Welcome to Our Parkinson's Place

I copy news articles pertaining to research, news and information for Parkinson's disease, Dementia, the Brain, Depression and Parkinson's with Dystonia. I also post about Fundraising for Parkinson's disease and events. I try to be up-to-date as possible. I have Parkinson's
diseases as well and thought it would be nice to have a place where
updated news is in one place. That is why I began this blog.
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Thank you.

Sunday, June 25, 2017

Parkinson’s forum to provide latest research and tips on living with the disorder

Parkinson's forum

What: 2016 Parkinson’s Education Forum
When: is 9:30 a.m. to 2 p.m. July 8
Where: DoubleTree by Hilton-Downtown Tulsa, 616 W. Seventh St.
Cost: Free, donations will be accepted
Deadline to register is July 5.
For more information, or to register, call 918-747-3747 or go online to

Parkinson’s experts will share the latest research and tips on living with the disorder at an upcoming forum.
The free event, hosted by the American Parkinson Disease Association, will be 9:30 a.m. to 2 p.m. July 8 at the DoubleTree by Hilton-Downtown Tulsa.
More than 300 people are expected to attend the event, which is intended to be both inspirational and educational, said Jenny Johnson, executive director of the American Parkinson Disease Association, Oklahoma Chapter.
“Parkinson’s Disease isn’t a death sentence, and those with Parkinson’s can live well given education and support while remaining active,” Johnson said. “We believe education is key in order to live successfully with Parkinson’s disease.”
Topics will include the benefits of movement and exercise and how participating in enjoyable activities can reduce symptoms.
There are an estimated 1.5 million Americans living with Parkinson’s. The disease affects men and women alike and is considerably more frequent among those 60 and older.
here are between 15,000 and 16,000 individuals with the disease across the state, Johnson said.
“Because of the nature of the disease and the impact it has on the individual, it affects the whole family,” Johnson said.

ACAC joins U.N. effort to help the disabled


The United Nations wants everyone to have the chance to be fit and healthy regardless of ability or disability, and it’s trying out its ideas at ACAC Fitness & Wellness Centers.
The local health club has joined the United Nations Educational, Scientific and Cultural Organization to test a program that trains staff to attract and serve more people with disabilities.
“UNESCO decided that as a world, a country and a community, we need to reach out to persons with disabilities to help them with wellness,” said Kelly Kyriacopoulos, director of ACAC’s Physician Referred Exercise Program.
“Everyone knows they need exercise, just like everyone knows that smoking is unhealthy. A lot of times the problem is that someone with disabilities feels self-conscious about being in a club situation,” she said.
The program, Universal Fitness Innovation and Transformation, or UFIT, is being tested in four health clubs across the country, including ACAC’s location at Albemarle Square and its club in Timonium, Maryland.
UFIT programs also are debuting in Ireland and Peru. The programs include specialized training for personal trainers and club managers to serve those with Parkinson’s disease, cerebral palsy, intellectual disabilities and spina bifida.
ACAC’s program will focus on aiding Parkinson’s patients and those with intellectual disabilities. The lessons learned, Kyriacopoulos said, also apply to those with other disabilities.
“We have a lot of the training in place already and we serve a wide variety of people,” she said. “UFIT is a different tack, but it’s really not that great of a stretch for us.”
Tom Vandever is executive director of the Charlottesville-based Independence Resource Center, which helps people with disabilities live as independently as possible. He said the program is welcomed.
“In the last 10 or 15 years, there has been a lot of innovation in providing accessible training facilities, but most of it has been at municipal levels,” said Vandever, a former mayor of Charlottesville. “As critical as the technical aspect of providing training is, embracing the concept that everyone should have access is even more critical.”
Critical is a word researchers often use to describe the need for exercise programs for the disabled.
People with disabilities are three times more likely to have heart disease, stroke, diabetes and cancer than adults without disabilities, according to a report by the Public Health Institute’s Center on Disability.
“Nearly half of all adults with disabilities get no aerobic physical activity,” wrote James Rimmer, a professor at the University of Alabama at Birmingham. “Adults with disabilities who get no physical activity are 50 percent more likely to have chronic diseases than those who get the recommended amount of physical activity.”
Rimmer’s research noted that people with disabilities have “a long history of being excluded from planning programs and services that directly affect them.” That includes health and exercise programs.
“Once aware of the gap, often non-disabled experts, program planners and other professionals will attempt to develop, implement and evaluate program activities to rectify the situation,” he wrote. “Unfortunately, these efforts can have unintended consequences.”
Vandever said adapting exercise regimens to meet physical abilities and setting goals are crucial. So is providing a supportive environment.
“If you have a marathoner in a wheelchair, you still train for endurance but you focus on upper arms and upper body strength,” Vandever said. “That can be done with machines or even barbells, which are very adaptable. The main thing is to have an environment that’s accepting so that the athlete feels comfortable training.”
Kyriacopoulos noted that ACAC has long offered programs designed for seniors and those with arthritis, as well as classes for Parkinson’s patients.
“More and more medical research shows the benefit of exercise and gross motor movement in slowing the progression of Parkinson’s and for improving quality of life,” she said. “That was a major factor in selecting this group for the [UFIT] pilot program.”
For Larry Hofmann, a Parkinson’s patient who has been a member of ACAC for five years, the program has proved perfect.

