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Friday, May 31, 2013

Diabetes drug takes us one step closer to the holy grail of Parkinson's treatment

Dr. Claire Bale                                                                                    May 20,2013


ITV News - Thanks to the likes of Michael J Fox, Muhammad Ali and more recently, Bob Hoskins, many more people have now heard of Parkinson's.

Yet despite this Parkinson's remains a condition that few understand.

Aside from a tremor, which most people associate with Parkinson's, it is a hugely debilitating condition that can eventually affect all aspects of daily life – with seemingly simple tasks like getting out of bed becoming increasingly difficult.

Anxiety, pain, problems with movement, sleep and speech are all part of daily life for the 127,000 people living with Parkinson's in the UK.

Although the impact of Parkinson's is all too clear, what causes this progressive condition to develop is much less so.

New research published today however, takes us one step closer to the holy grail of Parkinson's research – being able to slow down, or even stop, the condition in its tracks.

Exenatide is a drug commonly used to treat diabetes but this small trial has shown real promise that it could help to slow the course of Parkinson's in some people, and potentially help maintaining a good quality of life for longer.

The benefits of exenatide first came to light several years ago, when an initial study funded by Parkinson's UK, showed that the drug was able to rescue dying nerve cells.

This new research shows the potential the drug has when it is taken from the laboratory and delivered into the lives of people with Parkinson's.

People with diabetes are at a slightly increased risk of developing Parkinson's and although it isn't yet clear why; some diabetes drugs may also have potential for treating Parkinson's – such is the case with exenatide.

Despite these encouraging results, it is simply too soon to tell whether this drug is a blind alley or a breakthrough for people with Parkinson's.

The research was conducted in a very small number of people and, crucially, without a placebo group – making it difficult to draw too many firm conclusions at this early stage.

What needs to happen next is a much larger trial to fully examine the usefulness of exenatide for people with Parkinson's – we look forward to these results with anticipation.                        

Depression can affect health of Parkinson’s patients

Brenda Medina                                                                          May 31,2013


Miami Herald - Mark Worsdale decided it was time to retire from his 30-year career in business when he was diagnosed with early-stage Parkinson’s disease three years ago.

“I wanted to dedicate more time to my well-being,” said Worsdale, 59. “It is important.”

Worsdale joined ParkOptimist, a group of about 100 members who meet a few times a week at St. Matthew Episcopal Church near South Miami for fitness classes like yoga, tai chi, and dance. ParkOptimist, whose umbrella organization is the National Parkinson Foundation’s South Florida chapter, also conducts a support group for Parkinson’s patients and hosts voice and music therapy classes.

Worsdale said the activities, and the friends he’s made, have made living with the disease easier.

“My only regret is not finding the group earlier, when I was diagnosed,” said Worsdale, who dedicates four to five hours a week to go to group activities, and also exercises at home. “I am doing very well, and I think it is the result of how active I keep myself.”

To date, there is no cure for Parkinson’s disease. But research has shown that diet and fitness play a big part in maintaining a healthy lifestyle, particularly curbing depression, a byproduct of the disease.

Parkinson’s disease is a neurological disorder that progresses slowly in most people, usually after age 50, although some patients can be in their 20s and 30s. It occurs when the cells in the brain that produce dopamine — a chemical that helps the brain send signals to control muscle movement — are slowly destroyed.

About one million Americans are diagnosed with the condition; Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s.

The disease causes stiffness, trouble with balance, slowness of movement and tremors, said Dr. Carlos Singer, chief of the Movement Disorders Division at the University of Miami Miller School Of Medicine. Other symptoms are lack of sleep, urinary and gastrointestinal problems and fatigue. People with the disease also can contend with depression and anxiety.

“It can be confusing at the beginning for many patients,” Singer said. “It affects their daily lives.”

A bedside examination by a neurologist remains the first and most important diagnosis tool for patients suspected of having Parkinson’s disease, according to the National Parkinson Foundation.

A neurologist will base the diagnosis on a detailed medical history of the patient, an examination of the patient’s ability to perform a number of tasks, and the patient’s response to medication that helps produce dopamine. Singer said that patients often get diagnosed when they start noticing a tendency to drag a leg and tremor of the arms either while resting or while holding an object.

