits in PARKINSON’S DISEASE for many years.  He is a Clinical Senior Researcher at the University of Luxembourg Centre for Systems Biomedicine and is presently a visiting scholar at Rush University Medical Center in Chicago, IL.  Together with three more researchers from Rush, they recently published a research study entitled “Are patients with Parkinson’s disease blind to blindsight?” in the scientific journal Brain that explains their concept for understanding visual impairment in PARKINSON’S DISEASE.

Dr. Diederich describes blindsight as the ability of the technically blind to accurately perceive a source of light or detect a rapid motion or even an emotional expression on someone’s face…without being consciously aware of “seeing”.  He describes it as similar to a reflex.  In “blindsight”, visual stimuli can pass through lower areas of the brain and still be processed to turn in a response.  His research on PARKINSON’S DISEASE has found that although PARKINSON’S patients have no problems with their general vision, their responses are impaired; hence he calls them “blind to blindsight”.

Approximately a third of people with PARKINSON’S also experience hallucinations, when small, involuntary movements flutter in the corner of the eye may be mistaken for people or animals.  Taken together, these visual impairments with a mistaken perception or a slow response time can greatly hinder the patient’s ability to drive and definitely negatively affect their quality of life.

“We have analyzed all known visual impairments in PARKINSON’S patients and compared them with the “blindsight” syndrome.  We could show that mostly evolutionary old brain networks are impaired and underlie the visual impairments observed in PARKINSON’S DISEASE, states Dr. Diederich.

Glenn Stebbins, Ph.D. and Christopher G. Goetz, M>D> from Rush University Medical Center in Chicago and Christine Schiltz, PHD, from the University of Lusembourg contributed to this research.

Original publication: Nico J Diederich, Glenn Stebbins, Christine Schiltz, Christopher Goetz (2014) Are patients with Parkinson’s disease blind to blindsight?Brain; doi: 10.1093/brain/awu/094

 

 

Review by Marcia McCall

 

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http://m.newhope360.com/blog/its-national-eye-exam-month-ill-go-if-you-do

http://stcharlescommunity.org/routine-eye-exams-top-five-reasons-why-are-they-important-for-seniors/

Parkinson’s Progression Marker Initiative Reports Reduced Tau found in CSF of Parkinson’s subjects

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Parkinson’s Progression Marker Initiative Reports Reduced Tau found in CSF of Parkinson’s subjects

 

The search for biological biomarkers to predict the risk or onset of Parkinson’s disease is important for the development of neuroprotective strategies that will benefit people who are at-risk, even before symptoms emerge.  Through the search for biomarkers, there is potential for a permanent cure, instead of temporary symptomatic treatments. The Parkinson’s Progression Markers Initiative (PPMI) has over 800 research subjects at 32 research sites in 13 countries of the world, a large observational study that is producing some fascinating results.

 

Ken Marek, M.D. is the president and senior scientist at the Institute for Neurodegenerative Disorders in New Haven, Connecticut and also clinical professor of Neurology at Yale University.  He is also the principal investigator for the PPMI study.  In the past he said, “The entire goal of this study is to help us to accelerate therapies. The general way in which we can do that is by simply having tools that can be used to objectively measure disease, but the more specific way is that many of these biomarkers will hopefully identify subsets of individuals who may be affected in different ways. For example, some individuals with Parkinson disease might have more of a synuclein problem, whereas others have more of a LRRK2 problem. Using these biomarkers to direct therapy will also be extremely valuable in making those therapeutic trials more likely to be effective.”

 

Dr. Marek presented the most recent data from this study at the 18th International Congress of Parkinson’s Disease and Movement Disorders in Stockholm, Sweden.

He reported that one recent, significant observation has been that in the cerebrospinal fluid (CSF) samples from people with PARKINSON’S so far examined, there has been a reduction of tau.  Tau is a protein abundantly found in neurons, but when it malfunctions and clumps together it contributes to neurodegeneration and is indicative of Alzheimer’s disease.  Because PARKINSON’S is also a neurodegenerative disease, there was an expectation to find tau elevated in the CSF of PARKINSON’S patients. .  So it was surprising to find that it was reduced.  Similar results were reported in two smaller studies.  “But our data is the biggest sample, it does seem to be a real finding” he said.  Then he added: “We can’t explain it at the moment.  It is leading to much discussion and additional research is needed to understand what we are seeing.”