New approaches to early detection of Parkinson's disease on the horizon

June 24, 2017

Detecting Parkinson's disease before non-reversible symptoms occur: New approaches to early detection are meant to ensure just that. They are based on detection of alpha-synuclein in the skin or intestines. New therapy approaches such as a potential "vaccination" could improve the prognosis of affected individuals in future. Prof Günther Deuschl, President of the European Academy of Neurology (EAN), summarized the latest findings in research on Parkinson's' disease.
New findings on the early detection and treatment of Parkinson's disease are being discussed at the 3rd Congress of the European Academy of Neurology (EAN) in Amsterdam. "We are getting closer to the big goal of being able to detect Parkinson's disease at a very early stage," said EAN President Prof Dr Günther Deuschl from University Hospital Schleswig-Holstein in Kiel. The diagnosis of Parkinson's disease is difficult particularly in the early phase of the disease (prodromal stage). Although complaints such as sleep disorders, loss of smell, bouts of depression or digestive disorders have been identified as possible early signs of Parkinson's disease, diagnosis today cannot be carried out with greater certainty until the typical movement disorders manifest themselves, such as tremors and slow, stiff movements. These symptoms are preceded by years of nerve cells dying off.  About 80 per cent of the dopaminergic nerve endings and as many as 50 per cent of the nerve cells in the substantia nigra area of the brain are already destroyed by that stage. A therapy capable of stopping the disease from taking its course is no longer possible at that point in time. The pathological hallmark of Parkinson's disease is the deposit of pathologic alpha-synuclein in cells of the nervous system.
Early detection with biopsies
Different research groups have reported biopsies of the skin (Donadio et al., 2016), submandibular glands (Adler et al., 2016, Vilas et al., 2016) and colon biopsies (Schneider et al., 2016) showing such alpha synuclein at a very early stage of Parkinson's disease.  A further major success in early detection was reported recently (Doppler et al., 2017): Pathologic alpha synuclein was demonstrated in REM-sleep behavioural disorder, a condition which leads in about 85 per cent of the sufferers to Parkinson's disease with the aid of a skin test - and thus, this is many years before the onset of the typical movement disorders. The skin biopsy requires taking only a five millimeter large sample. Detection of pathological deposits of the protein alpha-synuclein in the fine nerve endings of the skin indicates the genesis of the disease.
It has long been known that a high percentage of people suffering from REM sleep behaviour disorders entailing aggressive dreams and violent movements while sleeping will contract Parkinson's within 15 to 20 years. The study has now been able to identify the biomarker alpha-synuclein in the skin of these patients at risk. Alpha-synuclein is also found in healthy individuals but is present in pathological clumped form in Parkinson's patients. That results in a malfunction of cell metabolism and ultimately in the degeneration of nerve cells. Prof Deuschl: "The method has great potential for identifying patients for Parkinson's prevention studies and for winning them over to take part in clinical studies to test disease-modifying medications." In future, this diagnostic marker should be able to detect Parkinson's disease at an early stage also in individuals who do not have REM sleep behaviour disorders.
Biomarkers detectable in intestines and salivary glands
However, this is not the only early detection method that is currently the subject of intensive research. Pathologic alpha-synuclein aggregations also form in the enteric nervous system, which consists of the myenteric plexus between the muscle layers of the intestinal wall and the submucous plexus. The protein accumulations in this area cannot be viewed automatically as diagnosis criterion for Parkinson's disease, however, because they also occur in healthy individuals. Prof Deuschl: "But if aggregations exhibit certain patterns, we can distinguish Parkinson's patients from healthy individuals with a refined morphometric analysis. Nonetheless, further studies are needed to prove that Parkinson's can be diagnosed by means of gastrointestinal biopsies." A Spanish study was also able to prove that alpha-synuclein deposits are detectable by means of a needle biopsy also in the submandibular salivary glands in patients with REM sleep behavior disorders and thus with early signs of Parkinson's.
