Ali's daughter gathers funds, aims to knock out Parkinson's Disease

Jan 09, 2016

By Gordon BoydLOUISVILLE, KY (WAVE)





She was six years from being born when the Rome Olympics' sensation then known as Cassius Clay won the Heavyweight Championship of the World with a first-round knockout of Sonny Liston.

She was in kindergarten when he won it back, “rope-a-doping” George Foreman.

“To us, he was just Daddy. He was no big deal,” Rasheda Ali Walsh said. “When we would see him on the television, our friends would say, ‘Oh

my God that's your father!’ Yeah, he is kind of cool, huh!”

Walsh is the second-born of Muhammad Ali’s nine children. She was 14 years old when the Champ learned he had Parkinson’s Disease.

“If it hit harder on him, he would never say it,” Walsh said. “For us, we were kind of like, 'That's interesting,' because outwardly, I didn't

see a different person. My Dad looked the same, he sounded the same.”

The symptoms took hold slowly, but cruelly.

“For it to affect someone like my Dad, who talked so much, the Louisville Lip who couldn’t shut his mouth, it’s frustrating,” Walsh said.

The tremors were clear when Ali lit the torch during the opening ceremonies of the 1996 Summer Olympics in Atlanta. But a question from her then-5-year-old son, Nico, would set her on a mission.

“'Why is Poppy shaking,'” she recalled her son asking. “And I said, ‘Well he has Parkinson's,' and I'm like, 'Don't you know?' And then I’m like, wait, this is silly.” 

She’d write I'll Hold Your Hand So You Won't Fall: A Child's Guide to Parkinson's Disease, a book for parents to explain Parkinson’s symptoms and treatments.

“I just want to know more about stem-cell therapy because I believe that is going to be our cure moving forward,” Walsh said.

That’s why she visited the Muhammad Ali Center on Saturday for only the second time since its opening. An “advance party” from the American Bus Association joined her Saturday. The ABA’s 4,000+ members are gathering at the Kentucky International Convention Center this weekend.

The travel and tourism show represents more than 1,000 motor coach and tour companies and creates “strong potential for future booked business

and economic benefits….as a direct result of showcasing Louisville to thousands of tour operators,” according to a press release from the Louisville Convention & Visitors Bureau.

“Probably giving $4 million back to Louisville, we need that,” Walsh said.

She’ll be the keynote speaker for the ABA’s opening luncheon Sunday. The group also has named the Michael J. Fox Foundation for Parkinson’s Research as its “charity of choice” for 2016.

“The more they can give to this Foundation, the more I think it's going to get this closer to the cure that we need,” Walsh said.

Ali’s refusal to be drafted for the Vietnam War cost him his heavyweight titles and his boxing license.

Upon reinstatement, boxing served as his platform for stands that transcended the sport.

“Usin' this 'face-the-world-knows' fame and going out and representing truth and helping certain causes,” Ali told an interviewer, shortly

after his Parkinson’s diagnosis in 1984.

Thirty-two years later, the Greatest has rounds to go.

“On good days, you won't even recognize him, he talks and babbles like he did in the 80s,” Walsh said.

Such days include advising grandson, Nico, now 15, who already has fought his first amateur bout.

“Right now his goal is to reach young people,” Walsh said. And become the hero to, I think, people who don't really have one.”

http://www.wave3.com/story/30925779/ali-daughter-gathers-funds-punches-toward-knocking-out-parkinsons-disease

Lawrence J. Bracken dead; former state appeals court judge was 84

Former state Supreme Court Justice Lawrence Bracke Former Justice Bracken, who once led the Second Appellate Division in Brooklyn, has died from Parkinson's Disease. He retired from the bench in 2001. Photo Credit: Family photo

Former state Supreme Court Justice Lawrence J. Bracken, who as an appeals court judge played a key role in the 1983 Baby Jane Doe parental-rights case, has died.

Bracken, a longtime resident of Setauket and East Setauket, died Wednesday from complications of Parkinson’s disease at the Long Island State Veterans Home in Stony Brook, where he lived. He was 84.Bracken served on the state Supreme Court from 1973 to 1981, when he was appointed to the Second Appellate Division in Brooklyn. He served on that court until 2001, when he stepped down at the mandatory state retirement age of 70.

