Saturday, May 30, 2015
Feldenkrais Method Exercise Promising for Parkinson's
PALM SPRINGS, California — An exercise program based on the Feldenkrais Method can improve the mood and quality of life among people with Parkinson's disease, a new study shows.
By damaging neurologic functioning, Parkinson's disease often diminishes quality of life and leads to depression.
"The Feldenkrais Method uses easy movement and breath control and flexibility and balance to facilitate more control in the whole body," said first author Lavinia Teixeira-Machado, PT, PhD, from the Education in Health Department, Federal University of Sergipe in Sergipe, Brazil. "I use it in cerebral palsy, autism, and Down syndrome."
"We reduced the isolation," said Dr Teixeira-Machado told Medscape Medical News. "It's very interesting."
She presented the finding here at the American Pain Society (APS) 34th Annual Scientific Meeting.
Whole-Body Exercise
To see whether the Feldenkrais Method could help with Parkinson's disease, Dr Teixeira-Machado and her colleagues administered the Mini-Mental State Examination (MMSE), the Parkinson's Disease Quality of Life (PDQL) questionnaire, and the Beck Depression Inventory (BDI) to 36 people with Parkinson's.
They excluded four people from further study because of cognitive impairment, cardiopathy, or advanced impairment. Two others declined to participate.
The researchers then randomly assigned 15 of the patients to instruction in exercises based on the Feldenkrais Method. The remaining 15 got educational lectures. Both groups attended 50 one-hour sessions, with two sessions given per week.
The patients had an average age of 61 years, an average weight of 64 kg, an average height of 159 cm, and an average body mass index of 26 kg/m2. These measures did not statistically significantly differ between the two groups.
The groups were also statistically similar at baseline on the Unified Parkinson's Disease Rate Scale Part III (UPDRS III), the MMSE, and the BDI.
After the 50 sessions, the researchers tested the patients once again on the PDQL and the BDI. The group receiving Feldenkrais instruction improved significantly on both quality of life and depression while the control group got slightly worse on both scales.
The change in the Feldenkrais group compared with baseline was statistically significant for both PDQL (P = .004) and BDI (P = .0005).
The differences between the Feldenkrais group and the control group were also statistically significant for both PDQL (P = .002) and BDI (P = .05).
"People with Parkinson's have all kinds of trouble with movement, so if we can modify that it would be great," said Kathleen Sulka, PT, PhD, a professor of physical therapy at the University of Iowa in Iowa City.
But other exercise programs have also proved beneficial for people with Parkinson's disease, she said, so she would like to see a larger study in which some patients practiced the Feldenkrais Method and others practiced different exercises.
"I see this as a wonderful pilot study," she told Medscape Medical News.
The study was funded by Conselho Nacional de Desenvolvimento Cientifico e Tecnológico. Dr Teixeira-Machado and Dr Sulka have disclosed no relevant financial relationships.
American Pain Society (APS) 34th Annual Scientific Meeting. Presented May 14, 2015.
http://www.medscape.com/viewarticle/845526?src=wnl_edit_tpal
Parkinson’s patient fights disease with long runs, exercise
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ADVANCE FOR USE SATURDAY, MAY 30, 2015 AND THEREAFTER -
May 24, 2015, photo, Doug Rasmussen makes his way up Kokee Road during the Pedal to the Meadow race near Lihue, Hawaii. Rasmussen, who has Parkinson's, is a man who has been running for four decades and has completed the Western States 100 mile race in under 24 hours to earn the coveted belt buckle, climbed the canyon last year, too. (Bill Buley/The Garden Island via AP)
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LIHUE, Hawaii (AP) - While the guys on bicycles zoomed past on Kokee Road
on their way up Waimea Canyon, Doug Rasmussen kept running.
on their way up Waimea Canyon, Doug Rasmussen kept running.
Steady and strong, step after step. Around each turn, up each hill, on every dip and every rise, he plugged upward.
Wearing dark blue shorts, gray New Balance shoes, white socks and a watch on his left wrist, the shirtless Koloa man kept moving. Always moving, slowing only to refuel with water and energy gels provided by his support crew of one, his wife Janet, The Garden Island reported Wednesday.