New therapies for mitigation of symptoms
New therapeutic approaches rely on treating the disease already in its early stages and stopping nerve cells in the brain from dying off. In recent years, experts have gained an ever better understanding of how Parkinson's originates and how it spreads. Prof Deuschl: "Today we know that nerve cells sick from Parkinson's disease can 'infect' other nerve cells in a manner similar to prion diseases. The disease gradually spreads in this way throughout the entire nervous system." New therapy approaches are being developed based on this finding. Studies pursue the goal developing a "vaccine" against Parkinson's disease and rely on two different strategies in these efforts: Either stimulate the immune system to generate antibodies against alpha-synuclein or administer synthetic antibodies.
Another new therapy approach relies on binding larger quantities of iron. That is because oxidative stress in the cells also contributes to the development of Parkinson's disease. This in turn is caused by excessive amounts of iron in certain regions of the brain, which accelerate the demise of the cells.
New definition of diagnostic criteria
One important advance in the early detection of Parkinson's disease is the new definition of diagnostic criteria for the prodromal stage, during which the classic diagnosis based on motor symptoms is not yet possible. To this end, the Movement Disorder Society drew on clinical studies and statistical studies to create a criteria list that is meant to standardize the clinical research and to facilitate diagnosis in the very early stage (Berg et al., 2015). Prof Deuschl: "The new system for assessing the risk of Parkinson's disease consists of the age of the patient, environmental triggers such as smoking or caffeine consumption, genetic factors, the results of biomarker tests or prodromal symptoms such as constipation and loss of smell. This system can be expanded at any time if new tests are added for early detection - such as skin biopsies for example."
Parkinson's disease is second only to Alzheimer's as the most frequent neurodegenerative disease of the central nervous system. Parkinson's affects about two per cent of the population over age 65 and is one of the most common neurodegenerative diseases throughout Europe with 1.2 million people suffering from it. Estimates indicate that the number of cases might at least double by 2030 due to ever longer life expectancy figures.

Saturday, June 24, 2017

Lives remembered: Brian Cant 1933 - 2017

June 24, 2017

Brian Cant died after a long battle with Parkinson's disease

Cant played a role in the life of the nation’s children, presenting the BBC’s Play School for 21 years from 1964 and Play Away from 1971 to 1984. 

He was also a guest presenter on Jackanory and appeared on ITV’s Dappledown Farm. 
Brian Cant was born in Ipswich and educated at Northgate Grammar School and initially trained as a printer before deciding he would rather make his way as an actor instead. 
He was working in BBC Schools drama television programmes on a project about the Romans when he heard that BBC2 was looking for people for a new children’s programme. 
During the audition producer Joy Whitby asked him to get into a cardboard box and pretend to row out to sea. 
He duly fished from the boat and caught a wellington boot full of custard. 
The role was his. Although he became “Mr Play School”, he also did a great deal of work elsewhere.As well as Camberwick Green, Trumpton and Chigley, and hosting programmes for slightly older children such as Bric-a-Brac, he worked as an actor. 
In the 1960s he appeared in two Doctor Who stories, The Daleks’ Master Plan and The Dominators, and he also appeared in films including The Pleasure Girls, The Sandwich Man and A Feast At Midnight, which starred Christopher Lee. 
There were also numerous stage appearances and he continued to work until relatively recently, in 2011 making his third appearance in the show Doctors. In 2007, Cant was named the best loved voice from children’s television. He was married first to Mary Gibson, from whom he was divorced and secondly to Cherry Britton, who he wed in 1984. 
He had two sons from his first marriage and three children from his second. 
In 1999 he was diagnosed with Parkinson’s disease and at the time of his death had been living in Denville Hall, a retirement home popular with entertainers. 
The one thing he wanted children to take away from his work was, “that I made them laugh, I made them feel happy,” he said.