In October 1983, Bracken temporarily blocked a lower court decision that had ordered surgery for a 10-day-old Long Island girl born with spina bifida, identified in court papers as Baby Jane Doe. The girl’s parents had opposed the surgery.

The full appellate court later ruled in the parents’ favor, and the surgery was not performed. had been a Suffolk County assistant district attorney in the 1960s and also worked in private practice with his late brother, Edward P. Bracken Jr.

Lawrence Bracken also was a volunteer firefighter and former Setauket Fire District commissioner. Bracken and his wife, Mary, who survives him, were married for 59 years. 

Bracken’s daughter, Mary E. Hill of Pembroke, Massachusetts, said he took the family on history-oriented trips to , Virginia, and Gettysburg, Pennsylvania. He also enjoyed bodysurfing at Cupsogue Beach County Park in Westhampton Beach and taught his children to care for the underprivileged, she said.

“He was my first and best teacher,” Hill said. “He always taught us that no matter who you are in life, you should be treated with respect, and that’s the way he treated everybody.”

In addition to his wife and daughter, Mary E. Hill, Bracken is survived by three other daughters, Clare F. Boothe of Duluth, Georgia, Anne M. DeNicola of St. James, and Patricia E. Ostuni of Northport; three sons, Lawrence J. Bracken II of Alpharetta, Georgia, Christopher P. Bracken of Denver, and Michael LeStrange of Burlington, Vermont; a brother, Donald Bracken, of Southold; a sister, Patricia Kilton of Stratford, Connecticut; 15 grandchildren; and six great-grandchildren.

Visiting hours are 2 to 4 p.m. and 7 to 9 p.m. Monday at Bryant Funeral Home in East Setauket. A funeral Mass will be said at 10:45 a.m. Tuesday at St. James Roman Catholic Church in East Setauket, followed by burial at St. James Cemetery

http://www.newsday.com/long-island/lawrence-j-bracken-dead-former-state-appeals-court-judge-was-84-1.11305930http://www.newsday.com/long-island/lawrence-bracken-dead-former-state-

New Parkinson’s disease treatment changes Vt. patient’s life

A new treatment is giving Americans with Parkinson’s disease their mobility back. One of the first patients is a Vermonter who says the medical discovery has changed her life.

Cassie Blanchard loved to play with her grandchildren, build snowmen and be that hip grandma. When Parkinson’s started to take hold of her life, she opted for a radical new treatment and she says she’s glad she did. Blanchard has her mobility back.

Not long ago, she walked her daughter to the bus and couldn’t get home.

“I ended up stuck on a bridge and I couldn’t get back home. Some nice man came by and helped me get back home,” she said.

At 36, this Randolph mother was diagnosed with Parkinson’s disease. More than 1 million others in the U.S. live with it, as well. As the years went by, her oral medication was less and less effective. She was taking the medication most Parkinson’s patients use, but when a pill wears off many patients can barely move.

“You then have this yin and yang where at times you’re moving well, but moving too much, and at other times you’re completely immobile,” said Dr. James Boyd of the UVM Medical Center.

Boyd now has an option for patients whose pills aren’t helping and who don’t want brain surgery. Blanchard is one of the first patients in America to take Duopa, a gel medicine pumped into the stomach continuously throughout the day that helps the brain and body work together.

“I’ve got me back. I’m able to do things again,” said Blanchard.

Boyd was one of several doctors to run clinical trials on the drug. The Food and Drug Administration approved the procedure earlier this year, where through surgery a tube is inserted into the patient’s abdomen.

“Anywhere along the way if you have a time where it seems like your medicine is running out, you press this extra dose button,” said Boyd.

Now, when Cassie Blanchard gets low on her meds the pump gives more. That’s made times with her husband and grandchildren so much more enjoyable.