For nearly 16 miles, with an elevation gain of nearly 4,000 feet, Rasmussen pushed ahead as he made his way from Kokee Road in Kekaha to near the entrance to Kanaloahuluhulu Meadow in Kokee State Park. Not fast. Not slow. Steady. And when he finally stopped running after 2 hours and 56 minutes at the finish line of the Pedal to the Meadow on Sunday, there was no wild celebration. No party. No victory dance.
after 2 hours and 56 minutes at the finish line of the Pedal to the Meadow on Sunday, there was no wild celebration. No party. No victory dance.
Instead, he just chatted with a few people, shook a few hands, and wandered away with his wife. Since it was 55 degrees, he needed to warm up a bit,
“This is as good as it gets,” the 59-year-old said, smiling.
His wife laughed.
“He needs to take a shower,” she said.
Rasmussen, a man who has been running for four decades and has completed the Western States 100 mile race in under 24 hours to earn the coveted belt buckle, climbed the canyon last year, too. You wouldn’t know he was diagnosed with Parkinson’s disease a few years ago. But you should know it’s one of the reasons he runs seven days a week, logging about 40 miles in those seven days. Just get out there and put one foot in front of the other.
“It’s just motivation,” he said. “It’s my way of trying to beat the disease.”
So far, it’s working.
He’s fending off the effects of Parkinson’s, a progressive disorder of the nervous system that affects movement. It develops gradually, causing stiffness or slowing of movement, and symptoms worsen over time.
But Rasmussen, who works at Costco, is feeling strong enough to run up Waimea Canyon - of course, with his wife of nearly 40 years as his support crew - almost every Sunday. He starts about 6:30 a.m. near the Kekaha park and runs some 13 or 14 miles before calling it a day.
He often competes in local races and has finished the Kauai Marathon and Honolulu Marathon. One year, he ran marathons on five islands.
“Exercise is wonderful,” he said. “Doctors say it’s one of the best things you can do.”
Running, even more so. He loves it because there are no shortcuts. No easy route to success. You have to work at it. And keep working at it. Parkinson’s disease likely won’t let up, and neither will he.
“You get out of it as much as you put into it,” he said. “The harder you work, the better you get. It’s not a matter of talent.”
When he ran up Kokee Road on Sunday, starting an hour before the cyclists, it wasn’t a leisurely stroll. He tracked his progress on the Garmin GPS attached to his wrist. Once some of the bike riders caught up, his pace increased, too.
He finished 35 minutes faster than last year, which he attributed to better training.
The 6-foot, 135-pounder said conquering the canyon road is not as difficult as it might sound.
“It’s a matter of pacing,” he said.
Doug Rasmussen is pacing himself to a strong finish. In running, and life.
___
Information from: The Garden Island, http://thegardenisland.com/Read more: http://www.washingtontimes.com/news/2015/may/30/parkinsons-patient-fights-disease-with-long-runs-e/#ixzz3beRIwzOh
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CARBON MONOXIDE INCREASES RISK OF PARKINSON'S DISEASE
30th May 2015 - New research
Carbon monoxide poisoning has been found to be able to greatly increase the risk of Parkinson's Disease. Common sources of carbon monoxide include cigarette smoke, gas cookers, gas fires, vehicle exhaust, gasoline-powered tools. For more information go to : http://en.wikipedia.org/wiki/Carbon_monoxide_poisoning
The overall prevalence of Parkinson's Disease (per 100,000 people per year) in those people that had suffered carbon monoxide intoxication was 27.4. After this figure was adjusted for age, sex, and comorbidities, those people that had carbon monoxide intoxication had nine times the normal risk of developing Parkinson's Disease. This makes it one of the most potent uncommon causes of Parkinson's Disease.
Those people with carbon monoxide intoxication who were receiving hyperbaric oxygen therapy, which is used to treat carbon monoxide poisoning had a risk of Parkinson's Disease 14 times above normal. The therapy does not cause Parkinson's Disease but instead shows that it is used in more extreme cases.
The risk of Parkinson's Disease increased a lot in those people suffering carbon monoxide intoxication. The significance was increased in young people.
Therefore, in some people, carbon monoxide intoxication can be a serious factor leading to Parkinson's Disease.
