Essentially erasing an essential tremor

April 8, 2016

When I think of tremors, I picture an older man struggling to write, his fingers quivering. But for Brad Ackerman, an industrial designer shown at right, the trembling started early. For decades, a movement disorder known as essential tremor stymied his social life, career and daily activities. A recent article from Stanford Medicine News explains:

The tremor began to affect the direction of his life. In high school, he loved drawing and painting, but his tremor meant he could not easily hold or control a pencil, pen or paintbrush. He was in denial, telling himself that he just didn’t have the talent for art.

Although he learned to compensate, as he aged, the condition worsened. And the drugs he was prescribed had some unpleasant side effects:

The underpinning for essential tremor is irregular electrical activity in deep circuits of the brain. But for many years, medication was the only option available to quiet that activity… Ackerman did not like how he felt while medicated. “It just made me want to sit and do nothing,” he said. “It got harder and harder to do a drawing at work. After a while, I couldn’t do it.”

Fortunately, there was a newer, surgical remedy to alter the electrical activity. It involves implanting a device in his brain:

The treatment, called deep brain stimulation, is currently being used at Stanford to treat Parkinson’s disease and other movement disorders.

Ackerman had a procedure in February 2014 that involves MRI-guided placement of a small, insulated wire into one of the targeted brain structures. At the tip of that wire are four small electrodes that can release electrical impulses to block tremor. The wires are connected to a 2-by-3-inch battery pack that sits under the skin in the chest, just as cardiac pacemakers do. Like most people undergoing the procedure, Ackerman was awake during the process, providing feedback to his neurosurgeon, Casey Halpern, MD, so the surgeon could adjust the pacemaker to meet Ackerman’s particular needs.

Ackerman is pleased with the results. “It was much better and I can do my job better,” he said in the piece. “I had such anxiety as a result of the tremor, from all the things I had to think about to do what most people consider simple tasks. My whole life has changed.”

Photo by Norbert von der Groeben

- See more at: http://scopeblog.stanford.edu/2016/04/08/essentially-erasing-an-essential-tremor/#sthash.pNckCgHP.dpuf

http://scopeblog.stanford.edu/2016/04/08/essentially-erasing-an-essential-tremor/

THE EMOTIONAL EFFECTS OF DBS ON PARKINSON'S DISEASE

6th April 2016 - New research

Researchers assessed the effect of Deep Brain Stimulation (DBS) on anxiety, depression and psychosis. Deep Brain Stimulation involves the use of electrodes that are implanted into the brain and connected to a small electrical device that can be externally programmed. DBS can reduce the need for L-dopa and related drugs, which in turn decreases the dyskinesias that are a common side effect of L-dopa. DBS helps to alleviate fluctuations of symptoms and reduce tremors, slowness of movements, and gait problems. DBS requires careful programming of the stimulator device.

 For more information go to : http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm

Improvement of depression and anxiety was apparent after DBS, and was more pronounced in the short-term, an effect that seems to decline in later assessments. Concerning depression, DBS was more effective than medical treatment. However, with anxiety, medical treatments were found to be more effective than DBS. The pattern and course of depression and anxiety following DBS is not clear, although both seem to improve in the short-term.

The risk of psychosis remains fairly constant throughout the first five years after DBS implantation. Results suggest that most psychoses occurring postoperatively are independent of DBS implantation and stimulation settings.

References :
Acta Medica Portuguesa [2014] 27 (3) : 372-382 (M.I.Couto, A.Monteiro, A.Oliveira, N.Lunet, J.Massano) http://www.ncbi.nlm.nih.gov/pubmed/25017350
Neurosurgical Focus [2015] 38 (6) : E5 (A.A.Qureshi, J.J.Cheng, A.N.Sunshine, A.Wu, G.M.Pontone, N.Cascella, F.A.Lenz, S.E.Grill, W.S.Anderson) http://www.ncbi.nlm.nih.gov/pubmed/26030705

©2016 Viartis 
http://www.viartis.net/parkinsons.disease/news/160406.pdf

DNA Testing Combined With Wireless Sensor to Improve Parkinson’s Diagnosis

NEUROSCIENCE NEWSAPRIL 7,

Scripps Translational Science Institute partnering with Michael J. Fox Foundation and Intel. 