Friday, June 23, 2017

Tips for Daily Living: Preparing for Summer with Parkinson’s Disease

Does summer have you thinking about taking a trip or enjoying the great outdoors? Follow these tips on Parkinson’s and travel, sun safety and heat exhaustion.

Travel Hacks

Vacations are a big part of living well. Many people choose to travel during summer, but with Parkinson’s there are some extra things to consider before hitting the road. These tips can help you stay safe while you travel:
  • Bring your Aware in Care hospitalization kit Parkinson's ID bracelet and card everywhere. Order your free Aware in Care kit at, by calling your local chapter or our lifesaving Helpline at 1-800-4PD-INFO (473-4636).
  • Travel with all medications in original bottles. Keep the original label with the name of the drug and your doctor’s name.
  • Bring a copy of your prescriptions (generic and non-generic names) and medication schedule. Include your physician’s name and contact information.
  • Pack enough medication to last your entire trip in your carry-on bag. Include snacks, water or juice to take with medications. Pack extras in case your trip is delayed.
  • Continue to take your medications as prescribed, even if changing time zones. Keep the same intervals between doses. Consider wearing two watches: current time and time at home.
  • If staying in a hotel, ask these questions before you arrive:
    • What does “accessible room” actually entail?
    • Can you have room that has a walk-in shower with grab bars?
    • What is the proximity to elevators?
  • Ask your neurologist to give you the name of a doctor in the area you are traveling. Take note of your nearest Parkinson’s Foundation Center of Excellence, chapter or support group in the area.
  • Rest the day before your trip AND the first full day you arrive.

Sun Safety

If you plan to soak up the sun this summer, remember to take care of your skin. Melanoma is an invasive form of skin cancer that has been found to develop more often in people with Parkinson’s. Here’s how you can prevent melanoma:
  • Use sunscreen with a sun protection factor (SPF) of 30 or more. Apply sunscreen daily before leaving your house, year-round. If you drive often, keep sunscreen in your car so you can apply it to your hands. When in direct sun, wear protective clothes and a hat.
  • Examine yourself from head to toe. Melanoma can occur in hidden spots that can be easily overlooked. Once a month, look for odd marks and black spots on your skin and nails. Ask a loved one to help you check the areas you can’t see.
  • Know your spots. Look for a skin growth, mole or beauty mark that changes in size, color or texture.
  • Protect yourself from sun exposure. Schedule an annual screening with a dermatologist. Specifically ask for a skin cancer screening. Be sure to point out any abnormal spots.
  • Look for “sun sensitivity” listed on medication warning labels, these warnings can increase your chances of sunburns.
  • Use sunscreen when around reflective surfaces. Water and sand reflect sun rays and increase sun exposure, increasing your odds of getting a sunburn.
  • If diagnosed with skin cancer, get treated right away. Early-stage melanoma has a 98 percent survival rate.

Keep Cool

As the temperature rises, everyone is at risk of overheating. Be smart about your outside time. How to beat the heat:
  • Stay Hydrated. Drink water even if you are not thirsty.
  • Try to drink more than the recommended 9 to 13 cups of water per day when you are in the heat.
  • Exercise Smart. If exercising outside, keep track of how much time you spend in the heat. Consider exercising outdoors in the early morning or late afternoon when it’s cooler outside.
  • Know the Signs of heat stroke: flushed face, high body temperature, headache, nausea, rapid pulse, dizziness and confusion. Once heatstroke is suspected, begin cooling immediately. Go to your nearest emergency room or urgent care for treatment.
Annie Wallis, MSW, LSW, is the Parkinson’s Foundation Ohio Chapter program manager where she leads support, education and community granting programs. As a licensed social worker, she is passionate about making sure that Ohioans with PD and their loved ones have all the support and tools they need to live well with Parkinson’s.