Blanchard can take the drug for the rest of her life, but some symptoms are not affected by the new treatment. Any Parkinson’s patient could be a candidate.

http://mymedclinic.info/?p=3574

Researchers face potential danger from protein particles in the lab

Jan. 8, 2016

Lewy bodies and Lewy neurites are found in the brains of Parkinson's disease (PD) patients. They consist primarily of fibrils of the protein alpha-synuclein (α-Syn), which self-assembles into fibrils in vitro. If introduced into the human body, these seeds can act as prions and trigger the formation of toxic protein deposits. Because α-Syn fibrils are often used in research, it is important that they are not accidentally transferred to humans or cell cultures. Researchers reporting in the Journal of Parkinson's Disease describe three cleaning procedures that effectively remove and disassemble these α-synuclein seeds.

α-Syn is purified and assembled in test tubes into fibrils that are used to investigate/mimic PD pathogenesis in model animals ranging from worms (c. elegans) to rodents and non-human primates in a large number of laboratories. These laboratories typically contain surfaces and non-disposable items made from plastic, glass, aluminum, or stainless steel. These items are often rough, with areas that cannot be completely cleaned by wiping. Therefore, it is important to minimize contamination through effective cleaning procedures.

"Several teams, including ours, demonstrated that fibrillar α-Syn propagate from one cell, including neurons, to another and amplify during this propagation process mimicking prion particle behavior. These observations suggest that fibrillar α-Syn is not innocuous," explained lead investigator Ronald Melki, PhD, Director of Research at the Paris-Saclay Institute of Neurosciences, CNRS, Gif-sur-Yvette, France.

Researchers applied a solution of fluorescently-labeled fibrils and ribbons of α-Syn to roughened surfaces mimicking laboratory conditions. The droplets were easily visible to the eye and could be assessed by their fluorescence.

Five cleaning solutions were tested: 1) sodium hypochlorite (20,000 ppm); 2) sodium hydroxide (1N), 3) sodium dodecyl sulfate (SDS, 1%, W/V); 4) Hellmanex (1%, V/V); and 5) TFD4 (1%, V/V). As a control, the surfaces were washed with just commercially prepared pure water. After cleaning, the amount of small assemblies, fibrils, and ribbons of α-Syn remaining on the surfaces was measured by fluorescence. To evaluate whether the α-Syn fibrils that were washed off the surfaces were destroyed, fibrils and ribbons were incubated in the various cleaning solutions for one hour and the amount of remaining fibrils was measured.

The researchers found that the commercial detergents Hellmanex, and SDS (1%, W/V) are the most suitable cleaning reagents for removal and neutralization of α -Syn seeds from contaminated surfaces. However, solutions of sodium hypochlorite (20,000 ppm) or sodium hydroxide (1N), previously shown to diminish prion infectivity, were ineffective. Plain water was similarly ineffective.

As the result of this investigation, the research teams have implemented "Laboratory Standard Operating Procedures for fibrillar α-Syn" to minimize possible contamination. This includes a cleaning procedure that removes and disassembles α-Syn fibrils adsorbed on plastic, glass, aluminum, or stainless steel surfaces as well as recommended disposal procedures for various forms of α-Syn waste. This cleaning method is sufficiently mild to allow efficient decontamination of non-disposable tools in a laboratory.

"We conclude that cleaning procedures relying on the use of detergents that are compatible with most non-disposable tools in a laboratory are simple to implement and highly recommended when working with fibrillar α-Syn in a laboratory setting," stated co-investigator Patrik Brundin, MD, PhD, Editor-in-Chief of the Journal of Parkinson's Disease and Director of the Center for Neurodegenerative Science at Van Andel Research Institute in Grand Rapids, Michigan.

"The procedures we describe remove and inactivate α-Syn fibrillar assemblies to a level where they are undetectable, which significantly improve researchers' safety when handling fibrillar α-Syn. Further work is needed to establish the infectious unit of recombinant α-Syn and the biological efficiency of the cleaning," added co-investigator Luc Bousset, PhD, at the Paris-Saclay Institute of Neurosciences, CNRS.

http://www.medicalnewstoday.com/releases/304867.php

Takeda, NsGene collaborate to develop cell encapsulation therapies for Parkinson's disease

Osaka, Japan Saturday, January 09, 2016, 10:00 Hrs  [IST]