Researchers hope to validate a testing method that can accurately differentiate between Parkinson’s disease and essential tremor, the most common movement disorder, which is often mistaken for Parkinson’s. Image adapted from the Scripps Health press release.

Diagnosing Parkinson’s disease, especially in its early stages, has long been a challenge for physicians. A newly launched study by the Scripps Translational Science Institute (STSI) aims to improve screening accuracy by combining the power of genetic sequencing and wireless sensors.

Researchers hope to validate a testing method that can accurately differentiate between Parkinson’s disease and essential tremor, the most common movement disorder, which is often mistaken for Parkinson’s. Earlier and better diagnosis could improve the use of treatment options and speed research toward new therapies.

“Because there is no single reliable test for Parkinson’s, a diagnosis is often based on subjective observations by a physician,” said Ali Torkamani, Ph.D., director of genome informatics at STSI and the study’s lead investigator. “Misdiagnosis occurs in as many as 35 percent of cases, according to several clinical studies. By utilizing the power of precision medicine, we hope to create a more reliable method for screening patients exhibiting possible Parkinson’s symptoms.”

STSI has teamed up with The Michael J. Fox Foundation for Parkinson’s Research (MJFF) and Intel’s Health and Life Sciences organization to work on the study named GADGET-PD, which is short for Genetic and Digital Diagnosis of Essential Tremor and Parkinson’s Disease. MJFF has provided the use of a smartphone-based app, Fox Insight (developed with Intel), to collect tremor data. Intel has helped fund the research and developed a cloud-based platform that can store and process the sensor data and yields real-time insights that aid STSI in their Parkinson’s research.

STSI is a National Institutes of Health-sponsored consortium led by Scripps Health in collaboration with The Scripps Research Institute. Through this innovative research partnership, Scripps is leading the effort to translate wireless and genetic medical technologies into high-quality, cost-effective treatments and diagnostics for patients.

While 60,000 Americans are diagnosed with Parkinson’s each year, thousands more cases go undetected, according to the Parkinson’s Disease Foundation. As many as 1 million Americans live with the disease.

STSI researchers are recruiting 96 people to participate in the GADGET-PD clinical trial through the Parkinson’s Disease and Movement Disorder Center at Scripps Clinic in La Jolla, which is operated by neurologists Nelson Hwynn, D.O., and Melissa Houser, M.D. Half of the participants already will have been diagnosed with Parkinson’s, and the other half will have received an essential tremor diagnosis.

Patients will contribute blood samples for DNA sequencing, and researchers will search subjects’ genetic data for gene variants known to be associated with Parkinson’s risk.

Each participant also will be equipped with a smartwatch, which tracks motion through an imbedded accelerometer, and an Android smartphone, which uses the Fox Insight app to transmit study data to a cloud-based platform developed by Intel.

Participants will wear the smartwatches 24 hours a day for two weeks, except during charging periods. Three times a day, participants will induce a resting tremor by playing a logic game for two minutes on the smartphone app. The game requires the player to roll a ball around a video maze by tilting the device.

“By combining genetic risk data with subtle tremor characteristics, we hope to create a detailed patient profile that accurately differentiates patients with Parkinson’s from those with essential tremor at the early stages of disease,” Torkamani said.

Mark Frasier, Ph.D., MJFF senior vice president of research programs, said, “The ability to diagnose Parkinson’s more definitively would help patients manage their care and researchers confirm that the volunteers in their trial truly have the disease they’re targeting, raising the likelihood of successful treatments passing clinical testing. This project’s approach to combine genetic analysis and objective measures shows promise in advancing toward that goal.”

“Gaining access to valuable health data and turning it into meaningful insights will lead to advances in precision medicine,” said Ketan Paranjape, general manager of Intel’s Life Sciences team. “Through the implementation of the analytics solution developed by The Michael J. Fox Foundation and Intel, consisting of a consumer wearable and an analytics platform optimized for Intel® architecture that can analyze both genomics and phenotypical data, institutions like Scripps Translational Science Institute are able to use the power of data to accelerate their research on Parkinson’s disease.”

ABOUT THIS PARKINSON’S DISEASE RESEARCH

More information about the GADGET-PD trial is available at ClinicalTrials.gov (study Identifier: NCT02668835).