Reference : Journal of Pediatric Gastroenterology and Nutrition [2015] 94 (19) : 1-6 (C.Y. Lai, M.C.Chou, C.L.Lin, C.H.Kao)
Complete abstract : http://www.ncbi.nlm.nih.gov/pubmed/25984676
http://www.viartis.net/parkinsons.disease/news/150530.pdf mail@viartis.net
©2015 Viartis
Carbon monoxide poisoning has been found to be able to greatly increase the risk of Parkinson's Disease. Common sources of carbon monoxide include cigarette smoke, gas cookers, gas fires, vehicle exhaust, gasoline-powered tools. For more information go to : http://en.wikipedia.org/wiki/Carbon_monoxide_poisoning
The overall prevalence of Parkinson's Disease (per 100,000 people per year) in those people that had suffered carbon monoxide intoxication was 27.4. After this figure was adjusted for age, sex, and comorbidities, those people that had carbon monoxide intoxication had nine times the normal risk of developing Parkinson's Disease. This makes it one of the most potent uncommon causes of Parkinson's Disease.
Those people with carbon monoxide intoxication who were receiving hyperbaric oxygen therapy, which is used to treat carbon monoxide poisoning had a risk of Parkinson's Disease 14 times above normal. The therapy does not cause Parkinson's Disease but instead shows that it is used in more extreme cases.
The risk of Parkinson's Disease increased a lot in those people suffering carbon monoxide intoxication. The significance was increased in young people.
Therefore, in some people, carbon monoxide intoxication can be a serious factor leading to Parkinson's Disease.
Reference : Journal of Pediatric Gastroenterology and Nutrition [2015] 94 (19) : 1-6 (C.Y. Lai, M.C.Chou, C.L.Lin, C.H.Kao)
Complete abstract : http://www.ncbi.nlm.nih.gov/pubmed/25984676
http://www.viartis.net/parkinsons.disease/news/150530.pdf mail@viartis.net
©2015 Viartis
Friday, May 29, 2015
DeGette Opening Statement at 21st Century Cures Full Committee Markup
Colorado
Published on May 19, 2015
On May 19, Representative Diana DeGette (D-CO) specifically mentioned Parkinson's disease and her support for the Advancing Research for Neurological Diseases Act (H.R. 292/S. 849) in her opening statement during the 21st Century Cures Act mark-up.
The National Parkinson Foundation Removes Barriers to Expert Parkinson's Care Through Telemedicine
MIAMI, May 29, 2015 /PRNewswire-USNewswire/ -- The National Parkinson Foundation(NPF) announced today that the Connect.Parkinson national research study, comparing telemedicine care delivered to remote patients from a Parkinson's disease center of excellence to community-based care for Parkinson's disease, has achieved its enrollment target. The 200 enrolled participants with Parkinson's from across the country will be randomly assigned to continue their usual care, or to continue their usual care and see a Parkinson's expert via Internet video calls over the course of one year.
Connect.Parkinson is conducted by the University of Rochester, in collaboration with NPF, and is supported through a Patient-Centered Outcomes Research Institute (PCORI) award. This is the first nation-wide randomized, controlled clinical trial of telemedicine for Parkinson's and among the first national clinical trial of telemedicine that seeks to deliver care from a specialist to a patient directly in her home. Through NPF's Centers of Excellence network, Peter Schmidt, PhD, Senior Vice President and Chief Mission Officer was able to provide a national network of expert care for the study.
"Expert Parkinson's care has the potential to save 7,000 lives each year. However, for many patients today, access to expert care is difficult and time consuming. We are working to change the paradigm and demonstrate that the highest quality care can be delivered anywhere," said Dr. Schmidt.
The study team is led by Ray Dorsey, MD, a thought leader in digital health, who is announcing the completion of enrollment at the d.Health Summit 2015 in New York City on Friday, May 29. The summit provides a platform for national leaders in public policy, healthcare, finance and the high-tech industry to assemble for a day-long discussion on disruptive care models for aging Americans.
"We are excited by the overwhelming interest and completion of enrollment in the Connect.Parkinson study. Over 1000 individuals with Parkinson's disease and their families expressed interest in participating in the study, which speaks to the large latent demand for the next generation house call," said Dr. Dorsey, Professor of Neurology at the University of Rochester Medical Center. "We thank PCORI, NPF, our partners, the sites, and the participants for all of their efforts to date. We look forward to the successful completion of the study and moving us closer to enabling anyone anywhere with Parkinson's disease to receive care."
