Tracing Parkinson’s other passions besides the disease that bears his name

By Vanessa Grubbs September 1, 2017

Vanessa Grubbs is an associate professor of medicine at the University of California, San Francisco, and author of “Hundreds of Interlaced Fingers: A Kidney Doctor’s Search for the Perfect Match.”

“The Enlighted Mr. Parkinson” by Cherry Lewis (Pegasus Books)

As a doctor, I was drawn to Cherry Lewis’s “The Enlightened Mr. Parkinson: The Pioneering Life of a Forgotten Surgeon” by the title alone. I wondered how could this man be forgotten when everybody knows his name, because he was the first to describe the shaking palsy condition that later became known as Parkinson’s disease? 

Lewis provides a fascinating, illustrated account of the life and times of James Parkinson, who lived from 1755 to 1824, a time of significant political upheaval and considerable probing into the earth sciences and medicine. It was an era when only white male landowners had the right to vote and bloodletting was the go-to treatment for most ailments. As Lewis tells it, Parkinson fought for the rights of the vulnerable, moved some scientific fields forward and observed what most people could not see. 

Lewis, an honorary research fellow at the University of Bristol, explores three main themes of Parkinson’s life: politics, fossils and medicine. The author’s passion for geology gives us four chapters devoted to Parkinson’s fossil endeavors. Only the penultimate chapter focuses on why he has an ailment named after him.

Though I personally have no interest in fossils, I was absorbed by Lewis’s account of Parkinson’s pioneering work in the field. Particularly compelling was Lewis’s depiction of Parkinson’s struggle with his faith and how he reconciled history revealed in fossil evidence with his belief in the stories of the Bible. 

Lewis recounts the remarks of the lecturer John Hunter, a renowned Scottish scientist and surgeon, about his remarkable collection of skulls. A newspaper of the day, reporting on the lecture, noted that “the most perfect human skull is the European; the most imperfect, the Negro.” The paper added: “Mr. Hunter observed that in placing the Negro above the monkey, great honour is done to him; for although a man, he can hardly be called a brother.” 

In recounting this episode, Lewis writes rather off-handedly: “Today such comments shock our politically correct sensibilities.” In an otherwise fine book, I found her casual response almost like a justification of Hunter’s crassness.

Throughout the book, Lewis pieces together voluminous information from the late 18th and early 19th centuries to form her compelling tale. Anyone interested in the history of medicine, politics and geology will enjoy this book. I finished it in awe of Parkinson’s many accomplishments and contributions to politics, health and science, despite having a large family and a very busy medical practice. 

THE ENLIGHTENED MR. PARKINSON

The Pioneering Life of a Forgotten Surgeon

https://www.washingtonpost.com/outlook/tracing-parkinsons-other-passions-besides-the-disease-that-bears-his-name/2017/09/01/b1d77852-810f-11e7-902a2a9f2d808496_story.html?utm_term=.0838fc77a539

Parkinson's Disease Patients Can Receive Beneficial Care Via Telemedicine

September 1, 2017  By Mandi Nowitz 

Telemedicine and virtual house calls have been making huge strides in the medical field and are now extending to patients with Parkinson’s Disease. Thanks to telehealth services – videoconferencing capabilities used in the healthcare industry to allow easier and more efficient treatment of patients across distance – a neurologist can visit with his patient without the need for a physical office visit. It is most beneficial to patients who suffer from episodic conditions, while chronic is still undetermined. A publishing from Neurology stated that videoconferencing between neurologists and patients is just as effective as in-person care.

“Over 40% of people with Parkinson’s disease never receive care from a neurologist, yet studies have shown that people who see a neurologist are less likely to be hospitalized with illnesses related to Parkinson’s disease, have greater independence and are less likely to die prematurely,” according to Dr. Ray Dorsey of the University of Rochester Medical Center. Dorsey went on to conduct a one-year study with 195 individuals as a way of determining how well the concept of telemedicine can work with Parkinson’s patients and if it was “feasible, beneficial, and valuable.”