 

The PPMI study has divided its research into four different categories.  They are looking at clinical measures, such as can be measured by the Unified Parkinson’s Disease Rating Scale; imaging, including Magnetic Resonance Imaging (MRI) single photon emission computed tomography (PET scan) and photoacoustic computed tomography.  The genetics category includes people with LRRK2 and synuclein mutations and there is a category for bio specimen samples of CSF, blood or plasma.

 

International Parkinson and Movement Disorder Society (MDS) 18th International Congress of Parkinson’s Disease and Movement Disorders Abstract 729

 

Medscape Medical News , Topic Alert June 20, 2014

 

 

 

Review by Marcia McCall

 

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Three Dimensional Structure Revealed of an Important Neuronal Receptor

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Three Dimensional Structure Revealed of an Important Neuronal Receptor

 

Two new studies, from two different research institutions have reported very similar findings less than a month apart.  Both groups of researchers are very excited about the results of their research and its potential to lead to new therapeutic treatments for neurodegenerative diseases such as PARKINSON’S DISEASE, Huntington’s Disease and Alzheimer’s Disease as well as depression and schizophrenia.  Their excitement comes from their newly visualized structure of the NMDA receptor giving insights into its complex function that plays such a vital role in neurological processes in the brain.

 

The first group of investigators published their data in the journal Science on May 29, 2014. Dr. Hiro Furukawa, an associate professor of biology, and his graduate student, Dr. Erkan Karakas, lead the team of researchers from Cold Spring Harbor Laboratory, a private, non-profit research institution in Cold Spring Harbor, New York. According to Dr. Furukawa, “Previously, our group and others have crystallized individual subunits of the receptor – just fragments – but that simply was not enough.  To understand how this complex functions you need to see it all together, fully assembled.”

 

The second group of researchers are part of the Vollum Institute at Oregon Health and Science University in Portland, Oregon.  They published their data on June 27th in the journal Nature. Dr. Eric Gouaux led a team of six investigators.  He is a senior scientist and also an investigator with the Howard Hughes Medical Institute.  An excited Dr. Gouaux said: “The NMDA receptor is one of the most essential, and still sometimes mysterious, receptors in our brain.  Now, with this work, we can see it in fascinating detail.”

 

Both groups worked with the same innovative molecular photography called x-ray crystallography.  X-ray crystallography is not a new imaging technique but a way to examine the structure of a molecule using x-rays deflected from the surface of a collection of those molecules that form a crystal structure.  In this case, the researchers were examining the NMDA receptor, one of the most important for facilitating communication between neurons. This receptor is important in facilitating learning and memory.  Malfunctions in this receptor are responsible for a wide range of neurological diseases, including PARKINSON’S DISEASE.

 

This receptor is called NMDA, which stands for N-methyl, d-aspartate.  Its functional importance has been long understood, however its molecular structure and how it is controlled has been eluding researchers.  The receptor is a complex composition of subunits, whose individual actions have been extensively documented in over three decades of research.  Each unit has unique properties and operates in a distinct manner.  Disturbances in these subunits causing either over or under activity are responsible for various neurological disorders.  Until now understanding the interactions between the subunits and their total integration into the complex receptor has been limited.

 

Revealing the three dimensional structure of this receptor molecule has been an exhausting, tedious and time consuming labor. The image of the receptor that emerged  from this research has been compared to a bouquet of flowers, a mushroom or a hot air balloon.  It is this “balloon” part of the receptor that enables the cell to communicate through neurotransmitters, such as dopamine.  Through visualization of the entire structure it is possible to see how the actions of one sub-unit regulates the response of a different sub-unit on the other side of the receptor and how each of the sub-units contribute to the activity of the NMDA receptor.