Takeda Pharmaceutical Company Limited, a research-based global company, and NsGene, Inc., a privately held clinical stage biotechnology company, announced a research agreement to develop encapsulated cell therapies for the potential treatment of Parkinson’s disease. The partnership will focus on the delivery of recombinant Glial Cell Line-Derived Neurotrophic Factor (GDNF) to affected brain regions by way of implanted, encapsulated cell therapy devices. GDNF has been pursued as a neuro-regenerative growth factor that holds promise in the treatment of Parkinson’s disease, but has met problems in delivery of drug to the affected portions of the diseased brain. This collaboration will explore the potential of surgically implanted recombinant cells housed within a device to directly secrete GDNF on site to promote neuron survival and regeneration. NsGene has developed the experimental technology that originated at Brown University into a clinically applicable cell therapy platform. The device contains genetically engineered cells encased in an immune-shielding capsule that can continuously produce therapeutic levels of biotherapeutics for an extended time after implantation. GDNF is a neurotrophic factor that has been shown in preclinical systems to promote axon growth and protect dopaminergic neurons when delivered directly to the diseased cells for an extended duration. NsGene will receive funding from Takeda for technology development that enables NsGene to complete critical scientific milestones needed for clinical trials and further constructive partnering. Further details of the agreement were not disclosed. Takeda is considering regenerative medicine as a potential new modality to treat diseases and is committed to supporting such research. The research collaboration with NsGene marks one of Takeda’s efforts to explore a novel biologics modality and implantable drug delivery system that could potentially make an impact in the lives of many patients. http://health.einnews.com/article/305483905/TrC68vbkaNTBwC1p ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Takeda Pharmaceutical : and NsGene Partner to Perform Research in Cell Encapsulation Therapies for Parkinson's Disease Osaka, Japan, January 8, 2016, and Providence, RI; January 7, 2016 - Takeda Pharmaceutical Company Limited (TSE: 4502) and NsGene, Inc. today announced a research agreement to develop encapsulated cell therapies for the potential treatment of Parkinson's disease. The partnership will focus on the delivery of recombinant Glial Cell Line-Derived Neurotrophic Factor (GDNF) to affected brain regions by way of implanted, encapsulated cell therapy devices. GDNF has been pursued as a neuro-regenerative growth factor that holds promise in the treatment of Parkinson's disease, but has met problems in delivery of drug to the affected portions of the diseased brain. This collaboration will explore the potential of surgically implanted recombinant cells housed within a device to directly secrete GDNF on site to promote neuron survival and regeneration.  NsGene has developed the experimental technology that originated at Brown University into a clinically applicable cell therapy platform. The device contains genetically engineered cells encased in an immune-shielding capsule that can continuously produce therapeutic levels of biotherapeutics for an extended time after implantation. GDNF is a neurotrophic factor that has been shown in preclinical systems to promote axon growth and protect dopaminergic neurons when delivered directly to the diseased cells for an extended duration. NsGene will receive funding from Takeda for technology development that enables NsGene to complete critical scientific milestones needed for clinical trials and further constructive partnering. Further details of the agreement were not disclosed. Takeda is considering regenerative medicine as a potential new modality to treat diseases and is committed to supporting such research. The research collaboration with NsGene marks one of Takeda's efforts to explore a novel biologics modality and implantable drug delivery system that could potentially make an impact in the lives of many patients. About NsGeneNsGene, Inc. is a privately held clinical stage biotechnology company based in Providence, Rhode Island developing the Encapsulated Cell Therapy platform. The company works with industrial and academic partners to develop products with applications in neurological disorders and sensorineural hearing loss. The company has successfully applied its technology in initial clinical studies for the treatment of Alzheimer's disease. About TakedaLocated in Osaka, Japan, Takeda (TSE: 4502) is a research-based global company with its main focus on pharmaceuticals. As the largest pharmaceutical company in Japan and one of the global leaders of the industry, Takeda is committed to strive towards better health for people worldwide through leading innovation in medicine. Additional information about Takeda is available through its corporate website, www.takeda.com. CONTACTS:NsGeneLars Wahlberg, CEO +1 401-489-4765 TakedaJapanese Media Tsuyoshi Tada tsuyoshi.tada@takeda.com +81-3-3278-2417 Media Outside of Japan Julia Ellwanger julia.ellwanger@takeda.com +1 224-554-7681 # # # Takeda Pharmaceutical Co. Ltd. issued this content on 2016-01-08 and is solely responsible for the information contained herein. Distributed by Public, unedited and unaltered, on 2016-01-08 01:06:08 UTC http://health.einnews.com/article/305272630/NjXGGlVimAA2aCBg