Source: Keith Darce – Scripps Health
Image Source: The image is adapted from the Scripps Health press release.

http://neurosciencenews.com/parkinsons-genetics-wireless-technology-3991/

Brain Stimulation And You: How Does It Work And Can It Really Juice Up Your Thinking Cap?

April 8, 2016

DBS Surgery

For as long as people have had access to electricity, we’ve tried to use it to cure our maladies. From grabbing onto electric eels to treat our headaches in the 1st Century to subjecting ourselves to electroshock therapy in attempts to dispel depression and schizophrenia, we’ve often come out with mixed, but not entirely fruitless, results. 

Thankfully, as modern medicine has progressed, so too has our mastery of therapeutic lightning in a bottle. Nowadays, a variety of electrical stimulation techniques that more precisely target the brain have found homes within doctors’ offices. They’ve proven effective in treating Parkinson’s disease and other movement disorders, while also showing promise for conditions like anorexia, tourette syndrome, and, you guessed it, depression. Meanwhile, techniques like transcranial direct current stimulation (tDCS) are becoming increasingly commercialized as easy-to-use consumer products that can either juice up our noggins or calm our anxious minds

http://www.biospace.com/news_story.aspx?StoryID=414980&full=1

Pfizer : Taps IBM for Research Collaboration to Transform Parkinson's Disease Care

April 8, 2016

New York and Armonk, N.Y -- Pfizer Inc. (NYSE:PFE) and IBM(NYSE: IBM) today announced a first-of-its-kind research collaboration to develop innovative remote monitoring solutions aimed at transforming how clinicians deliver care to patients suffering from Parkinson's disease. The experimental approach will rely on a system of sensors, mobile devices, and machine learning to provide real-time, around-the-clock disease symptom information to clinicians and researchers. The ultimate goal is to obtain a better understanding of a patient's disease progression and medication response to help inform treatment decisions and clinical trial design, while also speeding the development of new therapeutic options.

Parkinson's disease in particular requires ongoing adjustment to medication depending on the progression of the disease and response of the patient. The collaboration seeks to create a holistic view of a patient's well-being by seeking to accurately measure a variety of health indicators, including motor function, dyskinesia, cognition, sleep and daily activities such as grooming, dressing and eating. Insights from these data could help clinicians understand the effect of a patient's medication as the disease progresses, enabling them to help optimize the patient's treatment regimen as needed. Data generated through the system could also arm researchers with the insights and real-world evidence needed to help accelerate potential new and better therapies.

According to the World Health Organization, neurological disorders including Parkinson's disease, Alzheimer's disease, stroke, multiple sclerosis and epilepsy impact almost one billion families around the worldi and account for 12 percent of total deaths globally.ii Many diseases of the brain, spine, and nerves are progressive conditions that get worse over time and can create uncontrolled movement, impair the ability to think, and cause other debilitating symptoms impacting the patient's quality of life. Approximately 60,000 Americans are diagnosed with Parkinson's disease each year according to the Parkinson's Disease Foundation, and an estimated seven to 10 million people suffer from the disease globally.iii

"We have an opportunity to potentially redefine how we think about patient outcomes and 24/7 monitoring, by combining Pfizer'sscientific, medical and regulatory expertise with IBM's ability to integrate and interpret complex data in innovative ways," said Mikael Dolsten, M.D., Ph.D., President of Pfizer Worldwide Research and Development. "The key to our success will be to deliver a reliable, scalable system of measurement and analysis that would help inform our clinical programs across important areas of unmet medical need, potentially accelerating the drug development and regulatory approval processes and helping us to get better therapies to patients, faster."

"With the proliferation of digital health information, one area that remains elusive is the collection of real-time physiological data to support disease management," said Arvind Krishna, Senior Vice President and Director of IBM Research. "We are testing ways to create a system that passively collects data with little to no burden on the patient, and to provide doctors and researchers with objective, real-time insights that we believe could fundamentally change the way patients are monitored and treated."

The two companies project that the system will move into initial clinical testing quickly. Pfizer and IBM will convene an external advisory board of patient groups, advocacy organizations, clinicians, and neuroscientists for guidance on the use of technology, medical devices, data management, and research protocols, and to ensure the needs of patients guide the program.

