Dancing Might Help Prevent Parkinson’s, Recent Research Points Out

APRIL 21, 2017  BY CAROLINA HENRIQUES IN NEWS.

Dancing helps prevent Parkinson’s disease, obesity, dementia, depression and anxiety, says Dr. Patricia Bragg, CEO of organic health company Bragg Live Food Products.

“New studies show that dancing increases your memory and helps prevent a wide variety of diseases such as Alzheimer’s,” Bragg said in a press release.

Bragg’s father, Dr. Paul C. Bragg, was the originator of health stores in the United States, in 1912. For both father and daughter, dancing became a way of life.

Today, the 87-year-old Bragg sees herself as a crusader, born to carry on her father’s health movement, which pioneered many approaches that today would be considered “‘alternative medicine.”

“I have been dancing all of my life, and it’s not surprising to me that medical science is proving what I’ve known all along,” said Bragg.

Dancing has indeed been shown to help people with Parkinson’s recover balance and muscle control, as well as to help reduce the risk of Alzheimer’s dementia by 50 percent, which is expected to strike nearly 14 million Americans over the next 30 years.

“Think of the millions who can avoid this trauma simply by dancing,” said Bragg, the author of 10 best-selling “self-health” books.

According to a University of California Berkeley report, dancing has been shown to reduce depression, anxiety and stress and boost self-esteem. The New York Times also recently reported that dancing improves how the brain processes memory. Another study comparing the neurological effects of country dancing with those of walking and other activities suggested there might be something unique about social dancing.

In fact, dancing seems to increase cognitive acuity at all ages in a singular way, since they demand split-second decisions and exercise neuronal synapses. Dancing also helps keep the only neural connection to memory strong and efficient.

“My memories of dancing with Fred Astaire, Lawrence Welk, Arthur Murray and Gene Kelly are crystal-clear and so is my memory of the great time I had dancing last night,” said Bragg.

https://parkinsonsnewstoday.com/2017/04/21/parkinson-other-diseases-prevented-dancing-recent-research-suggests/

Milk study improves understanding of age-related diseases

April 20, 2017

Professor John Carver in his lab, holding a beaker of UHT milk. Credit: Stuart Hay, ANU

A new study on UHT milk is helping scientists to better understand Alzheimer's, Parkinson's and type 2 diabetes, opening the door to improved treatments for these age-related diseases.

Co-lead researcher, ANU Professor John Carver, said that two unrelated proteins aggregate in UHT milk over a period of months to form clusters called amyloid fibrils, which cause the milk to transform from a liquid into a gel.

He said the same type of protein clusters are found in plaque deposits in cases of Alzheimer's and Parkinson's.

"Parkinson's, dementia and type 2 diabetes are big problems for the ageing population in Australia and many other countries around the world," said Professor Carver from the ANU Research School of Chemistry.

"Our interest in milk proteins led to a discovery of the reason for this gelling phenomenon occurring in aged UHT milk."

"The research does not suggest UHT milk can cause these age-related diseases."

Professor Carver said milk proteins changed structurally when heated briefly to around 140 degrees to produce UHT milk, causing the gelling phenomenon with long-term storage.

He said normal pasteurised milk did not form amyloid fibrils.

ANU worked with CSIRO, University of Wollongong and international researchers on the study, which is published in the journal Small.

Watch a video interview with Professor John Carver about the study.

Go to:https://medicalxpress.com/news/2017-04-age-related-diseases.html

More information: Jared K. Raynes et al, Coaggregation of κ-Casein and β-Lactoglobulin Produces Morphologically Distinct Amyloid Fibrils, Small (2017).  DOI: 10.1002/smll.201603591 

Journal reference: Small

Provided by: Australian National University

https://medicalxpress.com/news/2017-04-age-related-diseases.html

PREVALENT ESOPHAGEAL SYMPTOMS IN PARKINSON'S DISEASE

April 16, 2017

Dysphagia (difficulty in swallowing) is a common problem in people with Parkinson's Disease. In order to assess the prevalence of dysphagia and other related symptoms, people with Parkinson's Disease presenting with dysphagia, odynophagia, heartburn, regurgitation, chest pain, and weight loss underwent evaluation using high-resolution manometry (HRM). 