The candidates came from National Parkinson Foundation, PatientsLikeMe and the Michael J. Fox Foundation for Parkinson’s Research and in the end, 98 percent felt that the care did not go up nor down via videoconferencing with neurologists. An average of 88 minutes and 38 miles were saved and 55 percent preferred virtual meetings over in-office. Herein lies the problem: two-thirds of those with Parkinson’s are on Medicare and telemedicine is one practice not covered.

Dorsey further addresses this predicament: “Virtual house calls for chronic diseases like Parkinson's are not only as effective as in-person care but broader adoption of this technology has the potential to expand access to patient-centered care. We now have the ability to reach anyone, anywhere but the promise and benefits of telemedicine will not be fully realized until the changes are made in Medicare policy.”

Doctors are huge advocates for telemedicine, especially when it comes to diseases that make like virtually unbearable. According to David Shprecher, DO, Msci, a member of the American Academy of Neurology: “Virtual house calls have the potential to dramatically increase access to care for people with such a debilitating disease. The 21st Century Cures Act mandated a report on which chronic conditions could be improved most by the expansion of telemedicine. Parkinson’s disease should be considered for this report, and it should expand the definition of telemedicine to include the virtual house call.”

http://conferencing.tmcnet.com/topics/conferencing/articles/434288-parkinsons-disease-patients-receive-beneficial-care-via-telemedicine.htm

Stem Cell Transplant Trial in Parkinson’s Patients Planned After Test in Japan Succeeds in Monkeys

SEPTEMBER 1, 2017   BY MAGDALENA KEGEL IN NEWS.

Researchers in Japan are preparing for a first human trial of induced pluripotent stem cells (iPSCs) in patients with Parkinson’s disease, after obtaining promising data from a study in monkeys.

The study, which appeared in the journal Nature, demonstrated that transplanting human iPSCs into the brains of the primate models of Parkinson’s was safe, and allowed the monkeys to move spontaneously.

Importantly, although researchers said the effectiveness could be compared to that of levodopa, the animals showed no signs of abnormal and jerky movements, known as dyskinesia.

Researchers from the Center for iPS Cell Research and Application (CiRA) at Kyoto Universitysaid the study, “Human iPS cell-derived dopaminergic neurons function in a primate Parkinson’s disease model,” made it clear that the technique was now close to being ready for assessment in humans.

They hope to launch a clinical trial by the end of 2018.

In contrast to embryonic stem cells, iPSCs are derived from adults. Researchers have learned how to backtrack a cell — most often from blood or skin — in its development to force it to become a stem cell. Such cells can then be grown into a range of specialized cells, including dopamine-producing neurons.

“Our research has shown that DA [dopamine] neurons made from iPS cells are just as good as DA neurons made from fetal midbrain,” Dr. Jun Takahashi, a professor and neurosurgeon specializing in Parkinson’s disease and the study’s senior author, said in a press release. “Because iPS cells are easy to obtain, we can standardize them to only use the best iPS cells for therapy.”

The Kyoto researchers made several key advances in their study in monkeys that had been exposed to a chemical that made the brain degenerate in a way similar to Parkinson’s.

They studied the animals for two years after the transplant and verified that the cells survived, and became integrated, forming new connections in the monkeys’ brains. Importantly, they showed that it was possible to track the health of the cells using brain imaging methods, such as magnetic resonance imaging (MRI) and positron emission tomography (PET).

This allows for a feasible way to monitor patients in clinical trials.

“MRI and PET are non-invasive imaging modalities. Following cell transplantation, we must regularly observe the patient. A non-invasive method is preferred,”  Takahashi said.

But the work also demonstrated that cells from healthy donors did not outperform cells taken from Parkinson’s patients, and outcomes could be compared to tests with embryonic stem cells.

“We made DA neurons from different iPS cells lines. Some were made with iPS cells from healthy donors. Others were made from Parkinson’s disease patients,” said Tetsuhiro Kikuchi, a neurosurgeon working with Takahashi.

Researchers also underscored that the method used to grow neurons from iPSCs is suitable for clinical trials.

Using patient-derived cells is, from an immunological perspective, the best option, as the patient’s immune system will recognize they belong there once transplanted. But making individual cells for each patient is a far more costly and time-consuming procedure than making a batch of cells from a donor.