As chronic conditions affect an estimated 140 million Americans and account for more than 75 percent of healthcare spending today, the goal of the study is to demonstrate the effectiveness of using video technology in care for patients. Once scaled, this effort could bring together the country's leading healthcare organizations and potentially transform care in unprecedented ways.
"It's one thing to show how one highly-skilled doctor can deliver effective care at a distance, as Dr. Dorsey has done in previous studies. It's quite another to show how the same quality can be achieved with a network of providers at the scale of this study," said Christopher Herot, Chief Executive Officer of SBR Health.
Additional partners in the study include SBR Health, Vidyo, IDSolutions, and PatientsLikeMe.
The Connect.Parkinson study is part of NPF's broader mission to improve the quality of care and to improve access to care for people living with Parkinson's. For more information, call NPF's Helpline, 1-800-4PD-INFO (473-4636).
About the National Parkinson Foundation (NPF)
Founded in 1957, the National Parkinson Foundation's mission is to improve the quality of care for people with Parkinson's disease through research, education and outreach. NPF has funded more than $189 million in care, research and support services. For more information about NPF, visit www.parkinson.org, or call the NPF Helpline at 1-800-4PD-INFO (473-4636).
Founded in 1957, the National Parkinson Foundation's mission is to improve the quality of care for people with Parkinson's disease through research, education and outreach. NPF has funded more than $189 million in care, research and support services. For more information about NPF, visit www.parkinson.org, or call the NPF Helpline at 1-800-4PD-INFO (473-4636).
About Parkinson's Disease (PD)
Affecting an estimated one million Americans and four to six million worldwide, PD is the second most common neurodegenerative disease after Alzheimer's and is the 14th leading cause of death in the United States. It is associated with a progressive loss of motor control (e.g., shaking or tremor at rest and lack of facial expression) as well as non-motor symptoms (e.g., depression and anxiety). There is no cure for PD and 60,000 new cases are diagnosed each year in the United States alone.
Affecting an estimated one million Americans and four to six million worldwide, PD is the second most common neurodegenerative disease after Alzheimer's and is the 14th leading cause of death in the United States. It is associated with a progressive loss of motor control (e.g., shaking or tremor at rest and lack of facial expression) as well as non-motor symptoms (e.g., depression and anxiety). There is no cure for PD and 60,000 new cases are diagnosed each year in the United States alone.
Funding Acknowledgement:
This work was supported through a Patient-Centered Outcomes Research Institute (PCORI) Award (AD 12-11-4701).
Disclaimer:
All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee.
Contact:
Leilani Pearl
305-537-9907
lpearl@parkinson.org
Leilani Pearl
305-537-9907
lpearl@parkinson.org
http://health.einnews.com/article/268017418/-8koY-StU1uPsDG-
Dutch program could make Grand Rapids a destination for Parkinson's care
Professor Bas Bloem (Shandra Martinez | MLive Media Group)
DUTCH ROYAL VISIT
GRAND RAPIDS, MI -- Van Andel Institute has put Grand Rapids on the map for Parkinson's research.
Now, a potential collaboration with ParkinsonNet, an acclaimed Dutch health care concept, could make the region a leader in the care of those with the neurological disease that often affects the ability to walk and talk.
"This could be a fantastic opportunity for the people in West Michigan because it would mean it would be easier for them to get access to the best possible care," said Patrik Brundin, the Swedish scientist recruited in 2011 to lead Van Andel Institute's research into Parkinson's disease.
Brundin is recognized internationally as an authority on Parkinson's, the second biggest neurodegenerative disease after Alzheimer's with more than 7 million diagnosed worldwide.
VAI wants to partner with hospital systems in West Michigan on the program, Brundin said.
Dr. Patrik Brundin, director of Van Andel Research Institute's Center for Neurodegenerative ScienceOne reason costs dropped was because care needed for injuries related to the disease fell dramatically. Treatment of hip fractures were cut in half.