Most people with Parkinson's Disease (62%) experienced dysphagia (difficult swallowing), which probably contributed to weight loss in 41% of people because they were unable to eat as much. The prevalence of other symptoms was heartburn (37%), regurgitation (31%), chest pain (28%), and odynophagia (painful swallowing) (6%). Problems in the esophagus were also common. 

The esophagus is through which food passes from the mouth to the stomach. The most common problems were : failure by the esophagus to contract properly (ineffective esophageal peristalsis) (55%), fragmented contraction in the esophagus (fragmented peristalsis) (48%), spasms in the esophagus (DES - diffuse esophageal spasm) (48%), and obstruction of the exit of the esophagus to the stomach (EGJ outflow obstruction) (39%). Each of these causes digestive problems.

Reference : Diseases of the Esophagus [2017] 30 (4) : 1-6 (A.Su, R.Gandhy, C.Barlow, G.Triadafilopoulos) Complete abstract : http://www.ncbi.nlm.nih.gov/pubmed/28375482

http://www.viartis.net/parkinsons.disease/news/170416.pdf

TOLEDO Trial: Apomorphine Infusions Reduce 'Off' Time in Parkinson's Disease

Deborah Brauser

April 20, 2017

Dr Andrew J. Lees

Treatment with subcutaneous infusion (SCI) of the dopamine agonist apomorphine (Britannia Pharmaceuticals) can decrease "off" time in advanced Parkinson's disease (PD), new research suggests.

In PD, "off" time refers to the wearing off of a medication's effects as the condition progresses, often leading to periods of immobility. The phase 3 TOLEDO trial is the first prospective and randomized study to assess the efficacy of apomorphine SCI vs placebo to fight this outcome in this patient population, note its investigators. 

TOLEDO showed that the participants who received the active treatment had significantly greater reduction in "off" time between baseline and week 12 than did those who received placebo saline infusions (the primary endpoint). These reductions were seen as early as the first week of treatment and were sustained during the entire 12-week period.

In addition, the apomorphine SCI group had greater "on" episodes without experiencing the treatment-associated adverse event of dyskinesia.

"The results were expected, based on clinical experience, and confirmed that apomorphine is a very efficacious treatment — comparable to deep-brain stimulation surgery and enteral levodopa therapy," coinvestigator Andrew J. Lees, FMedSci, FRCP, The National Hospital, London, United Kingdom, told Medscape Medical News.

Professor Lees said their findings provide "incontrovertible evidence of apomorphine's efficacy in parkinsonian patients with refractory motor fluctuations."

The findings were released April 19 and will be presented at the upcoming American Academy of Neurology 2017 Annual Meeting (AAN).

Delayed Introduction?

Apomorphine was first produced in 1865, and its first use as a PD treatment in the United States was in 1950, according to an American Academy of Neurology press release. In the 1990s, European doctors started using SCI versions of the drug to treat these patients' mobility fluctuations not controlled by medication.

"Although apomorphine pumps are an established therapy for advanced Parkinson’s disease in many countries, the lack of a randomized controlled trial has delayed introduction of a highly efficacious treatment in the Americas," said Professor Lees.

TOLEDO included 106 patients (100% white) with advanced PD from seven Western European countries. Of these participants, 53 were randomly assigned to receive apomorphine SCI (64% men; mean age, 63.6 years) and 53 were assigned to placebo (60% men; mean age, 63 years).

The mean hourly infusion rate was 4.35 ± 1.39 mg (range, 1.8 - 7.6 mg) in the active-treatment group and 5.00 ± 1.59 mg (range, 1.5 - 7.7 mg) in the placebo group. Infusions were administered over 16 ± 2 hours during waking time.

From baseline to 12 weeks, the apomorphine group had a reduction in "off" time of 2.47 hours vs 0.58 hours for the placebo group (P = .0025).