In a second study, “MHC matching improves engraftment of iPSC-derived neurons in non-human primates,” the team demonstrated that by matching donor cells to the patient with the help of immune markers, called MHC, the transplant elicited a lower immune response.

The publication in Nature Communications showed that monkeys given matched transplants required less immunosuppressive treatment to harness the immune response to a transplant, compared to those who received unmatched transplants.

“The combination of MHC-matching and immunosuppression will reduce the dose and duration of the immunosuppressive drug and be the best strategy for the transplantation,” said Asuka Morizane, a neurosurgeon and assistant professor at CiRA who lead the study.

The Nature study provided even further insights. Earlier, researchers believed that the number of transplanted cells was the most important factor to consider. But the team found the transplanted cells’ quality was a key factor for success.

“Each animal received cells prepared from a different iPS cell donor. We found the quality of donor cells had a large effect on the DA neuron survival,” Kikuchi said.

To assess cell quality, the team compared cells transplanted into monkeys with many surviving transplanted cells to those in which relatively few cells survived. A screen of gene activity provided researchers with a list of factors that stood out in the group with excellent outcomes.

One of these genes — called Dlk1 — has previously been identified as a marker of good outcomes in a study that assessed stem cell transplants in a rat model of Parkinson’s disease.

“Dlk1 is one of the predictive markers of cell quality for DA neurons made from embryonic stem cells and transplanted into rat. We found Dlk1 in DA neurons transplanted into monkey. We are investigating Dlk1 to evaluate the quality of the cells for clinical applications,” Kikuchi said.

Efforts using stem cell transplants to treat Parkinson’s are ongoing around the globe. One approach already being tested in a clinical trial uses so-called human parthenogenetic stem cells (hpSC).

These cells are derived from unfertilized egg-cells that are chemically stimulated to start dividing to form stem cells. According to International Stem Cell Corporation, which developed the treatment, these cells have the advantages of embryonic stem cells, but avoid the ethical dilemma, since they cannot generate a human being.

Yet others aim to use embryonic cells. Chinese and Australian research teams have already launched such studies, according to a Nature News article by Ewen Callaway, on the topic.

Although some researchers argue that there are issues to be resolved before stem cells can safely be tried in humans, the Japanese team appears confident of the feasibility of its approach.

“This study is our answer to bring iPS cells to clinical settings,” Takahashi said.

https://parkinsonsnewstoday.com/2017/09/01/stem-cell-trial-in-parkinsons-patients-planned-after-success-in-monkeys-in-japan-study/

Titan to Start Phase 1/2 Study of Subdermal Implant to Deliver Requip to Parkinson’s Patients

SEPTEMBER 1, 2017   BY JANET STEWART, MSC IN NEWS.

The U.S. Food and Drug Administration (FDA) has given a green light to Titan Pharmaceuticals to begin a first-in-human clinical trial testing an implant that provides continuous release of ropinirole to treat Parkinson’s signs and symptoms.

In the open-label Phase 1/2 trial (NCT03250117), which is now recruiting, roughly 20 Parkinson’s disease patients taking levodopa along with oral ropinirole (marketed as Requip) will be switched to the subdermal, or under the skin, implant for three months. They will continue using levodopa.

This study will measure how much ropinirole is released in the blood during the three months, and evaluate possible side effects caused by the new drug delivery route. It will also look for evidence of treatment efficacy through changes in the severity of Parkinson’s disease in participants. The trial will take place at three or more U.S. sites, although only one — in Michigan — is currently registered.

“New treatments that offer continuous delivery of medication providing non-pulsatile stimulation of dopamine receptors in the brain appear to have some advantages over oral formulations,” Dr. Aaron Ellenbogen of the Michigan Institute of Neurological Disorders said in a press release.

“The ProNeura implants with ropinirole could potentially offer an important treatment option for continuous drug delivery that overcomes the fluctuating drug levels associated with oral administration of ropinirole, and we look forward to conducting this study,” said Ellenbogen, the study’s principal investigator at the site near Detroit.

Requip, a dopaminergic agent, is approved in the U.S. as immediate-release and extended-release tablets to treat such signs and symptoms of Parkinson’s as stiffness, tremors, muscle spasms, and poor muscle control. The immediate release formulation is also approved to treat restless leg syndrome.