"Our starting point was listening to patients. I think there is a movement to see patients as an invaluable source of information," said Bas Bloem, a Dutch neurologist and creator of ParkinsonNet with Dr. Marten Munneke.
Bloem is trying to revolutionize the treatment of Parkinson's disease by advocating for patients to partner with their medical team in determining a treatment plan.
The 6-foot-7 doctor, who played volleyball on the Netherlands' national team in his youth, resembles actor Matthew McConaughey. His Ted Talk, "From God to Guide," has drawn a litany of praise on YouTube. One watcher calls the 11-minute video a "must watch" for every health care provider and patient.
MLive and The Grand Rapids Press interviewed Bloem at Radboud University Nijmegen Medical Centre last week during a five-day visit to the Netherlands at the invitation of the Dutch government.
Professor Bastiaan Bloem is the founder of ParkinsonNet, a program credited with improving care of patients with Parkinson's disease in the Netherlands. Willem-Alexander has a personal connection to Parkinson's. His father, Prince Claus, suffered from the disease before his death in 2002 at age 76. It is a connection that Brundin shares with the 48-year-old monarch. His father was also diagnosed with Parkinson's.
The Grand Rapids institute was started in 1996 by Amway co-founder Jay Van Andel, who died of Parkinson's in 2004.
Like Bloem, VAI advocates for patient-centered care. During its annual symposium last year, the institute held Rallying to the Challenge, a patient-centered meeting co-organized with two international patient advocate groups.
During his visit, he will speak at a symposium at the Van Andel Institute on June 1. The meeting is titled "The United States of America and the Netherlands: A Partnership that Works." Next week, Bloem will also lecture at a health care conference in Chicago before heading to Boston to meet with medical experts there about his program.
In the Netherlands, ParkinsonNet consists of 64 professional networks of trained professionals from occupational, speech and language therapists and physical therapists to nursing home specialists and doctors that specialize in geriatrics and neurology.
ParkinsonNet has received several awards including the "Best Pearl for Healthcare Innovation" in 2011. The The model was featured last year in The BMJ, formerly the British Medical Journal.
California-based health care giant Kaiser Permanente is partnering with Bloem to bring the ParkinsonNet model into its system because the program has applications for other chronic diseases including dementia, rheumatoid arthritis and heart disease.
Last year, Kaiser introduced the model in two counties in Southern California and is gearing up to spread the program statewide.
One of the features of the program is a website -- similar to Facebook but with stronger privacy controls in place -- which provides a place for patients and caregivers to raise questions, exchange experiences and talk about issues.
ParkinsonNet also has an online care finder the lets patients research doctors, therapists and nursing home staff who are trained in Parkinson's treatment and care. The site provides background about the medical personnel including information about their track record working with patients. The care finder is intended to assist Parkinson's patients in building personal networks of care.
Partnering with ParkinsonNet will help also VAI in its research to find a cure to the disease, because researchers can tap into the local network to recruit patients for a clinical trial or obtain DNA samples for a study.
Bloem thinks Grand Rapids could be the ideal platform for showing the effectiveness of ParkinsonNet in the United States.
"Obviously, our goal is not to stay in Grand Rapids alone," said Bloem. "We'll start small, think big, act fast. We'll start in Grand Rapids but hopefully expand to the rest of Michigan, and why not the rest of the states."
http://health.einnews.com/article/268009300/ZSBJZq9UxMId1xw7
Poor diet can cause Alzheimer's or Parkinson's in rats
May 28,2015
For several years, a researcher fed rodents in his laboratory a high caloric diet with glucose concentrations, which resulted in diabetes. By scientifically assessing what occurred in rats, Samuel Treviño Mora from the Meritorious University of Puebla (BUAP) in Mexico observed that "Diabetes and poor diet is a risk factor for developing Alzheimer's or Parkinson's."
The scientist at the faculty of chemistry (FCQ) reproduces human consumption in biological models with different genetic conditions. He feeds the animals with a high calorie diet, then analyzes the resulting metabolic disorder, triglycerides, insulin resistance, obesity and overweight development triggered in type II diabetes.
By measuring the effects on the brain, the analysis determined the existence of inflammation and neurodegeneration in the hippocampus and cerebral cortex, important areas for the proper functioning of short and long term memory. "With a diet based on high carbohydrates neurodegenerative conditions arise associated with Alzheimer's and Parkinson's diseases," says Trevino Mora.