IBM IoT in Healthcare

This project marks a significant milestone in IBM's work to advance Internet of Things (IoT) technologies in healthcare. Emory University Hospital is creating an instrumented ICU using IBM's streaming analytics technology to advance predictive medicine for critical patients in the ICU. The new system will enable clinicians to acquire, analyze and correlate medical data at a volume and velocity that was never before possible. Neonatal intensive care specialists at The University of Ontario Institute of Technology are relying on the same software to analyze more than 1,000 pieces of unique information per second flowing from sensors and equipment monitoring premature babies, helping caregivers spot the onset of sepsis infections up to 24 hours earlier. And, Medtronic is working with IBM Watson Health to create a cognitive app designed to analyze real-time data from Medtronic devices to help detect important patterns and trends for people with diabetes.

About IBM

Learn more about IBM Research at www.research.ibm.com.

Learn more about IBM Watson Health at www.ibm.com/watsonhealth.

Follow us on Twitter at @IBMResearch and @IBMWatsonHealth

About Pfizer Inc.

At Pfizer, we apply science and our global resources to bring therapies to people that extend and significantly improve their lives. We strive to set the standard for quality, safety and value in the discovery, development and manufacture of health care products. Our global portfolio includes medicines and vaccines as well as many of the world's best-known consumer health care products. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as one of the world's premier innovative biopharmaceutical companies, we collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For more than 150 years, Pfizer has worked to make a difference for all who rely on us. For more information, please visit us at www.pfizer.com. In addition, to learn more, follow us on Twitter at @Pfizer and @Pfizer_News and like us on Facebook at Facebook.com/Pfizer.

Pfizer Disclosure Notice

The information contained in this release is as of April 7, 2016. Pfizer assumes no obligation to update forward-looking statements contained in this release as the result of new information or future events or developments.

This release contains forward-looking information about a research collaboration with IBM to develop innovative remote monitoring solutions aimed at transforming how clinicians deliver care to patients suffering from Parkinson's disease, and its potential benefits, that involves substantial risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statements. Risks and uncertainties include, among other things, the uncertainties inherent in research and development; risks related to the ability to realize the anticipated benefits of the collaboration with IBM, including the possibility that the expected benefits from such collaboration will not be realized or will not be realized within the expected time period; other business effects, including the effects of industry, market, economic, political or regulatory conditions; and competitive developments.

A further description of risks and uncertainties can be found in Pfizer's Annual Report on Form 10-K for the fiscal year ended December 31, 2015, and in its subsequent reports on Form 10-Q, including in the sections thereof captioned "Risk Factors" and "Forward-Looking Information and Factors That May Affect Future Results", as well as in its subsequent reports on Form 8-K, all of which are filed with the U.S. Securities and Exchange Commissionand available at www.sec.gov and www.pfizer.com.

iii Parkinson's Disease Foundation. Statistics on Parkinson's. Available at www.pdf.org/en/parkinson_statistics Accessed on April 4, 2016

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(c) 2016 M2 COMMUNICATIONS, source M2 PressWIRE

http://health.einnews.com/article/320459612/7twhBqejVQFV3PAt

Michael J. Fox cosies up to Tom Hanks at NYC event as he continues battle with Parkinson's

MICHAEL J. FOX put on a brave face last night as he joined a star-studded crowd at the 31st Annual Rock And Roll Hall Of Fame Induction Ceremony in New York.

By BECCA LONGMIRE

Sat, Apr 9, 2016

Michael J. Fox posed at the Rock and Roll event with Tom Hanks

The 54-year-old - who has been open about his battle with Parkinson's Disease - joined the likes of Tom Hanks and Michael Douglas inside the Barclays Center to celebrate rock music's finest.

Michael dressed to impress for the evening wearing a blue shirt and black blazer jacket, while fellow actor Tom Hanks posed alongside him in an all-black get-up.

Pair were amongst an array of A-list guests at the ceremony

Back in February, Michael is said to have been seen struggling to get into a car outside Hollywood restaurant Craig's, with sources describing the incident as "heartbreaking".

“It was heartbreaking,” an insider told RadarOnline.com. “Michael’s bravery knows no bounds. But as the disease takes its toll on his body, even he is beginning to see that his battle is a losing one.

“Michael sees every day as a gift, as well as an opportunity to help other sufferers,” they continued.