Those receiving the active infusion also reported higher scores on the Patient Global Impression of Change at the 12-week mark than those receiving placebo (P < .001).

Also, 71% vs 18%, respectively, reported that they felt their symptoms had improved, while 19% vs 45% reported that they had worsened.

Finally, the active treatment "was generally well tolerated and no unexpected adverse events were observed," write the investigators.

"If a person with Parkinson's disease can reduce their off times, that can have a great impact on their everyday life," lead author Regina Katzenschlager, MD, Danube Hospital and the Medical University of Vienna, Austria, noted in the release.

"In some patients in the trial, the insecurity of unpredictable periods of incapacity was completely alleviated," said Dr Katzenschlager.

The investigators add that the findings fill "an important knowledge gap" about the medication.

FDA Approval Coming?

Rajesh Pahwa, MD, professor of neurology and director of the Parkinson's Disease and Movement Disorder Center at the University of Kansas Medical Center, Kansas City, noted to Medscape Medical News that apomorphine injections are currently available in the United States for rescue therapy.

Dr Rajesh Pahwa

"This study used the same medication but subcutaneously. And while this [version] has been available in Europe for several years, it isn't in the US because they have not had good controlled studies to get approval" from the US Food and Drug Administration (FDA), he said.

He added that he sees TOLEDO being more about getting FDA approval than about changing current clinical practice. "Even if I wanted to use it today, I couldn't."

That said, he thinks the study will go a long way toward getting that approval. "It was a controlled study that was positive."

A few limitations he mentioned, however, were the lack of detail about treatment-related adverse events, "which is always an issue as people want to know the safety parts of a study" and its being conducted only in Europe, with no patients from the United States.

"But I think this study is efficacious, and, I think, based on it, the FDA is very likely to approve this route of administration of this drug," said Dr Pahwa.

Old Drug, New Forms of Delivery

Although he wasn't involved with this research, Dr Pahwa published a study in 2007 that looked at subcutaneous apomorphine treatment of PD.

He is also working on the open-label dose-titration part of a phase 3 trial assessing sublingual apomorphine film (APL-130277, Sunovion Pharmaceuticals) for the treatment of off episodes in PD, which will be presented at the upcoming AAN meeting.

The analysis, which included 76 patients, showed that 83% achieved a full "on" with this version of the drug and that there was a 5- to 12-minute onset for clinical benefit. In patients who achieved "on" status, 38% reached this by 15 minutes after treatment and 78% by the 30-minute mark.

In addition, topline results were released last month from a phase 1 pilot study from another investigative team assessing the medication in a sublingual spray (Renown Pharmaceuticals).

Twelve healthy volunteers first received a 2.5-mg subcutaneous injection of apomorphine, followed by 10-, 15-, 20-, and 25-mg doses of the spray. The 25-mg dose "closely replicated the characteristics of the subcutaneous injectable with very fast absorption…and similar peak plasma concentrations," the manufacturer reported in a release.

On the basis of these data, the investigators estimate that time to "on" would be 5 to 10 minutes and the dose to treat "off" episodes would be between 15 and 25 mg "for the majority of patients."

"This was using the same drug in a different route of administration. The idea is that people don't like using injections, so using a spray or a strip would be another way to get the medicine," said Dr Pahwa.

He added that an intranasal spray version had been assessed before, "but because of some nasal problems, that was given up. So this is more of a sublingual spray, which bypasses some of those problems. But it's still a novel control."

Overall, "the idea is to provide rescue therapy for people who have episodes of 'off' times," said Dr Pahwa. "It's an old drug that we know works in Parkinson's, but now it's being used in different ways."

TOLEDO was supported by Britannia Pharmaceuticals; the sublingual film study was supported by Sunovion Pharmaceuticals and Cynapsus Therapeutics; and the sublingual spray study was supported by Renown Pharmaceuticals. 