"The diet of Mexicans is based on high caloric content, junk food and poor implementation of foods that we (mistakenly) think are healthy, like large quantities of cereals, drinks with high portions of sucrose or light foods containing fructose as a sweetener."
A child growing up overweight or obese may begin to develop diabetes in adolescence, and if this metabolic disease is not regulated, it is likely to result in brain damage. The same happens with adults. A poor dietmaintained at age 30 could result in these same features and reduce labor productivity in a very short time.
"We are talking about an progression from childhood that causes premature aging of the brain, similar to brain conditions observed in patients from 70 to 80 years of age, and occurring currently in people between 50 and 60," says Trevino Mora.
He adds that since childhood obesity could have a direct association with poor learning and consolidation of information, as well as problems retaining knowledge, and in the long-term, Alzheimer's.
Carbohydrate-based diets alter the conditions of brain regulation in people such as consumption (orexigenis) and lack of appetite (anorexigenis). When there is no energy balance, the body begins to lose these regulatory features and generate pathologies like Alzheimer's.
Samuel Treviño Mora is also developing a cellular device that measures the levels of glucose without a blood sample. He is developing sensors that record the voltage created by the flow of glucose on the skin, which are incorporated in a ring-shaped device.
"The idea is to create a phone application so that the patient has a constant measurement of their blood glucose levels without pricking their fingers," says the specialist.
http://health.einnews.com/article/267829259/2OzGpLQi3C8KVeob
Wednesday, May 27, 2015
FDA Clears Droxidopa for Neurogenic Orthostatic Hypotension
The US Food and Drug Administration (FDA) today approved droxidopa (Northera, Chelsea Therapeutics) for the treatment of neurogenic orthostatic hypotension (NOH) that is associated with Parkinson's disease, multiple-system atrophy, and pure autonomic failure.
The green light follows a 16-1 vote last month in favor of approval of droxidopa for NOH from the FDA's Cardiovascular and Renal Drugs Advisory Committee, despite their concerns about lack of evidence of long-term durability, as reported previously by Medscape Medical News .
The Committee first considered droxidopa for NOH in February 2012, and voted in a close vote of 7 to 4 in favor of approval. The FDA declined approval, though, in March 2012, suggesting the drug needed more study.
"People with neurogenic orthostatic hypotension are often severely limited in their ability to perform routine daily activities that require walking or standing," Norman Stockbridge, MD, PhD, director of the Division of Cardiovascular and Renal Drugs in the FDA's Center for Drug Evaluation and Research, said in an FDA statement released today.
"There are limited treatment options for people with NOH and we are committed to helping make safe and effective treatments available," Dr. Stockbridge added.
Droxidopa is converted in the body to norepinephrine. It is only the second drug approved for NOH in the United States; the other is the vasoconstrictor midodrine.
The FDA notes that the effectiveness of droxidopa was shown through 2 weeks in 2 clinical trials in patients with NOH. Patients taking droxidopa reported a decrease in dizziness, lightheadedness, feeling faint, or feeling as if they might black out compared with those taking a placebo, the FDA said.
"Durability of the improvement in patient symptoms beyond 2 weeks has not been demonstrated," the agency notes.
The most common adverse events reported by clinical trial participants taking droxidopa were headache, dizziness, nausea, hypertension, and fatigue.
The FDA says droxidopa will carry a boxed warning about the risk for supine hypertension. "It is essential that patients be reminded that they must sleep with their head and upper body elevated. Supine blood pressure should be monitored prior to and during treatment and more frequently when increasing doses," the FDA advises.
The FDA approved droxidopa under the accelerated approval program, which allows for approval of a drug to treat a serious disease based on clinical data showing that the drug has an effect on an intermediate clinical measure (in this case, short-term relief of dizziness) that is reasonably likely to predict the outcome of ultimate interest (relief of dizziness during chronic treatment).