“It starts taking them longer to shave,” he said. “Or it becomes difficult to get dressed, sit at the table to eat, or take a walk.”

Last fall, the National Parkinson Foundation (NPF) released a study showing that depression is one of the biggest factors influencing the health of Parkinson’s patients. Several places in South Florida offer extensive health and fitness programs for people with Parkinson’s.

In addition to the programs at St. Matthew, which cost $25 per year per membership with the National Parkinson Foundation, St. Catherine’s Rehabilitation Hospital, of Catholic Health Service, offers Parkinson’s focus groups in North Miami and Hialeah Gardens.

The Michael Ann Russell Jewish Community Center in North Miami Beach and the David Posnack JCC Fitness Center in Davie also run extensive programs for people with Parkinson’s.

“I encourage Parkinson’s patients at any stage to participate in these kinds of activities,” Worsdale said. “I am not saying it can cure the disease but you are going to look and feel better.”

For those seeking medical intervention, deep brain stimulation, or DBS, may be an option.

But this surgical technique does not slow or retard the progression of Parkinson’s disease, said Dr. Bruno Gallo, who has been the director of DBS Therapy at UM Health System for a decade.

Deep brain stimulation consists of electric wires implanted in the patient’s brain and connected to a brain pacemaker in the chest. The pacemaker sends electrical impulses to certain parts of the brain to stimulate activity in targeted areas affected by the disease.

“I like to set realistic goals of what the treatment can and cannot accomplish,” said Gallo, who explained that some patients seek the surgical procedure hoping the disease goes away. “It does improve patients’ quality of life significantly, much more than maximal medical management can in patients who qualify for therapy."

Pesticides again tied to Parkinson's disease

Northwest Parkinson's Foundation 
Parkinson's News Update  

Andrew M. Seaman                                                                                  May 31, 2013

Reuters - Exposure to pesticides and other chemicals is linked to an increased risk of developing Parkinson's disease, according to a fresh look at some past research.

Dr. James Bower, a neurologist from the Mayo Clinic in Rochester, Minnesota, said the finding is consistent with previous research but the study still can't prove that pesticides cause people to develop the neurological condition.

"We're definitely learning that Parkinson's disease is not caused by one thing. We're finding a lot of risks for Parkinson's and pesticides are just one of many," said Bower, who wasn't involved with the new study.

In 2011, a study of U.S. farm workers from National Institutes of Health found some pesticides that are known to interfere with cell function were linked to the development of Parkinson's disease.

Another study that was published in 2012 also reported that people with Parkinson's disease were more likely to report exposure to pesticides, compared to people without the condition.

The disease affects about 500,000 Americans.

For the new study, Dr. Emanuele Cereda, of the IRCCS University Hospital San Matteo Foundation in Pavia, Italy, and his coauthor pulled data from 104 studies that were published between 1975 and 2011 and examined the link between pesticides and Parkinson's disease.

Overall, they found exposure to pesticides was tied to a 58 percent increased risk of developing the disease.

That increase, according to Bower, would be equivalent to 10 more Parkinson's cases among every 1,000 40-year-old residents living in Olmstead County, Minnesota.

Currently, Bower said about 17 of every 1,000 40-year-old Olmstead County residents will go on to develop Parkinson's disease.

The new study's researchers also found that certain pesticides - such as the plant killer paraquat and fungus killers maneb and mancozeb - were tied to a doubling of Parkinson's disease risk.

Bower said these findings are more applicable to farm workers who regularly use pesticides - not necessarily people who use weed killers around their homes.

Cereda told Reuters Health in an email that the study's results suggest that people should avoid contact with pesticides or - at least - wear proper protection when handling the chemicals.

"The use of protective equipment and compliance with suggested, or even recommended, preventive practices should be emphasized in high-risk working categories (such as farming)," he wrote.

Bower echoed that statement and said people who work with pesticides should wear protective equipment that is recommended by the U.S. Occupational Safety and Health Administration - also known as OSHA.