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Friday, July 26, 2013

COFFEE REDUCES THE RISK OF PARKINSON'S DISEASE

26th July 2013 - New research


Geriatrics and Gerontology International [2013] Jul 23 [Epub ahead of print] (H.Qi, S.Li)  \

In the largest assessment of its kind coffee has been found to reduce the risk of Parkinson's Disease as have tea and caffeine. With coffee the risk of Parkinson's Disease was reduced to 72%.  The strength of this association reached the maximum at approximately 3 cups per day.
When tea and caffeine were included in the assessment the risk of Parkinson's Disease reduced in relation to the intake. The risk of Parkinson's Disease was reduced by 26% for every two cups of tea consumed and by 17% for every 200mg of caffeine taken. The association of coffee and tea consumption with the risk of Parkinson's Disease was stronger for men than it was for women. The association of caffeine consumption with the risk of Parkinson's Disease was stronger in postmenopausal women when they had ever used hormones. These associations were weaker in the USA than they were in Europe and Asia.
Caffeine and theophylline, which is found in tea, are a type of drug called adenosine antagonists. Adenosine antagonists include drugs presently being developed for the treatment of Parkinson's Disease including : Preladenant, Tozadenant, and Istradefylline




Tuesday, July 23, 2013

Dry cleaning and Parkinson's risk

06/17/2010 

Trichloroethylene (TCA), a chemical used in commercial may increase risk of getting Parkinson's disease.  This population based study was presented at the American Academy of neurology Annual Meetin in Spring 2010. 
 
Dr. Goldman from the Parkinson's Institute looked at 99 pairs of twins (half were identical twins) in which one of the pair had Parkinson's disease.  Men exposed that worked with TCE for more than 2 years had over a 6 times increase in risk.
 
TCE is a chemical used in the dry cleaning industry. Fortunately it is being phased out of use. It is important to note that the increased of risk in the study above was associated with chronic occupational exposure (over 2 years) and not casual use of dry cleaning services. 
 
Dry cleaning is not dry but uses solvents to clean clothes and dissolve stains.  Organic dry cleaning options are available but consumer beware.  Some dry cleaning store fronts that advertise organic or 'green' are still using organic solvents.
 
If you wish to find a different method for your dry clean only clothes, look for the 'wet method' or carbon dioxide method as an alternative method to clean your clothes.
 
Author: Monique Giroux, MD

MAKING THE CONNECTION BETWEEN BRAIN AND BEHAVIOR

23rd July 2013 - New book

Joseph Friedman 


Publisher's description :  Although many patients and families are aware of the physical challenges that accompany Parkinson's disease, few are prepared to deal with the common behavioral issues that impact their quality of life. Behavior problems in PD are not always catastrophic, but they are common. It is estimated that 65-90% of PD patients experience some level of depression, anxiety, dementia, hallucinations, paranoid delusions, sleep disorders, and other behavioral disorders that affect everyone involved. The self-contained chapters will help readers understand, address, and cope with common behavioral issues, as well as provide guidance on ways to communicate with the healthcare team

THE PREVALENCE OF IMPULSE DISORDERS IN PARKINSON'S DISEASE

21st July 2013 - New research

 
Journal of Clinical Psychopharmacology [2013] July 12 [Epub ahead of print] (M.Poletti, C.Logi, C.Lucetti, P.Del Dotto, F.Baldacci, A.Vergallo, M.Ulivi, S.Del Sarto, G.Rossi, R.Ceravolo, U.Bonuccelli) 

Researchers aimed at establishing the prevalence of impulse control disorders (ICDs) in people with Parkinson's Disease and their association with demographic, drug-related, and disease-related characteristics. Impulse control disorders were identified in 8% of people with Parkinson's Disease. Impulse control disorders were present in 9% of people who did not also have dementia. Only 4% of people who also had dementia had impulse control disorders.Pathological gambling and hypersexuality were the most frequent.

              
Impulse control disorders were significantly associated with dopamine agonists, making Impulse control disorders 5.5 times more likely. Impulse control disorders frequency was greater but similar for the dopamine agonists pramipexole and ropinirole. The use of L-dopa made Impulse control disorders 2.4 times more likely. So although dopamine agonists more commonly cause them, L-dopa is still a common cause. Other factors associated with Impulse control disorders being more likely were being male and being younger age. 
So although dopamine agonists are the most common cause there can be a combination of factors that are responsible.

ALCOHOL AND THE RISK OF PARKINSON'S DISEASE




17th July 2013 - New research


PLoS One [2013] 8 (6) : e66452 (R.Liu, X.Guo, Y.Park, J.Wang, X.Huang, A.Hollenbeck, A.Blair, H.Chen




Researchers examined total alcohol consumption and consumption of specific types of alcoholic drinks in relation to future risk of developing Parkinson's Disease. It was the largest study of its kind, assessing over 300,000 people. Total alcohol consumption was not associated with Parkinson's Disease. However, the association differed according to the types of alcoholic drinks consumed.
Compared with non-beer drinkers, beer drinkers were less likely to develop Parkinson's Disease, whether they had less than 1, 1 to 2, or 2 drinks per day. For liquor (spirit) drinkers the likelihood of developing Parkinson's Disease appeared to gradually increase with the number of drinks they consumed per day, but with less than one drink per day making no difference.  The results for wine consumption were less clear. However, a drink or two of wine per day made no difference to the risk of Parkinson's Disease. So beer drinking appears to be associated with a reduced likelihood of developing Parkinson's Disease, but liquor (spirit) drinking appears to be associated with an increased likelihood of developing Parkinson's Disease.