 

With this knowledge, scientists will be better able to develop specific treatments to control the NMDA receptor and affect their role in neurodegenerative diseases. Dr. Furukawa said,  “Our structure defines the interfaces where multiple subunits and domains contact one another.  In the future, these will guide the design of therapeutic compounds to treat a wide range of devastating neurological diseases.”

 

E. Karakas, H. Furukawa. Crystal structure of a heterotetrameric NMDA receptor ion channelScience, 2014; 344 (6187): 992 DOI:10.1126/science.1251915

Chia-Hsueh Lee, Wei Lü, Jennifer Carlisle Michel, April Goehring, Juan Du, Xianqiang Song, Eric Gouaux. NMDA receptor structures reveal subunit arrangement and pore architectureNature, 2014; DOI: 10.1038/nature13548

 

Review by Marcia McCall

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Clinical Trial Shows Levodopa is Still Best Treatment for Parkinson’s Disease

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Clinical Trial Shows Levodopa is Still Best Treatment for Parkinson’s Disease

 

The results of a long term, open label clinical trial took place in the United Kingdom has shown that people with PARKINSON’S DISEASE had a better long-term benefit from levodopa than from other forms of treatment.  Principal investigator for this seven-year study was Dr. Richard Gray, who was the director of the University of Birmingham Clinical Trials Unit but is now a professor at University of Oxford.

 

The trial was designed to allow doctors treating people newly diagnosed with PARKINSON’S DISEASE freedom to begin treatment with which ever drug they preferred, based on the patient’s own symptoms and medical status.  Medications used included dopamine replacement with levodopa, dopamine agonists such as ropinerole or pramipexole or a monoamine oxidase type B inhibitor like selegiline or rasagiline.  If symptom management was not achieved with initial treatment, doses could be increased or levodopa used as an adjunct or medication could be changed from agonist to levodopa.

 

There have always been questions in the minds of both patients and their doctors about which is the best way to begin treatment for PARKINSON’S DISEASE.  Some thought that using levodopa early in the treatment process would limit its effectiveness later in the disease process or even lead to faster progression of the symptoms. Initial treatment with levodopa has often been found in other studies to induce dyskinesias making early treatment of PARKINSON’S symptoms with dopamine agonists of MAO-B inhibitors the first choice.  But dopamine agonists also have a high incidence of troublesome side effects such as sleep disturbance or compulsive behaviors and lack of impulse control.  This study followed 1620 patients for seven years to study the benefits and risks as well as the improvement in quality of life of the patients for both short term and long term treatment options.

 

An early discovery in this study was that treatment that began with monoamine oxidase type B Inhibitor was as effective as treatment that began with dopamine agonists.  They also found that patients were more likely to discontinue their treatment with MAO-B inhibitors or dopamine agonists than patients taking levodopa.  These treatments were discontinued usually due to quality of life issues or side effects that interfered with other aspects of the patients’ lives.  Researchers used a quality of life scale (the PDQ- 39) to evaluate patient responses that were not measured by clinical evaluation scales.

 

After seven years of treatment, patients that had been started with levodopa therapy were doing only slightly better on scales of mobility. They were also more likely to develop dyskinesias.  Patients on levodopa also rated their satisfaction with activities of daily living, cognitive abilities, communication skills and pain levels as being slightly better than the patients on agonists.

 

Study researchers believe this study dispels the thought that early treatment with levodopa limits its effectiveness later in the disease process.  While the improvement and benefit was very small in the levodopa group, the difference in outcomes may have been dependent on the adverse effects of the dopamine agonists. Levodopa appears to maintain its effectiveness over time, however the risk of motor complications such as dyskinesias still remains. The results of this study may also be somewhat hampered because the research studied subjects over age 70.  Younger onset subjects may have different responses leading to other outcomes.

 

For PARKINSON’S patients and their treating physicians, this study should help to relieve the anxiety that early treatment with levodopa will not induce a more rapid progression of the disease and may even improve the quality of life in the earliest stages.