Michael J Fox Foundation backs wearable device trial

Partners with chip manufacturer Intel and Cynapsus Therapeutics on Parkinson's study

January 16, 2016
Article by
Phil Taylor

Trials of a new therapy for Parkinson's disease developed by Cynapsus Therapeutics will use a smartwatch-like device to monitor results, thanks to backing from the Michael J Fox Foundation.

Chip manufacturer Intel and MJFF are working with Cynapsus to develop the sensor, which will be used to detect when patients with Parkinson's suffer an 'off' episode - a period of time during which symptoms re-emerge despite the use of medicines.

The smartwatch incorporates motion sensors that can detect when the symptoms of an off episode, such as muscle stiffness, slow movements, and difficulty starting movements known as 'freezing'. Off episodes remain a major problem for patients who have been on long term therapy with drugs such as levodopa, occurring in up to 50% of all patients on treatment for five years or more.

The device will be used in a phase III trial of Cynapsus' APL-130277, a rapid-acting, sublingual formulation of apomorphine, to treat off episodes in patients with Parkinson's. It is paired with an Intel-developed app that will harvest and analyse the data generated from the smartwatch.

Apomorphine is a dopamine agonist that is already widely used to treat off episodes but is currently only available as an injection as it has a very short half-life in the body.

Cynapsus chief executive Anthony Giovinazzo said that using wearable technology to collect data in the trial "has enormous potential to improve our understanding of how drugs and other treatments impact patients living with the debilitating symptoms of this disease."

The technology will be used in a sub-population of patients in the study and tie into an ongoing collaboration between the MJFF and Intel - first signed in 2014 - that is focusing on the use of a 'big data' approach to the collection, storage and interpretation of results from Parkinson's studies.

The trial ties in with a growing emphasis on the use of wearable technologies in clinical applications, and the availability of accelerometer sensors has made movement disorders such as Parkinson's disease a prime candidate.

Last month, UCB revealed that is trialling a wearable patch and associated app that can be used to monitor and record symptoms in Parkinson's patients, freeing them from the need to write paper-based diaries.

MJFF recently launched a new programme called Fox Insight, which aims to gather movement data from Parkinson's patients as they go about their daily activities over a five-year period. All the participants in Fox Insight receive a free Pebble smartwatch, linked to an Android app.

Commenting on the Cynapsus trial, MJFF chief executive Todd Sherer said: "Data science approaches hold the potential to accelerate the pace of progress by allowing drug developers to objectively gather and analyse unprecedented volumes of data and more quickly reveal insights about a potential new treatment."

http://health.einnews.com/article/305348935/yEi_VYy71lV34bd7

CareMAP: Plans and Scheduling Part 1

CareMAP: Plans and Scheduling Part 2

Parkinson’s Patients Could Dance Their Way to Better Health

Repeat studies show multiple benefits in brain function and body movement through dance practice

Jan. 8, 2016

By Magdalena Kegel

A recent article in the Harvard Gazette suggests dance as a potential treatment for neurodegenerative disorders such as Parkinson’s disease (PD).

Imaging studies have identified several brain regions involved in the complex, rhythmical, and coordinated movements that constitute dance. The motor cortex is — as with other kinds of voluntary movement — involved in planning, controlling, and executing dance moves.

The somatosensory cortex, as the name implies, is involved in processing sensory information, but it is also responsible for motor control. The basal ganglia connects with other brain regions to make movement smooth, and the cerebellum helps by combining brain and spinal cord signals to execute complex and delicate movements.