This program provides patient access to promising drugs while the company conducts postapproval clinical trials to verify the drug's clinical benefit, which for this approval is a long-term effect on patient symptoms in NOH, a chronic disease.
http://www.medscape.com/viewarticle/820786
Fetal cells injected into a man's brain to cure his Parkinson's
- 20:00 26 May 2015 by Andy Coghlan
A man in
his mid-50s with Parkinson's disease had fetal brain cells injected into his
brain last week. He is the first person in nearly 20 years to be treated this way
– and could recover full control of his movements in roughly five
years.
"It
seemed to go fine," says Roger Barker
of the University of Cambridge, who is leading the international team that is
reviving the procedure.
The
treatment was pioneered 28 years ago
in Sweden, but two trials in the US
reported no significant benefit within the first two years following the
injections, and the procedure was abandoned in favour of deep brain stimulation
treatments.
What these
trials overlooked is that it takes several years for fetal cells to "bed
in" and connect properly to the recipient's brain. Many Swedish and North
American recipients improved dramatically, around three years or more after the
implants – long after the trials had finished. "In the best cases,
patients who had the treatment pretty much went back to normal," says
Barker
After the
fetal cells were wired up properly in their brains, they started producing the
brain signalling chemical dopamine – low levels of this cause the classic
Parkinson's symptom of uncontrolled movements. In fact, the cells produced so
much dopamine that many patients could stop taking their Parkinson's drugs.
"The prospect of not having to take medications for Parkinson's is
fantastic," says James Beck of the Parkinson's Disease Foundation in the
US.
Because
the early trials missed this improvement no one had received fetal brain cells
since the 1990s. But the man treated at Addenbrooke's Hospital in Cambridge on
18 May did not receive a full treatment, because the team only had enough cells
to treat one half of his brain.
The
transplant depends on fetal cell donations from women terminating pregnancies,
so the researchers don't know when cells are likely to be available. It takes
cells from at least three fetuses to treat each half of the brain, and four
earlier attempts to treat the same man had to be stopped due to a lack of
cells.
Lack of cells
But
Barker hopes to treat the other half of the man's brain soon. "We would
expect that if we do both sides, he will see an improvement in around six
months to a year," says Barker. But the maximum benefits are predicted to
happen in three to five years' time, and should then be sustained for more than
a decade, he says.
The team
plans to test the treatment in a further 19 people, in a trial split between
Cambridge and Sweden.
Barker
sees the revival of the technique as a stepping stone to injecting
dopamine-producing cells made by stem cells (see "Stem cells – the next
step" below). Trials of such treatments are expected as early as 2017, and
Barker hopes lessons learned from the fetal cell transplants will guide how to
apply and assess them once they are ready.
"We
are now on the road towards a 2.0 version of the cell therapy paradigm,"
says Lorenz Studer
of the Memorial Sloan Kettering Cancer Center in New York. He thinks future
treatment will eventually involve the use of dopamine neurons that come from
stem cells rather than fetal cells, which will permanently resolve the supply
problem.
Members
of the Parkinson's Disease Global Force met
in New York last week to discuss the progress of this stem cell work. When
Barker announced that his team's first patient had just left the operating
theatre, the meeting's attendees burst into spontaneous applause.
"There's
a real sense within the community that this is a collaborative effort to make
cell treatments work, and that there's real potential to change the lives of
hundreds of people worldwide," said Barker.
Stem
cells – the next step
The team
behind the fetal cell treatment (main story) hopes it will pave the way for
bespoke stem cell treatments to replace the missing dopamine in people with
Parkinson's disease. Rather than relying on fetal cells, these stem cell
treatments could in theory be made to order.
Four
teams – two in Europe and two in the US – have managed to make neurons from
embryonic stem cells and all are hoping to use them to treat people
with Parkinson's. Unlike fetal cells, these stem cells can provide a limitless
supply of neurons because they can divide many times.
Meanwhile
in Japan, researchers are using "induced pluripotent" stem cells to
make dopamine-producing cells. Unlike embryonic stem cells, such iPS cells can
be created from an adult's ordinary body tissues.
Roger
Barker of the University of Cambridge says all these teams are now gearing up
to test their cells in patients, hoping to begin in 2017.
http://www.newscientist.com/article/dn27593-fetal-cells-injected-into-a-mans-brain-to-cure-his-parkinsons.html?cmpid=RSS%7CNSNS%7C2012-GLOBAL%7Conline-news#.VWXoEGCKzAM