PD MED Collaborative Group. Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson’s disease (PD MED): a large, open-label, pragmatic randomized trial. The Lancet, 2014; DOI: 10.1016/S0140-6736(14)60683-8

 

Review by Marcia McCall

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Practical Help for PARKINSON’S Patients from Wearable Computer Technology

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Practical Help for PARKINSON’S Patients from Wearable Computer Technology

A team of young computer researchers at Newcastle University in the U.K. have undertaken a study to help people with PARKINSON’S DISEASE.  They want to use the newest interactive technology to help people with PARKINSON’S maintain their independence and preserve their dignity.  Much to the delight and enthusiasm of the first PARKINSON’S volunteers, the new Google Glass improves not only their physical symptoms but helps their self esteem as well.

The Internet technology firm Google donated five pair of their new Google Glass to these innovative researchers.  The Google Glass is Google’s first application of wearable computer technology.  It is a headset, worn like a pair of regular, albeit designer-like, glasses that can connect to both the Internet and the wearer’s cellular phone.  Google introduced it in 2012.  These clever, technology savvy investigators, headed by Dr. John Vines at Newcastle University saw the potential for wearable computing technology to improve the lives of people with progressive diseases, such as PARKINSON’S DISEASE.  But, of course, developing this potential had to be done in partnership with people who would use it: only they could tell if it really would be helpful.

Voice activation connects the Glass to the Internet so that tremulous or stiffened hands do not have to be used.  Information appears unobtrusively on a small screen in the upper corner of one lens, and does not interfere with normal sight.  Corrective lenses can also be used in the Glass.  Like any mobile device, applications can be programmed into it that will provide the wearer with various types of information or reminders.  It could be programmed to be a useful reminder to the wearer to take their medication on time or prompt them to speak more loudly, to remember to swallow to prevent drooling.  Motion sensors in the Glass may also be able to help them get moving again if they experience freezing episodes.  Best of all, it is discreet, giving cues to the wearer that no one else can see, saving them embarrassment in social situations

The interactive ability of the Glass can allow wearers to alert their caregivers their whereabouts, simply by looking through the lens.  Wearers can also verbally request the device to make a phone call to any number of pre programmed specific persons or numbers, making communication much easier and faster for people whose motor skills are challenged.  Each device can be programmed to the specific individual needs or requirements of the person using it and technology researchers like the ones at Newcastle are helping to develop the programs that will be particularly useful to the PARKINSON’S population.

Two of the volunteers who have been part of the Google Glass trial have had some very enthusiastic comments.  “The difference is incredible.  It hasn’t stopped the episodes completely and I still have to take the medication but it’s helping to control the symptoms so I can live my life.”  And “They are just fantastic.  The potential for someone with PARKINSON’S is endless.”  While praise for help with the motor problems has been high, appreciation is also high for the discreet help that relieves embarrassment and improves confidence in social situations.  Google Glass can help maintain independence and improve the quality of life.

Google Glass is still a prototypical computer technology.  For one, it is very expensive at the present, $1,500 each.  There are still developmental issues, and concerns that wearers could be using the device’s ability to take photos or videos to invade the privacy of unsuspecting people in public situation.  At present, Google is giving users orientation and training sessions on the polite etiquette for use in public.  As with all the newest technological devices, there will be future improvements and it will take some time for the public to become accustomed to the new device.  But how wonderful that this new technology offers the potential to improve the lives of people with PARKINSON’S DISEASE.

Sources:

“Exploring the acceptability of Google Glass as an everyday assistive device for people with Parkinson’s” Roisin McNaney, John Vines, Daniel ROggen, Madeline Batlaam, Penfei Zhang, Ivan Poliakov and Patrick Olivier. CHI2014. April 26-May 01. http://chi2014.acm.org/

 

“Everything you need to know about Google Glass” Haley Tsukayama, Washington Post, February 27, 2014

 

 

Review by Marcia McCall

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http://notihoy.com/las-google-glass-mejoran-la-vida-de-las-personas-con-parkinson/

http://www.johnvines.eu/google-glass-for-people-with-parkinsons/

Smoking, the Sense of Smell and PARKINSON’S DISEASE

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Smoking, the Sense of Smell and PARKINSON’S DISEASE

Advice to the general population is that smoking is bad for your health…. very bad, indeed.  But there has been information to the contrary for people with PARKINSON’S DISEASE…some 60 studies report that smokers have a lower risk of developing PARKINSON’S DISEASE.  So, then, what are people with PARKINSON’S supposed to believe?