L-DOPA INCREASES THE RISK OF NEUROPATHY

14th July 2013 - New research
 
Movement Disorders [2013] Jul 8 [Epub ahead of print] (R.Ceravolo, G.Cossu, M.B.di Poggio, L.Santoro, P.Barone, M.Zibetti, D.Frosini, V.Nicoletti, F.Manganelli, R.Iodice, M.Picillo, A.Merola, L.Lopiano, A.Paribello, D.Manca, M.Melis, R.Marchese, P.Borelli, A.Mereu, P.Contu, G.Abbruzzese, U.Bonuccelli) 

L-dopa has been found to increase the risk of neuropathy. Neuropathy is a collection of medical disorders that occur when nerves of the peripheral nervous system are damaged by various means.
Motor nerve damage leads to symptoms such as muscle weakness, cramps, spasms, a loss of balance and coordination. People may find it difficult to walk, feel like they have heavy legs, stumble, or tire easily. Damage to arm nerves may make it difficult to do routine tasks like carry bags, open jars, or turn door knobs. Sensory nerve damage can cause tingling, numbness, pinching and pain. Autonomic nerve damage can lead to abnormal blood pressure and heart rate, reduced ability to perspire, constipation, bladder dysfunction, diarrhea, incontinence, sexual dysfunction, and thinning of the skin. For more information go to Neuropathy
Those people taking L-dopa for more than 3 years were most affected with nearly 20% of them being diagnosed with neuropathy. Only 7% of those people taking L-dopa for less than three years were diagnosed with neuropathy. The risk of neuropathy was not influenced by : Parkinson's Disease duration, severity of Parkinson's Disease or gender. The risk of neuropathy increased by approximately 8% for each year of age. The L-dopa dosages were higher in those affected. So L-dopa dosage and duration and age were the main risk factors for neuropathy. 

THE EFFECT OF PHYSIOTHERAPY ON PARKINSON'S DISEASE

11th July 2013
Neurologia i Neurochirurgia Polska [2013] 47 (3) : 256-262 (J.Cholewa, M.Boczarska-Jedynak, G.Opala) 


The aim of this study was to evaluate the influence of movement rehabilitation on the severity of motor symptoms in Parkinson's Disease. Patients took part in one hour  rehabilitation exercises twice a week, which were aimed at increasing movement ranges, balance improvement, movement agility and walking. Patients' clinical status was assessed with the major Parkinson's Disease symptom score (the Unified Parkinson's Disease Rating Scale (UPDRS) parts I-III). Activity of daily living was evaluated with the Schwab and England scale. The quality of life was evaluated by the Parkinson's Disease Questionnaire (PDQ-39).
The main emphasis was placed on the ability to cope with daily activities. A significant difference in scores on the given scales was observed before and after the 12-week assessment period. Parkinson's Disease symptom score (UPDRS part I) improved by 17%, part II improved by 22%, part III improved by 19%, and PDQ-39 score improved by 17%. Mean score of the Schwab and England scale improved by 9%, indicating an improved quality of life. The rehabilitation programme clearly improved the severity of motor symptoms in people with Parkinson's Disease. 

THE MODIFIED RANKIN SCALE FOR ASSESSING PARKINSON'S DISEASE

7th July 2013
 
Journal of Clinical Neuroscience [2013] Jun 26 [Epub ahead of print] (T.Simuni, S.T.Luo, K.L.Chou, H.Fernandez, B.He, S.Parashos) 
An exploratory analysis was conducted in to the use of the modified Rankin Scale (mRS) as a global measure of disability in early Parkinson's Disease. For more information go to the Modified Rankin Scale The mRS assesses the level of disability caused by neurological disorders. It is scored 0-6 with lower scores reflecting less disability.
1 No symptoms                                                                                                                                                           1 - No significant disability : Able to carry out all usual activities, despite some symptoms. 
2 - Slight disability : Able to look after own affairs without assistance, but unable to carry out all previous activities. 
3 - Moderate disability : Requires some help, but able to walk unassisted. 
4 - Moderately severe disability : Unable to attend to bodily needs without assistance. Unable to walk unassisted. 
5 - Severe disability : Requires constant nursing care and attention, bedridden, incontinent. 
6 - Dead
The association of the Modified Rankin Scale was compared with Parkinson's Disease related assessments : the Unified Parkinson Disease Rating Scale (UPDRS), cognitive function characterized by the Symbol Digit Modalities - verbal, Scales for Outcomes in Parkinson's disease - cognition (SCOPA-COG), quality of life (Parkinson's disease questionnaire (PDQ-39), EuroQOL,  Beck Depression Inventory II (BDI), and Total Functional Capacity (TFC). All of the measures except SCOPA-COG had a significant association with the modified Rankin Scale thereby demonstrating its significance to Parkinson's Disease.