While many researchers want to know how our brain makes us dance, the effects of dance on the brain are a popular field of investigation. Many of these findings, not surprisingly, overlap with results from exercise studies, showing improved memory and increased neural connectivity in dancers.

Harvard Gazette specifically mentions a study in the high-profile New England Journal of Medicine demonstrating that dance lowered dementia risk. The study explored the effects of a long list of physical activities, including cycling, golf, swimming, and tennis, but found only dance to protect against dementia. According to the researchers, it was the combination of mental effort and social interaction that gave dance its unique neuroprotective aspect.

Another study found the dance Zumba improved mood, decision-making, and visual recognition, while additional studies point to beneficial effects of reduced stress, increased levels of serotonin, and improved cognitive skills such as executive function, long-term memory, and spatial recognition.

Parkinson’s disease researchers are among these investigators, and studies in PD patients show that gait and upper-extremity function is improved when patients are exposed to rhythmic auditory stimulation (RAS).

Daniel Tarsy, professor of neurology at Harvard Medical School and director of the Parkinson’s Disease and Movement Disorders Center at Beth Israel Deaconess Medical Center, sees dance as a form of RAS. Tarsy told the Gazette that PD patients “speak and walk better if they have a steady rhythmic cue.”

Peter Wayne, an assistant professor of medicine at Harvard, studies tai chi in PD patients. Tai chi was developed as a Chinese self-defense martial art but is now a popular form of exercise. Consisting of slow and balanced movements, it can be considered a ritualized, structured form of dance, he said.

According to the Gazette, research has shown that PD patients practicing tai chi had improved strength, flexibility, and cognitive performance, and a reduced risk of falls, compared to non-practitioners.

Dr. Tarsy has initiated several programs that offer tai chi, Zumba, yoga, and drumming for people with PD at the Beth Israel Deaconess. He said that it is not known if, and how, these programs will benefit the patients, but research evidence clearly points to the possibility that dance can stabilize the effects of the disease and slow the progression of motor complications.

http://parkinsonsnewstoday.com/2016/01/08/dance-may-improve-symptoms-in-parkinsons-disease/

5 Facts About Parkinson’s Disease

Jan. 7, 2016

Brought into the limelight by actor Michael J. Fox, Parkinson’s disease affects the body’s ability to control movement.

The most prominent signs of Parkinson’s disease result from damage to brain cells that produce a neurochemical called dopamine. Dopamine helps people have smooth, coordinated muscle movements by relaying messages to the parts of the brain that control these movements.Damage to dopamine-producing cells can induce symptoms, such as tremors, stiffness and slowness.

“The early signs tend to be subtle and intermittent, and then they become more progressive until it is clear that something is wrong,” says Kathleen Shannon, MD, a neurologist who specializes in movement disorders at Rush University Medical Center.

The damage to brain cells is not limited to those producing dopamine. Other symptoms such as depression, anxiety, cognitive impairment, constipation and fatigue result from damage to other brain regions and are the focus of more recent research.

At present, Parkinson’s disease is a chronic disease with no known cure. While symptoms can be managed with medication, they continue to worsen.

The good news? Shannon predicts that in the next decade there will be significant breakthroughs in treating Parkinson’s disease and slowing the progression of the disease.

In fact, according to the National Institute of Neurological Disorders and Stroke, current advances in Parkinson’s research have already raised realistic hopes of being able to halt the progression of the disease, restore lost function and even prevent it entirely.

While the timeframe for this is hard to predict — it could be within five to 10 years — one thing is certain: hope is on the horizon. Here, Shannon shares five things to know about Parkinson’s disease.

Early detection may improve future treatments.

One of the big pushes in Parkinson’s research today is detecting the disease before such characteristic movement symptoms, like tremors, surface.

Research suggests that dopamine begins to decline six to 10 years before any neurological symptoms appear and that damage to other nervous system regions may occur even earlier. Very early signs of Parkinson’s disease that may appear before evident motor deterioration include the following:

• Loss of sense of smell, which begins about four to six years before movement dysfunction.
• Chronic constipation, which can begin up to 12 years before motor symptoms.
• Physically acting out dreams at night, a sleep disorder that is known as REM behavior disorder, can begin up to decades before any motor symptoms.