The Canadian-American actor - who launched The Michael J. Fox Foundation for Parkinson's Research - has spoken openly about his struggle.

Michael Douglas also attended the star-studded bash

Michael's illness is said to be 'taking its toll' on the actor

During an interview with David Letterman, Michael previously described the day he received his diagnosis.

He said: "It was pretty scary. I was 29 years old and so it was the last thing I expected to hear.

"I thought I'd hurt my shoulder doing some stunt because I had a twitch in my pinkie. And the doctor said 'You have Parkinson's disease.' He said, 'The good news is that you have 10 years of work left'.

"That was 22 years ago and I’m still working," he added in the interview, which aired in April 2015.

https://www.express.co.uk/celebrity-news/659611/Michael-J-Fox-Tom-Hanks-NYC-event-continues-battle-Parkinsons-Disease

Taking on Parkinson’s

Posted: Friday, April 8, 2016

By Joe Carmona/ Tri- County Parkinson's Support Group

The month of April was designated as Parkinson's Awareness Month by the United States Senate on March 29, 2012. With the resolution, we honor those who live with Parkinson's and raise awareness of the disease.

I encourage other victims, like myself, to reach out to the public and educate them on this silent disease called Parkinson's. Once we communicate our disease with the public, they will have a better understanding of our symptoms and the image we project.

Like anything else, once we shine the light and investigate a subject, we become more informed and have a different point of view. With that being said, I would like to shine the light on my Parkinson's disease. First I would like to give you a few facts about Parkinson's:

• Parkinson's disease is a chronic and progressive neurological disease.

• 1.5 million Americans live with Parkinson's.

• Cause of Parkinson's disease remain unknown.

• The disease was named after a British scientist named "James Parkinson" in 1817.

• Economic burden of Parkinson's disease is at least $14.4 billion a year and will double by 2040 in the U.S. only.

• There is no cure therapy or drug to slow or halt the progression of Parkinson's.

• Nearly 60,000 people are diagnosed each year in the U.S. with Parkinson's.

• The average age of diagnosis for Parkinson's disease is 60 years old.

My story, like many others who have Parkinson's, is not unique, but I hope to raise awareness of the disease.

Looking back, prior to being diagnosed, I had stiffness and loss of elasticity on my joints. I also noticed a small tremor on my index finger. My doctor prescribed some type of muscle relaxer. My joint stiffness continued and my tremors became more noticeable. My daughter, who is a therapist, looked at my symptoms and told me to get an MRI, because she suspected I had Parkinson's.

I was diagnosed with Parkinson's and I remember having many questions about it. The effects it would have on me, my family and my future were just a few of the questions. The next stage for me was the questions of, why me, how did it happen and what will happen next. I tried to hide my symptoms (tremors) from other people, because I was embarrassed of what I had. During this stage, I made some hasty decisions, like quit my teaching position and gave up officiating high school sports, which was part of my life for 30 years. I felt no one understood my disease and no one could answer questions of what I was experiencing.

Finally, thank God, I came to deal with what I have and accepted the disease for what it is. I read materials on Parkinson's and talked with other "Parky" friends to better understand my symptoms. I can now look into the eyes of that person on the mirror and accept myself.

Parkinson's is a life-changing disease and is a huge challenge not only to the victim but also to the family. It is hard to live with a disease which has no cure. The medications we take are only a bandage fix and they have many side effects. I see Parkinson's as a silent disease because there are many symptoms that are not visible such as: depression, anxiety, loss of smell, sleep disturbance, hallucination, and loss of concentration, and confidence, fatigue and pain. In the past few years, more institutions are shining the light on Parkinson's to better understand the disease. There are more studies and medications to improve the life of a person with Parkinson's, so there is hope for all of us.

With this disability, I need to focus on what I can do not on what I used to do. I need to stay active not only physically but mentally also.

Parkinson's has made me a different person but there is a reason for everything that happens to us. One of these days I will understand why I was chosen to have this disease.

By sharing part of my story on Parkinson's I hope it will create some curiosity. So shine the light on Parkinson's and be more aware of this silent disease.

So come and join the Tri- County Parkinson's Support Group shine the light on Parkinson's. For more information, call George or Mary Lou Chumbly at 671-0767 or 415-6237

http://www.appeal-democrat.com/features/family_and_friends/column-taking-on-parkinson-s/article_439fb9da-fdee-11e5-842d-933b6030e2cb.html

Brain Stimulation And You: How Does It Work And Can It Really Juice Up Your Thinking Cap?