American Academy of Neurology 2017 Annual Meeting (AAN). Emerging Science abstract 9049, to be presented April 25, 2017; abstract 1348, to be presented via poster April 23, 2017.

http://www.medscape.com/viewarticle/878848?src=wnl_edit_tpal#vp_2

Parkinson’s Disease Is #MoreThanMotor, New Campaign Says

April 20, 2017

BY SARAH OWENS

Tremor, stiffness, slowness, and impaired balance—these movement-related symptoms are the hallmarks of Parkinson's disease. But they aren't the only ones. In fact, many symptoms of the disease are less visible and unrelated to movement. They include depression, anxiety, apathy, hallucinations, cognitive changes, constipation, sleeping problems, and sexual dysfunction.

Since many patients are unaware of these symptoms, they often go untreated. A new campaign by the Parkinson's Foundation—#MoreThanMotor—aims to change that by raising awareness of non-motor symptoms and encouraging patients to discuss and treat them.

Thinking Outside Motor

"In Parkinson's disease, many symptoms—loss of smell, acting out dreams, constipation, depression, and more—show up long before the onset of motor dysfunction," says Michael Okun, MD, FAAN, medical director of the Parkinson's Foundation, a merger of the National Parkinson's Foundation and the Parkinson's Disease Foundation.

As a result, he says, doctors and caregivers should be on the lookout for these symptoms, and doctors should consider Parkinson's when trying to diagnose unexplained changes in mood, loss of sex drive, sleep problems, or constipation in their patients.

Challenging Stereotypes

#MoreThanMotor also wants to challenge the traditional view that Parkinson's "is an old person's disease," Dr. Okun says. "It's true that Parkinson's gets more common as you age, but we see the disease in teenagers and in people in their 20s, 30s, and 40s." The disease can be missed in younger patients because the symptoms are often quite different, he says. "A lot of the neuropsychiatric symptoms, such as depression and anxiety, are more common in younger patients." The disease also affects women, even though it is predominant in men, Dr. Okun adds. It's important to look out for, and treat, both motor and non-motor symptoms in all these patients.

Talk to Your Doctor

If you have Parkinson's disease and are experiencing changes in mood, such as depression and anxiety, or other, non-motor symptoms, don't wait. Talk with your doctor about ways to treat them, Dr. Okun says. Many treatments, including medications, psychotherapy, and lifestyle modifications can help.

"If you have depression, anxiety, apathy, sleeping problems, or sexual dysfunction, and you have Parkinson's disease or you think you do, talk to your doctor," Dr. Okun says. "Ask him or her what's new in treatments [for non-motor symptoms]—there have been a lot of clinical trials lately—and what the tried-and-true techniques are that can help."

Help Raise Awareness

The Parkinson's Foundation is organizing a social media "thunderclap" to promote the campaign. On April 25, all users who've signed up to participate in the thunderclap will automatically post the following message on their Facebook, Twitter, and/or Tumblr account:

#Parkinsons is #MoreThanMotor! Join me to raise awareness of the non-motor symptoms of Parkinson's: http://thndr.me/d8hJK

Join Neurology Now in participating in the thunderclap, and help raise awareness of Parkinson's non-motor symptoms, here: bit.ly/NN-PF-Thunderclap.

http://journals.lww.com/neurologynow/blog/breakingnews/pages/post.aspx?PostID=478

Scientists discover two repurposed drugs that arrest neurodegeneration in mice

April 20, 2017

PET scan of a human brain with Alzheimer's disease. Credit: US National Institute on Aging, Alzheimer's Disease Education and Referral Center

A team of scientists who a few years ago identified a major pathway that leads to brain cell death in mice, have now found two drugs that block the pathway and prevent neurodegeneration. The drugs caused minimal side effects in the mice and one is already licensed for use in humans, so is ready for clinical trials.

Misfolded proteins build up in the brain in several neurodegenerative diseases and are a major factor in dementias such as Alzheimer's and Parkinson's as well as prion diseases. 

Previously, the team found that the accumulation of misfolded proteins in mice with prion disease over-activates a natural defence mechanism, 'switching off' the vital production of new proteins in brain cells. They then found switching protein production back on with an experimental drug halted neurodegeneration. However, the drug tested was toxic to the pancreas and not suitable for testing in humans.