Cherish Life’s Fleeting Moments and Do Not Surrender


I am not the first to realize how quickly time flies. My oldest son turned 34 this year. I remember thinking my mom was really old when I found out that she was 34. Ha. Little did I know how young she really was.
I sometimes send myself into shock when I think about how old my children have become and how quickly. How quickly the days and the years pass. There are no do-overs, nor are there second chances. It can leave you feeling sad. I watch my grandson each day and I am fully aware of how the same thing is happening to him. And to me. Each day comes. Each day goes. No second chances. No do-overs.
One day at a time.
They’re gone.

As a young mother or father, it is hard to realize how fast the time passes by. Oh, there are moments when the doctor tells you little Jimmy has grown a foot and you wonder how that could be, for it was just yesterday you were counting his stubby little toes. You’re too busy changing diapers and feeding hungry bellies. You’re engulfed in tubs of laundry and running to Little League events.Throughout all of the busyness, you are so consumed with the next activity that you lose sight that this could be one of “the lasts.” When once you thought you had forever, now you realize you may not have tomorrow. The games are over. The baby clothes are given away. The Big Wheels are worn out.
I am not sure how all that came running out, except to say it was May before I realized Parkinson’s Awareness Month in April was over and I mostly flaked out on making others aware. Go ahead. Throw the tomatoes. I don’t really think I could have done much better.
As my grandkids keep growing and refuse to slow down ― no matter how much I plead and beg them to stop ― I often wonder when will be the last day I’ll rock them because they just won’t fit in my lap anymore? Or the day, when I pick them up, when they won’t come running into my arms anymore? The time when they won’t be enamored with a hummingbird and wave goodbye as it buzzes away?
Sometimes life has a way of bringing us down. The thing we need to try to avoid is staying down. When dealing with a chronic illness day in and day out, that can feel somewhat impossible some days. We can lose the desire to be a part of the fleeting days and may rather flee right along with them.
That’s one reason I watch my grandkids. Life is so very precious and we aren’t promised tomorrow. That can be taken two ways.
First, we aren’t promised tomorrow in that we may not have the opportunity ever again to spend time with those we love. We may choke on an olive at dinner tonight, and that will be the end of life as we know it.
Second, we aren’t promised tomorrow, in that we may still be here physically, but too soon our grandkids may just about tip our wheelchairs over if they were to get on our laps now. They grow up too fast.
I know that should I avoid choking on an olive at dinner tonight, I may very possibly still not be able to do things with others because of the journey on which this disease is taking me. And so, I must make a choice.
In spite of what can be excruciating pain, loss of mobility, tiredness, and everything else that can come with Parkinson’s disease, do I say forget it and give in to that dying spirit or choose to endure the pain and whatever else may come and keep fighting this thing?
I choose to fight.
Today, however, I know there are some of you who may not be so sure. That is what prompted this post. Somebody may feel like giving up, like giving in. Please don’t.
If you don’t have the strength to fight emotionally, reach out to someone. You can write me or message me on Facebook. Find someone, so you know that you are not in this alone. I will fight with you. I will fight for you. I’ve been there in the dark places, and fighting is so much better because even in the pain, life ― just like rocking grandchildren ― is so very precious.

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s Disease.

FoxFeed Blog: New Tool May Help Researchers Predict Cognitive Decline with Parkinson's Disease