Apr 8, 2016 09:00 AM By Ed Cara

Medical Daily takes a look at the ins-and-outs of brain stimulation, from its useful applications in medicine to its growing but possibly unwarranted hype as a mind enhancer. Above, users try out their foc.us tDCS headsets. foc.us, CC BY 4.0

For as long as people have had access to electricity, we’ve tried to use it to cure our maladies. From grabbing onto electric eels to treat our headaches in the 1st Century to subjecting ourselves to electroshock therapy in attempts to dispel depression and schizophrenia, we’ve often come out with mixed, but not entirely fruitless, results.

Thankfully, as modern medicine has progressed, so too has our mastery of therapeutic lightning in a bottle. Nowadays, a variety of electrical stimulation techniques that more precisely target the brain have found homes within doctors’ offices. They’ve proven effective in treating Parkinson’s disease and other movement disorders, while also showing promise for conditions like anorexia, tourette syndrome, and, you guessed it, depression. Meanwhile, techniques like transcranial direct current stimulation (tDCS) are becoming increasingly commercialized as easy-to-use consumer products that can either juice up our noggins or calm our anxious minds.

With all the noteworthy buzz surrounding brain stimulation, Medical Daily decided to break down its basics and provide an honest look at its overall potential in the near future.

Restoring Balance

Brain stimulation can be broadly broken into two categories: invasive and noninvasive.

The most common type of the former is known as deep brain stimulation(DBS), where a battery-powered device, the implanted pulse generator (IPG), one or more electrode leads, and extension wires are all surgically rooted within the body. Where the leads go on the brain depends on which condition is being treated, but the basic premise remains the same: Electrical pulses sent from the pulse generator to the leads cause a disruption in nearby neural activity.

Because the symptoms of movement disorders coincide with erratic neural patterns in the targeted brain region (often the subthalamic nucleus for Parkinson’s), it’s theorized DBS acts as a sort of pacemaker, temporarily restoring a healthy rhythm of activity. DBS was first approved by the Food and Drug Administration for the treatment of essential tremors and Parkinson’s in 1997, and since then, the devices, and clinicians who use them, have gotten better at targeting specific regions.

Noninvasive stimulation, which includes the still-available but last resort electroshock therapy described above, works on a less forceful principle. With tDCS, which is quickly becoming the technique of choice due to its affordability and precision, two electrodes are placed on the head — an anode and cathode — where they send constant electrical currents to the neurons beneath them during a treatment session. Rather than shocking the brain into normalcy, though, the currents are thought to only nudge it back. The cathode hyperpolarizes the neurons underneath it, making it harder for them to fire and presumably slowing the neural activity nearby, while the anode does the opposite, making it easier for neurons to fire and likewise ramping up our local connection speed, seemingly in a repeatable and predictable pattern.

Hype Before Results

Cool as these stimulation techniques are, though, we shouldn’t overhype them.

Despite increasing sophistication and the potential for research into their broader applications to lead somewhere great, they’ll likely never be a first line treatment for many, if any, conditions. In the case of DBS, that’s not merely because of the surgical upkeep they require and severe side effects, like hallucinations, that they cause, but also because the brain is a beautiful and intricate mess. Much as we’d like to assume, our brains aren’t neatly arranged into segments that correspond perfectly to one specific physical or mental function of the body. For instance, remembering something requires different shifting parts of the brain, the specific regions depending on whether it’s a fond memory of your first kiss or tracking down the last place your keys were.

The same is true of the neural dysfunctions that cause someone to shake uncontrollably or feel persistently depressed. Even for disorders like Parkinson’s, DBS is only recommended for those who already respond well to the common Parkinson’s drug levodopa — the precursor chemical of dopamine — and are otherwise mentally healthy. Similarly, the more complicated the condition, neurologically speaking, the less likely DBS will be effective; if only because the powerful shock can’t fix everything.