In the latest study, published today in Brain, the team tested 1,040 compounds from the National Institute for Neurological Disorders and Stroke, first in worms (C.elegans) which have a functioning nervous system and are a good experimental model for screening drugs to be used on the nervous system and then in mammalian cells. This revealed a number of suitable candidate compounds that could then be tested in mouse models of prion disease and a form of familial tauopathy (frontotemporal dementia - FTD), both of which had been protected by the experimental - but toxic - compounds in the team's previous studies. 

The researchers identified two drugs that restored protein production rates in mice – trazodone hydrochloride, a licensed antidepressant, and dibenzoylmethane, a compound being trialled as an anti-cancer drug. Both drugs prevented the emergence of signs of brain cell damage in most of the prion-diseased mice and restored memory in the FTD mice. In both mouse models, the drugs reduced brain shrinkage which is a feature of neurodegenerative disease.

Professor Giovanna Mallucci, who led the team from the Medical Research Council's (MRC) Toxicology Unit in Leicester and is now based at the University of Cambridge, was today announced as one of the five associate directors of the UK Dementia Research Institute. She said: "We know that trazodone is safe to use in humans, so a clinical trial is now possible to test whether the protective effects of the drug we see on brain cells in mice with neurodegeneration also applies to people in the early stages of Alzheimer's disease and other dementias. We could know in 2-3 years whether this approach can slow down disease progression, which would be a very exciting first step in treating these disorders.

"Interestingly, trazodone has been used to treat the symptoms of patients in later stages of dementia, so we know it is safe for this group. We now need to find out whether giving the drug to patients at an early stage could help arrest or slow down the disease through its effects on this pathway."

The research was funded by the MRC and Professor Mallucci was also funded by a grant from Alzheimer's Society and Alzheimer's Drug Discovery Foundation.

Dr Rob Buckle, Chief Science Officer at the MRC, said: "This study builds on previous work by this team and is a great example of how really innovative discovery science can quite quickly translate into the possibility of real drugs to treat disease." 

Dr Doug Brown, Director of Research and Development at the Alzheimer's Society, said: "We're excited by the potential of these findings. They show that a treatment approach originally discovered in mice with prion disease might also work to prevent the death of brain cells in some forms of dementia. This research is at a very early stage and has not yet been tested in people - but as one of the drugs is already available as a treatment for depression, the time taken to get from the lab to the pharmacy could be dramatically reduced."

More information: Mark Halliday et al. Repurposed drugs targeting eIF2α-P-mediated translational repression prevent neurodegeneration in mice, Brain (2017). DOI: 10.1093/brain/awx074

Journal reference: Brain

Provided by: University of Cambridge

https://medicalxpress.com/news/2017-04-scientists-repurposed-drugs-neurodegeneration-mice.html

Adamas to Give Presentations on Treatment for Involuntary Muscle Movements in Parkinson’s

APRIL 20, 2017  BY DANIELA SEMEDO, PHD

Adamas Pharmaceuticals will make two presentations in Boston this month on ADS-5102 as a treatment for involuntary muscle movements associated with Parkinson’s disease.

ADS-5102, a high-dose amantadine therapy, decreases the duration, intensity and debility of the muscle movements, clinical trials have shown.

The problems, which range from slight hand tremors to uncontrollable upper body movements, stem from the long-term use of an amino-acid based therapy for Parkinson’s. That amino acid is levodopa, and the involuntary muscle movements are known as levodopa-induced dyskinesia (LID).

Adamas’ presentations on ADS-5102, also known as amantadine hydrochloride, will be at the 69th annual meeting of the American Academy of Neurology April 22-28 in Boston, the company said in a news release.

The presentations will cover two of the three Phase 3 clinical trials of ADS-5102 extended-release capsules as a treatment for LID in Parkinson’s, EASE LID and EASE LID 3.

EASE LID was a placebo-controlled randomized Phase 3 clinical trial (NCT02136914) that examined the effectiveness and safety of a 340-mg dose of ADS-5102 that patients received once a day, at bedtime, for 24 weeks.