Maggie McGuire Kuhl    June 23, 2017

A new tool from researchers at Harvard Medical School may allow investigators to predict cognitive decline in people with Parkinson's disease (PD), which could help design clinical trials and test new therapies. The tool uses an algorithm combining varied personal details -- age at onset, baseline score on the Mini Mental State Examination, years of education, motor exam score, sex, depression, and GBA mutation status.
The scientific team, led by Clemens Scherzer, MD, published this work in the scientific journal The LancetNeurology. They compared data from six studies to develop the tool, which they validated with data from three studies, including The Michael J. Fox Foundation's landmark biomarkers study, the Parkinson's Progression Markers Initiative (PPMI). Overall, they looked at data from 3,200 people with PD.
Predictive modeling - a process that uses data mining and probability to forecast outcomes - is important as we work toward objective, biological markers of Parkinson's disease. (In fact, a recent PPMI study did reveal potential biomarkers of Parkinson's cognitive decline).
Prediction tools can allow studies to enroll fewer participants, thereby saving time and money. If we want to better understand cognitive decline or test a treatment against this symptom, we need a certain number of people who will get cognitive impairment. Without a prediction tool, we may have to enroll a larger population to account for those who won't develop cognitive decline. The algorithm can help researchers choose people likely to experience this symptom.
An interesting inclusion in the algorithm is education years. The more years of formal education patients in the study had, the greater was their protection against cognitive decline.
"This fits with the theory that education might provide your brain with a 'cognitive reserve,' which is the capacity to potentially compensate for some of the disease-related effects," said Dr. Scherzer. "I hope researchers will take a closer look at this. It would be amazing, if this simple observation could be turned into a useful therapeutic intervention."
The researchers say the tool is not ready for widespread clinical use as there is considerable work required to optimize the algorithm (their next step) and currently there are no therapies approved to prevent or stop cognitive decline in PD.
Through use in research studies, though, their prediction tool may aid in the discovery of new PD treatments and determine which patients would benefit most from those therapies.
"Prediction is the first step," said Dr. Scherzer. "Prevention is the ultimate goal, preventing a dismal prognosis from ever happening."

New Program Brings Hope and Fitness to People with Parkinson’s

 BY Rachel Urbanski | June 23, 2017

WAYNE, NE — The tremors, stiff muscles and overall restlessness are what people with Parkinson’s disease deal with everyday.
For Randy Peterson, who was diagnosed with Parkinson seven years ago, boxing has helped.
“I have boxing equipment in my basement and I see results. I think it’s positive. It’s hard work.”
The Providence Wellness Center in Wayne just began to offer Rock Steady Boxing, a program that is a non-contact form of boxing targeting people with Parkinson’s. The program has been around for 11 years and the location in Wayne is one of 260 affiliates around the world. 
“It really improves your flexibility and balance and those are the things that progress in Parkinson’s….”
As many as 1 million people in the united States are currently diagnosed with Parkinson’s disease, with 60,000 being diagnosed each year according to the Parkinson’s Disease Foundation.
Heidi Keller, an instructor, says the training improves motor skills, but most of all about confidence.
“It’s engaging for them, it’s great because the people in the group all have similar conditions so they aren’t alone or in the gym by themselves…They all have the same thing…It’s a good group of people.”
There’s no denying it’s working, according to Peterson who encourages those with Parkinson’s to join.
“It’s a no brainer, you have to do it.”

An African plant extract may be a potential cure for Alzheimer's Disease

India TV Lifestyle Desk, New Delhi  
21 Jun 2017

The tree extract could pave the way for new drugs to tackle patient symptoms but without the unwanted side-effects associated with some current treatments.

A recent study published in the journal Pharmaceutical Biology has raised hope for a novel treatment for Alzheimer’s disease. It has been found that a plant extract that was used for centuries in traditional medicine in Nigeria, known as the Carpolobia lutea could form the basis of a new drug to treat the progressive brain disorder that impairs memory. The extract taken from the leaves, stem and roots of this plant protects chemical messengers in the brain which plays a vital role in the functioning of the brain, including memory and learning.
According to the study, the tree extract could pave the way for new drugs to tackle patient symptoms but without the unwanted side-effects associated with some current treatments.
The researchers found that the Carpolobia lutea plant was highly effective in preventing the breakdown of acetylcholine and also had other beneficial antioxidant properties in fighting free radicals -- the unstable atoms that can cause damage to cells and contribute to ageing and disease, that may be exacerbated in Alzheimer's disease.
Carpolobia lutea, known more commonly as cattle stick, is a small shrub found native to Central and West Africa. Herbalists in Nigerian tribes use the essence of the root as an aphrodisiac and the treatment of genitourinary infections, gingivitis, and waist pains. In patients with Alzheimer's disease and other diseases such as Parkinson's disease and myasthenia gravis, the activity of the neurotransmitter acetylcholine is reduced, leading to problems with memory and attention.
"As a population we are living longer, and the number of people with dementia is growing at an alarming rate. Our findings suggest that traditional medicines will provide new chemicals able to temper Alzheimer's disease progression," said lead researcher Wayne Carter from University of Nottingham in Britain.