While these symptoms do not always signify Parkinson’s disease, people should discuss these issues with a physician. By studying groups of people with early signs, researchers are developing treatments that target different parts of the brain that could slow, or even halt, the progression of the disease.

“Our goal is to find ways to prevent people from developing movement problems, and we’re getting to a point where that is an achievable goal,” Shannon says.

Standard treatments are being tweaked.

Since the late 1960s, levodopa (a medication that the brain converts to dopamine) has been the most effective treatment for addressing motor symptoms of Parkinson’s disease. The problem for some patients, however, is levodopa does not provide the constant flow of dopamine necessary for smooth function throughout the day.

“People sometimes get into a pattern of good function when the medication is working well, alternating with bad function when the medication is not working well,” Shannon says. “That unpredictability makes it hard to live a normal lifestyle.”New research is focused on developing treatments that will give people a more steady flow of dopamine and decrease fluctuations.

“There is a lot of work going on to fine-tune brain cells to receive dopamine so the response is better,” says Shannon. “The Michael J. Fox Foundation and some of the drug companies are very interested in this area of research.”

One common side effect of not having steady levels of dopamine is dyskinesia (involuntary movements). To address this issue, Christopher Goetz, MD, director of the Parkinson’s Disease and Movement Disorders Program at Rush, is working on a multi-center clinical trial of topiramate (a seizure medication) as an add-on to amantadine (a medication used for treating dyskinesia) to improve control of dyskinesia. This study is funded by the Michael J. Fox Foundation, and Rush is both a participating site and the coordinating site for the study.

Additionally, Leo Verhagen, MD, PhD, a neurologist at Rush, is participating in a study involving an investigational agent for dyskinesia. The study will include people who are taking amantadine as well as those who are not taking amantadine for dyskinesia.

Surgical intervention decreases fluctuations.

People who respond well to medications, but struggle with fluctuations throughout the day may be eligible for deep brain stimulation (DBS), a surgical treatment in which a neurostimulator delivers tiny electrical signals to areas of the brain that control movement.

“DBS is not dopamine, and it does not cause the release of dopamine. But the stimulation is constant, so it reproduces the effect of having constant dopamine,” says Shannon. “For people who do well with DBS, it is a miraculous improvement.”

While DBS is rarely a substitute for medication, it is a good option for otherwise healthy people who have periods where their medications aren’t working.

Exercise can improve function.

In addition to its well-known effects of slowing down cognitive decline and boosting heart and lung function, exercise can help improve gait, balance, tremor, flexibility, grip strength and motor coordination in people with Parkinson’s disease. Ongoing studies are also looking at how exercise may, in fact, influence the progression of the disease.

Beneficial exercises include treadmill training, biking, dance, tai chi, yoga, and strength and flexibility training.

Five years ago, Rush partnered with Hubbard Street Dance Center to create a dance class for Parkinson’s patients. Today, Hubbard Street Dance’s Parkinson’s Project is a popular weekly class for people with Parkinson’s disease, their loved ones and their caregivers.

The program uses contemporary dance techniques, along with live music, to help patients improve their balance, dexterity or an overall mobility. Equally as important, the class is a warm, welcoming community that provides emotional support to its participants.

Managing your mood is crucial.

Living with a chronic, progressive disease can take a serious emotional toll on patients and their loved ones. Depression and anxiety are common symptoms of Parkinson’s disease, with up to 60 percent of people who have the disease experiencing mild or moderate depressive symptoms.

“Depression becomes the real driver of quality of life for people with Parkinson’s disease,” says Shannon. “You can adjust people’s motor function all day long with medication or surgery, but if you can’t improve their mood, then they have a poor quality of life.”

Some patients benefit from psychological counseling and/or taking medications to help improve their mood. Support groups — such as the group hosted by Rush Oak Park Hospital the second Saturday of each month — can also help people with Parkinson’s disease learn how to live changed, yet still full lives.

“We work with our patients to find medications and other strategies that will improve their quality of life at every stage of the disease, targeting the symptoms that matter most to them and their families,” says Shannon.

http://mymedclinic.info/?p=3506