The treatment led to an improvement in LID symptoms at 12 weeks, and the results held at 24 weeks, Adamas reported in April 2016.

EASE LID 3 was a placebo-controlled, randomized Phase 3 clinical trial (NCT02274766) that also looked at the effectiveness and safety of ADS-5102 in treating LID in Parkinson’s. Patients received one dose a day at bedtime.

In September 2016, Adamas reported that, after 12 weeks, EASE LID 3 had met its primary goal of reducing Parkinson’s patients’ scores on the Unified Dyskinesia Rating Scale. The drop in the scores indicated that ADS-5102 had decreased the duration, intensity, and disability associated with LID, the company said.

ADS-5102 also reduced Parkinson’s patients’ off-time, the period when Parkinson’s symptoms returned because the effects of levodopa treatment had worn off.

Another study, called EASED, was a placebo-controlled, randomized Phase 2/3 clinical trial (NCT01397422) that looked at the effectiveness and tolerability of three dose levels of ADS-5102 once a day in 83 Parkinson’s patients with LID.

More information about the ADS-5102 presentations can be found here, or by visiting the conference website.

In January the U.S. Food and Drug Administration (FDA) agreed to review Adamas’ New Drug Application (NDA) for ADS-5102 as an LID treatment in Parkinson’s.

https://parkinsonsnewstoday.com/2017/04/20/adamas-present-parkinsons-related-muscle-movement-therapy-boston-conference/

Alpena native works in field of Parkinson’s disease research

April 17, 2017

Alpena native Laurie Mischley has been featured in a Bastyr University publication regarding her work in the field of Parkinson’s disease research. 

Mischley holds a doctorate in naturopathic medicine from Bastyr and is currently associate clinical investigator at Bastyr University Research University. As such, she is the primary investigator on a study of intranasal gluthathione in Parkinson’s disease as well as several studies exploring complementary and alternative medical treatments for Parkinson’s, MS and other neurological conditions.

Mischley also works with Parkinson’s patients, helping to educate and empower them. Taking an approach that focuses her research not on sickness but on wellness, she created a worldwide study designed to find the recipe for success for slowing the progression of Parkinson’s in patients. 

The article about her focuses on her “Next Generation of Parkinson’s Disease Care” and her positive relationship with patients she has helped by taking a collaborative and comprehensive approach to their disease.

Mischley is the daughter of Bill and Nancy Mischley of Alpena. She is an Alpena High School graduate and studied nutrition at Pennsylvania State University and epidemiology at the University of Washington. She currently resides in the Seattle, Wash., area.

http://www.thealpenanews.com/life/2017/04/alpena-native-works-in-field-of-parkinsons-disease-research/

10 Organizations That Support Parkinson’s Disease Patients and Their Families

APRIL 20, 2017 BY ROBIN DIX

If you’re struggling with Parkinson’s disease or know someone who is, it’s incredibly helpful to have a list of organizations that can support you or your loved one along the way. The following is not an exhaustive list, but hopefully it will prove to be a helpful resource.

1. National Parkinson’s Foundation helps patients actively enjoy life through expert care and treatment research.

2. American Parkinson’s Disease Association provides support, education, and research to help you live a fuller life.

3. Michael J. Fox Foundation is helping to raise money for much-needed research to help find a cure. From ways you can get involved to a great blog chock-full of Parkinson’s-related information, there is so much information here.

4. Parkinson’s Disease Foundation provides information including news about the disease, information about upcoming events, insight into the latest research, and education about what to expect.

5. European Parkinson’s Disease Association advocates for the rights and needs of patients and their families.

6. The Davis Phinney Foundation is committed to supporting programs as well as research that help to deliver inspiration, information and provide tools that will enable people living with Parkinson’s to have more control in managing their disease.

7. The Parkinson Alliance is the umbrella organization for the Parkinson’s Unity Walk that takes place every spring in New York City. They also sponsor Team Parkinson, a fundraising racing event. You can find current news and information on research projects on their site.

8. Partners in Parkinson’s has a program where you can be connected to an advocate who will listen, offer advice and support to patients and caregivers at no cost. This is just one of the services you can find through Partners in Parkinson’s.