Correct connections are crucial

Individualizing deep brain stimulation in patients with Parkinson's disease
June 23, 2017
Charité - Universitätsmedizin Berlin
Investigators have been examining the use of deep brain stimulation in the treatment of Parkinson's disease in an attempt to optimize treatment effectiveness.

The stimulation volume (red), i.e. the area of the brain immediately adjacent to the electrode, which becomes 'activated' when stimulation occurs. Credit: Andreas Horn, Charité

Working with colleagues from Harvard Medical School and Würzburg, researchers from Charité -- Universitätsmedizin Berlin have been examining the use of deep brain stimulation in the treatment of Parkison's disease in an attempt to optimize treatment effectiveness. Specifically, they have been looking at which brain regions need to be connected to the electrode used for deep brain stimulation. The researchers found a way to use brain connectivity (i.e. connections in the brain) to predict the best possible relief of Parkinson's Disease symptoms. The results, describing an effective network profile of deep brain stimulation has been reported in the journal Annals of Neurology.
Deep brain stimulation (DBS) is an established treatment for Parkinson's disease, usually leading to significant improvement in motor symptoms and quality of life. Symptoms such as movement restrictions, muscle rigidity, or tremor can be alleviated using the neurosurgical procedure which places small electrodes into deep structures of the brain. Whether optimal symptom relief is achieved depends on the correct placement of the electrode. Characteristic connectivity patterns can be observed between the area surrounding the implant and other areas of the brain. "An optimally-positioned neurostimulator disposes of an optimal connectivity profile," explains Dr. Andreas Horn, a researcher at Charité's Department of Neurology and Experimental Neurology. "High treatment effectivity is associated with strong connections between the DBS electrode and specific frontal areas of the brain, such as the 'supplementary motor area'," says Dr. Horn. This relationship was not previously known.
The researchers were also able to show that an electrode's connectivity profile can be used to predict the extent to which treatment can alleviate a patient's movement restrictions. They did so by using a special electrode localization procedure which was developed at Charité in the laboratory of Prof. Dr. Andrea Kühn over a period of several years. The procedure continues to be based on exact brain connectivity maps which were developed in cooperation with Harvard Medical School. The researchers used the MRI sequences of more than 1,000 test subjects to create a 'connectivity map' of the average human brain. Using both of these methods in combination, it is possible to produce connectivity profiles for any DBS electrode. Using basic principles from the field of machine learning, the researchers succeeded in producing and validating an optimal connectivity profile. Dr. Andreas Horn and his international research partners successfully ensured the high-precision placement of more than 90 DBS electrodes.
The researchers are planning to conduct further studies to develop a patient-specific, 'made-to-measure' method of brain stimulation. This may become feasible since it is possible to analyze a patient's specific connectivity profile using MRI training data even before he or she undergoes DBS electrode placement surgery. "It would be possible to determine the optimal location for stimulation even before the invasive part of the procedure starts," says Dr. Horn. "We are now in the process of developing a complete procedure for connectivity-based deep brain stimulation, which will then need to undergo further validation studies." At some point in the distant future, this will make it possible to run a computer simulation prior to using the treatment in a specific patient.

Story Source:
Materials provided by Charité - Universitätsmedizin BerlinNote: Content may be edited for style and length.

Journal Reference:
  1. Andreas Horn, Martin Reich, Johannes Vorwerk, Ningfei Li, Gregor Wenzel, Qianqian Fang, Tanja Schmitz-Hübsch, Robert Nickl, Andreas Kupsch, Jens Volkmann, Andrea A. Kühn, Michael D. Fox. Connectivity predicts deep brain stimulation outcome in Parkinson's diseaseAnnals of Neurology, 2017; DOI: 10.1002/ana.24974