While tDCS also has this drawback, there’s an even deeper problem with it: We’re not entirely sure it works at all, at least in healthy people. In 2015, a review of 59 studies found no “reliable effect of tDCS on executive function, language, [or] memory,” as well as other measures of cognitive function in healthy subjects. Though some studies did find a brain boost, others effectively canceled them out. The study’s lead author and graduate student in neuroscience at the University of Melbourne, Jared Horvath, has also published research showing a similar lack of reliably measured physical changes in healthy subjects given tDCS.

It isn’t necessarily that tDCS doesn’t influence patients; certainly the number of people who report not being able to form words after a session or slightly burnt skin suggest something real is happening. But Horvath argues that researchers don’t yet have a firm grasp on the best way to study its effects, or how to channel the technique into something consistently beneficial.

A 2014 paper by Horvath and his colleagues detailed some of these flaws. For one, scientists can often spot the group of test subjects that receives tDCS versus a placebo, which might subtly influence their findings. People also have widely different reactions to tDCS, not only when compared to other people, but also after each individual session. And finally, there’s the distinct possibility that any treatment effects may disappear as soon as a user moves or thinks too much. Even having hair that’s too thick can interfere with the electrodes’ ability to reach the brain, a factor that’s obviously hard to take into account. Most of these problems can be seen when studying other forms of noninvasive brain stimulation too.

“I hope my work helps elucidate that research and medical progress is a tricky business,” Horvath told Medical Daily. “Scientists and researchers are as human as anyone else and we will chase our ideas and passions wherever they lead us; but, just because we're exploring something does not mean that thing will prove effective.”

Our shoddy homework is especially concerning when looking at the rise of consumer tDCS devices such as the Thync, which is only inspired by the DIY tDCS device kits readily available (Thync claims to use a novel form of neurostimulation). Unlike more reserved scientists, the companies behind these devices have touted them as mini-miracle workers, capable of restoring our mood, memory, and sleep to peak levels of awesome.

Despite exaggerated health claims, there’s no real check on their accuracy from expected places like the government, which hasn’t yet figured out how to regulate them. As Anna Wexler, a PhD candidate at MIT who is currently studying the subject, wrote in a 2015 paper and accompanying Slate article, the question of regulation is definitely a thorny one.

“Should they be considered medical devices, subject to stringent regulation from the Food and Drug Administration? Or are they ‘wearable technology’ like the Fitbit, subject to more lenient consumer regulation from the Consumer Product Safety Commission?” she wrote. The latter would require companies to pass a high bar of evidence before their products can reach the public, while the former would lead to a gold rush of Thync-like caps, all probably more effective at relieving our wallets of money than our brains of stress.

Regardless of what ends up happening, Wexler recommends we stay on our guard when evaluating these home-use devices. “Consumers should always take health claims — whether they are coming from electrical stimulation devices, dietary supplements, or even food — with a grain of salt,” she told Medical Daily.

None of this is to say that tDCS and its ilk are a bust, only that we’re nowhere near the home stretch of their development. While their effects on the Average Joe are still muddy, there is more support for their use in alleviating conditions like fibromyalgia, depression, and maybe even Parkinson's — though Horvath offers a word of caution even there.

Citing an upcoming review from top tDCS researchers in Europe, he told Medical Daily that the experts couldn’t recommend tDCS as an absolutely effective treatment for any medical condition. For a few conditions, they determined tDCS was probably or possibly effective, but for the majority looked at, they declined to offer any stamp of approval. “It appears the clinical research is as variable, unpredictable, and heterogeneous,” as the research on healthy volunteers, he said.

Brain stimulation, particularly DBS, has and will continue to have an important role in medicine; that's undeniable. But if you ever decide to attach some electrodes to your noggin, it’s best to keep this familiar saying in your mind too: If it sounds too good to be true, it probably is.

http://www.medicaldaily.com/brain-stimulation-how-does-it-work-parkinsons-disease-381118

Early diagnosis, therapy key to tackling Parkinson's disease: Austrian experts

VIENNA, April 8 (Xinhua)

 An early diagnosis and commencement of therapy are key factors in providing sufferers of Parkinson's disease with an improved quality of life, Austrian experts said ahead of World Parkinson's Disease Day on April 11.

In a joint press release Friday, the Austrian Society of Neurology (OeGN) and the Austrian Parkinson's Association (OePG) said the need to be aware of warning signs of onset of the disease is thus very important.