9. Caring.com has a support group for caregivers, family and friends of those with Parkinson’s disease. No subject is off-limits in this forum.

10. The National Parkinson Foundation has a site specifically geared to caregivers. They help carers navigate the emotional, financial, and physical challenges they may face caring for someone with Parkinson’s.

Having resources that help keep you informed, and offer support and encouragement to patients and their loved ones is so important. These are just 10 of the hundreds of organizations out there that are available to you. You can search online or visit your local library for more.

Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

https://parkinsonsnewstoday.com/2017/04/20/10-organizations-that-support-parkinsons-disease-patients-and-their-families/

EVERY STEP COUNTS AT THE 23RD PARKINSON'S UNITY WALK ON APRIL 22ND IN CENTRAL PARK

April 19, 2017

KINGSTON, New Jersey (WABC) -- 

Thousands of participants including patients, caregivers, family, and friends, are expected to walk together in the largest grassroots fundraiser for Parkinson's disease research in the United States.

The 23rd Parkinson's Unity Walk will be held on April 22, 2017 in New York City's Central Park.

"Together, one day we will achieve our shared goal of ending Parkinson's disease. There have been advancements in research and therapies, and the Unity Walk is a way to raise funding for research and keep the progress going," explained Martin Tuchman, Chairman of The Parkinson Alliance.

Parkinson's disease is a chronic, degenerative, neurological disorder, affecting over one million people in the country. 60,000 new cases (one person every nine minutes) are diagnosed each year.

Since the Unity Walk's inception in 1994, it has funded hundreds of research studies. For information on registration or donations, visit their website: www.UnityWalk.org.

http://abc7ny.com/health/parkinsons-unity-walk-on-april-22nd-in-central-park/1892801/

150-year-old drug may provide 'off' time relief for people with advanced Parkinson's disease

April 19, 2017

Immunohistochemistry for alpha-synuclein showing positive staining (brown) of an intraneural Lewy-body in the Substantia nigra in Parkinson's disease. Credit: Wikipedia

New research provides evidence that an old drug may provide relief for people with advanced Parkinson's, according to a study released today that will be presented at the American Academy of Neurology's 69th Annual Meeting in Boston, April 22 to 28, 2017.

When it comes to the treatment of Parkinson's disease, the oral drug levodopa has long been considered the gold standard, improving quality of life and longevity. But as the disease progresses, the effects of the medication can partially wear off more quickly after each dose, leaving people to experience "off" time, which are periods of immobility related to temporary unresponsiveness to medication. Parkinson's symptoms, such as slowness and muscle rigidity, often make movement difficult.

"If a person with Parkinson's disease can reduce their 'off' times, that can have a great impact on their everyday life," said study author Regina Katzenschlager, MD, of Danube Hospital, affiliated with the Medical University of Vienna, Austria. "In some patients in the trial, the insecurity of unpredictable periods of incapacity was completely alleviated."

The drug apomorphine, first produced in 1865, was first used to treat advanced Parkinson's disease in the United States in 1950. Its use grew in the 1990s when European doctors starting using subcutaneous infusions of the drug to treat fluctuations in mobility that could not be controlled by the pills. Despite its use in many countries of the world, high-level evidence from randomized, blinded studies of its effectiveness and safety has up until now been lacking.

In this phase III study, researchers recruited 107 people with advanced Parkinson's disease from 23 centers in seven countries. Participants were randomly selected to receive either apomorphine subcutaneous infusion or a placebo saline infusion. The infusion was administered over a period of 14 to 18 hours each day via a small portable pump similar to the sort used in the treatment of type 1 diabetes.

The study found that those who were given apomorphine had a significantly greater reduction of "off" time than those who were given the placebo infusion, with, on average, 2.5 hours less "off" time per day, while those who received the placebo infusion had an average 30 minutes per day reduction in "off" time. This improvement was apparent within the first week of treatment. At the same time, for those who received apomorphine, there was an increase of "on" time without the abnormal involuntary movements known as dyskinesias that are often observed with levodopa.