Smoking, for the general population, is known to lead to lung cancer, Chronic Obstructive Pulmonary Disease (COPD) and ultimately death.  Smoking goes straight through the olfactory system, bypassing any intermediate functions that could serve as a filter, carrying any and all environmental toxins from tobacco or smoke straight to the lungs and the brain.  It is well known that one of the early pre-motor symptoms of PARKINSON’S DISEASE is the loss of sense of smell.  Could smoking possibly be implicated in this?  Could smoking also be an environmental factor implicated in reducing the loss of dopamine producing neurons in the brain?  Can the effects of smoking and early non-motor symptoms help explain the relationship between genetics and environmental factors leading to either neuroprotection or the development and progression of PARKINSON’S DISEASE?

A group of researchers at Pennsylvania State University, Milton S. Hershey Medical Center headed by Xuemei Huang, M.D., Ph.D. developed a study to improve understanding of whether or how smoking affects olfaction in PARKINSON’S DISEASE and how the involvement with olfaction contributes to the development of PD.  They planned their study to. “test the hypothesis that smoking is associated with better olfaction in PARKINSON’S DISEASE.”

Seventy-six people with PARKINSON’S and seventy non- PARKINSON’S control subjects were recruited.  Of the PARKINSON’S subjects, there were 22 with a history of smoking and 54 who had never smoked.  In the control group, 17 were smokers and 53 were non-smokers. The histories of the smoking habits of all subjects were carefully noted.  Only one PARKINSON subject and three of the control subjects were current, active smokers.  While all the smokers had begun smoking in their mid to late teens, by their mid thirties they had stopped smoking.  All subjects were assessed by the mini-mental state examination (MMSE) and the University of Pennsylvania Smell Identification Test (UPSIT).  Non-motor symptoms were also carefully evaluated.

In the PARKINSON’S subject, age of onset was found to be at least 4 years later among the smokers than the nonsmokers.  Control subjects had better results overall for UPSIT smell tests than the PARKINSON’S subjects, however the smoker PARKINSON’S subjects scored better than the nonsmokers.  Smell scores among the PARKINSON’S subjects declined in relationship to age, but decline among the control subjects were not significant.  Women tended to have much better sense of smell than male subjects in the control group, but this was not seen in the PARKINSON’S group.  There was no correlation between the number of cigarettes smoked, the number of years smoked, or the years since the cessation of smoking and the scores of the UPSIT in the PARKINSON’S group, nor was there a correlation between the UPSIT scores and the age of onset or duration of the disease. This study also did not find a relationship between smoking and other non-motor symptoms, such as constipation, etc.

This research has shown some interesting results…that sense of smell in smokers is usually considered to be impaired was not found among the controls, and interestingly, the sense of smell among smokers in the PARKINSON’S group was better than that of the non-smokers.  More interesting, that a history of smoking appears to confer a neuroprotective effect and delays the onset of the disease but that smoking after diagnosis or the use of nicotine patches does not offer the same protection. The results of this study suggest that the protection offered from smoking or nicotine may be a gradual process that occurs over many years before the onset of the motor symptoms.

The authors of this study do show a protective correlation between smoking and the onset of PARKINSON’S DISEASE; however they are aware that there may be other factors, such as personality traits, head trauma, or the use of other medications that may play a role in these results.  Other studies will be needed to verify these results, but this study has made a genuine contribution to understanding the relationship between smoking and PARKINSON’S DISEASE.

Lucasson, E>B>; Sterling, N.W.;Lee, E-Y; Chen, H; Lewis, M.M.; Kong, L; Huang, X.; History of Smoking and Olfaction in Parkinson’s disease.  Early View. Mov. Disord.  doi 10.1002/mds.25912

 

 

Review by Marcia McCall

 

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