These include tremors in extremities on only one side of the body, such as a hand that is at rest. Further symptoms are disruptions to fine motor skills such as a slowing of movement, the lack of swinging of one arm or dragging of one foot while walking, a noticeable reduction in the size of handwriting, and joint pain through increased muscle tension.

"Today we have a wide range of therapeutic options available to treat Parkinson's in all stages," the two groups stated. They added that each individual case can be treated with a selection of relevant therapies, and that "the earlier we can begin, the better."

President of the OePG Eduard Auff said at the point of the above symptoms significant damage to nerve cells in the brain that are responsible for dopamine production has however already occurred, meaning the pathological processes behind the progression of the disease can have already gone unnoticed for years and caused damage.

"In future we will have to make early diagnoses even earlier, and find new ways to do this," he added.

An estimated 16,000 Austrians suffer from the disease, two-thirds of whom are men. Experts believe this number will at least double by the year 2030 due to increased life expectancies.

http://news.xinhuanet.com/english/2016-04/09/c_135262375.htm

Perceptions and Misconceptions

 April, 8, 2016 

I was in Rome, exhausted. My trip was stressful, being one month after a divorce and seven days without my daughter. All I wanted was to be back in the tiny arms of my four year old. I arrived at the airport on time, but groggy. I was confused by using Spanglish to navigate through Italy. I just wanted to go home.

As I checked my bag, I was asked to wait. And wait. And wait. After about 30 minutes, I was met by a Italian woman with the airlines. She held my way home in her grip. I saw a thick black line on my ticket. She said she would ask me a few questions, and I thought I won the lucky random screening seat.

“What was the purpose for your trip?” “Did you party with your friends?” “Did you do a little drinking, a little drugs?” “Are you carrying anything illegal?” “Did someone ask you to bring something back for them?” “Party a little too much?!” The questions fired off like bullets.

After enough “Yes ma’am”‘s and “No ma’am”‘s to last me a lifetime, I thought the interrogation was done. I spent the remainder of my Euro’s and waited to board. When my section was called, I was stopped again. A full pat down and all the contents of my Roman trip were displayed from my carry-on.

It wasn’t until I landed in the red, white and blue, and was drained of my jet lag when I realized, they saw my shaking as nerves. I was five weeks away from my Parkinson’s diagnosis and had no way to prove why I trembled.

Like Taylor Swift’s song, I just “Shake It Off.” (Pun intended.) Laughter is a great way to cope with misconceptions. Anytime someone forgets what they were going to say, I tell them I “gave” them Parkinson’s, a non-contagious movement disorder.

I also love when someone, familiar with the movement symptoms of the disease, say something to the effect of, “It’s not like it’s a brain disease.” Well, actually, Parkinson’s is a neurodegenerative brain disorder where the substantia nigra, in the brain, stops producing dopamine. And some people with Parkinson’s never have a tremor, concealing their visible symptoms.

I think the best was when someone commented on a picture of mine, “It’s sad she won’t even be able to care for herself in 10 years.” Or maybe it was the perception of several people that retorted, “She doesn’t really have Parkinson’s. She’s just making that up for attention.”

It’s kind of like hearing someone who has the “C” word, aka cancer. You immediately think of death and/or pain from the radiation and chemo. Yet, cancer doesn’t mean a death sentence. There are so many variables that factor into those cliches. When was it caught? Where was it caught? And can surgery cure it?

Misconceptions on disease are no different than stereotypes of people. Like snowflakes, not one of us are the same. If they were, I wouldn’t have to worry about Parkinson’s, as I’m not the normal 65+ year old white man. In fact, while there are many marked similarities, each person with PD is different from the next, from symptoms, to speed of progression, to finding that perfect cocktail of meds.

Whether you have Parkinson’s, MS, cancer, an autoimmune disease or are disease free you face perceptions and misconceptions. People are innately ignorant. We don’t research every disease that is out there. We tend to be self-absorbed, myself included. But that’s the thing about misconceptions and perceptions. As you glance at someone struggling, try to empathize. If someone is complaining, try to listen, as sometimes they just want someone to really hear them. Never be afraid to ever say, “I have no idea what you’re going through.” Try to be someone’s perception of light, in an all too often misconceived dim world.

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http://www.huffingtonpost.com/allison-toepperwein/perceptions-and-misconcep_b_9644534.html