Participants were also asked to evaluate how well they thought the treatment worked. Those who received apomorphine gave their treatment higher scores at week 12 than those who received the placebo infusion. In the apomorphine group, 71 percent of patients felt improved, compared to 18 percent on placebo, whereas 19 percent worsened on apomorphine compared to 45 percent on placebo. Apomorphine was generally well tolerated and there were no serious side effects.

"It is our hope that these findings confirming the efficacy of apomorphine infusion will encourage doctors in the United States to offer this treatment to their patients and assess its efficacy in their own clinical practice," said Katzenschlager.

Provided by: American Academy of Neurology

https://medicalxpress.com/news/2017-04-year-old-drug-relief-people-advanced.html

Cell biologists discover crucial 'traffic regulator' in neurons

April 19, 2017

This is a scanning electron micrograph (false color) of a human induced pluripotent stem cell-derived neuron. Credit: Thomas Deerinck, UC San Diego

Cell biologists from Utrecht University have discovered the protein that may be the crucial traffic regulator for the transport of vital molecules inside nerve cells. When this traffic regulator is removed, the flow of traffic comes to a halt. 'Traffic jams' are reported to play a key role in neurodegenerative diseases such as Alzheimer's and Parkinson's disease. The results of their research will be published in the scientific journal Neuron on April 19.

Neurons are the main cells in the nervous system. They process information by sending, receiving, and combining signals from around the brain and the body. All neurons have a cell body where molecules vital for its functioning and maintenance are produced. The axon, a long and slender extension that can reach one metre in length in humans, sends information from the nerve cell to other nerve cells. Neuronal survival is highly dependent on the transport of vital molecules within this axon. Research has shown that defects in the transport function in the axons play a key role in degenerative brain diseases such as Alzheimer.

First comprehensive map

"Previous research examined transport processes in small areas of the axon, such as the very beginning or the very end. This left it unclear how the movement of molecules through the axon was regulated over long distances. In our study, we provide the first comprehensive map of transport in mammalian axons", says Casper Hoogenraad, Professor of Cell Biology at Utrecht University, explaining the relevance of this study.

Stumped

In most neurons, an area between the cell body and the axon called the 'axon initial segment' serves as a checkpoint: only some molecules can pass through it. This area has stumped scientists for more than a decade. Why should one type of molecule be able to pass through this area, while others cannot? The answer is to be found in the traffic regulator, a protein called MAP2. "With this discovery, we have answered a fundamental question about the unique functioning of nerve cells that has occupied scientists for a long time", lead author of the study Dr Laura Gumy says.

Driving force

The cell biologists from Utrecht first discovered that larger quantities of MAP2 accumulate between the cell body and the axon. When they removed MAP2 from the neuron, the normal pattern of molecule movement changed. Certain molecules suddenly ceased to enter the axon, whereas others accumulated in the axon instead of passing through to the cell body. This abnormal transport indicates that MAP2 is the driving force behind transport within the axon.

Car key

The cell biologists from Utrecht University went on to make another very important discovery. Since axons are so long, transport in the neurons is carried out by sets of proteins - known as 'motor proteins' - that carry packages of other proteins on their back. As it turns out, MAP2 is able to switch a specific 'motor protein' on or off, like a car key. This means that MAP2 actually controls which packages of molecules may enter the axon and which may not. Targeting the activity of the transport engine allowed the researchers to make another interesting discovery: MAP2 is also able to control the delivery of molecules at specific points along the axon.

New targets for therapies

"Transport within axons has been shown to fail in Alzheimer, Parkinson's disease and Huntington's disease, as well as in many other diseases. When the neuron is no longer able to control where molecules go, or is unable to get molecules to where they need to be, it cannot do its job. By understanding how transport works, we have laid the foundation for considering new targets and potential therapies for various neurodegenerative disorders", Casper Hoogenraad concludes.

More information: Neuron (2017). DOI: 10.1016/j.neuron.2017.03.046 

Journal reference: Neuron

Provided by: Utrecht University

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