But some Parkinson’s patients develop motor complications and dyskinesia, or uncontrolled and jerky movements, after taking oral Requip for several years, due to fluctuations in blood levels of the medication. Dyskinesia can be anything from a slight tremor of the hands to an uncontrollable movement of the upper body or lower limbs.

The implant is based on Titan’s ProNeura technology, and is designed to continuously release a consistent dose of ropinirole for three months or more, avoiding the shifts in blood concentrations when ropinirole is taken as a tablet.

“While oral formulations of ropinirole have greatly benefitted those suffering from Parkinson’s disease, many patients develop serious motor complications and dyskinesias after several years, due to the peak-trough fluctuations of medication in the blood,” said Kate Beebe, PhD, executive vice president and chief development officer at Titan.

“Our ropinirole implant is designed to provide continuous, non-fluctuating therapeutic levels of medication for up to three months, potentially offering patients and clinicians a more effective treatment option,” Beebe said. “We thank the FDA for their timely review and comments on the IND and clinical protocol.”

https://parkinsonsnewstoday.com/2017/09/01/titan-receives-fda-ok-to-begin-first-clinical-trial-of-subdermal-implant-for-requip-parkinsons-treatment/

Rush testing if genetic clues identify best candidates for Parkinson's surgery

September 1, 2017

Rush Neurologist Gian Pal, MD, MS, the primary investigator for the National Institute of Health-funded clinical study Parkinson disease and DBS: cognitive effects in GBA mutation carriers. Credit: Rush Photo Group

In the first ever clinical investigation involving genetic screening for Parkinson's disease, researchers are testing whether the presence of a specific genetic mutation identifies which patients are the best candidates for deep brain stimulation surgery, and whether neurologists should perform that procedure differently based on that genetic information.

"We are at a very promising time in Parkinson's disease (PD) research. Finding the connections between the vast amounts of genetic data and cognitive data we are gathering will allow us to tailor future therapies based on genetic biomarkers," said Rush neurologist Gian Pal, MD, MS, the primary investigator for the National Institute of Health-funded clinical study "Parkinson disease and DBS: cognitive effects in GBA mutation carriers"

Deep brain stimulation (DBS) is a surgical procedure in which a battery-operated medical device implanted in the brain delivers electrical stimulation to specific areas in the brain that control movement, thus altering the abnormal signals that cause many PD motor symptoms.

DBS is typically used for individuals whose symptoms cannot be adequately controlled with medication and has proven to dramatically improve motor function and potentially reduce medication burden for many PD patients.

Research suggests that patients who carry a mutation in the glucocerebrosidase (GBA) gene may respond differently to DBS than those who do not carry the mutation. These GBA mutation carriers compose 10-17 percent of subjects undergoing DBS, and typically have higher deposits of alpha-synuclein protein in the brain. Abnormal accumulation of alpha-synuclein is thought to be a key reason for the development and progress ion of PD. These higher levels of alpha-synuclein in patients with the GBA mutation carriers may translate to even more problems with thinking, movement, behavior, and mood than expected in typical PD. Dr. Pal and colleagues are hoping to understand how DBS affects motor function and cognition in these GBA mutation carriers over time.

"If we can determine how GBA mutation carriers respond to DBS, we can better counsel patients on expectations from the surgery, and potentially target a different region of the brain to maximize the benefit and minimize side effects from the surgery. This would be the first time that genetics would inform a clinical decision in the field of PD"

"Deep brain stimulation is a tremendous option for many Parkinson's disease patients, but not all," said Pal, who is developing a programmatic line of research involving genetics and surgical treatments for PD at the Rush Parkinson's Disease and Movement Disorders Program.

The Rush Parkinson's Disease and Movement Disorders Program is one of the largest and oldest such centers in the country, treating more than 2,000 patients annually. Rush has been a longstanding Parkinson's Disease Foundation Center of Excellence, based on decades of clinical and research excellence, and is now also recognized as a National Parkinson Foundation Center of Excellence as well.

Provided by: Rush University Medical Center

https://medicalxpress.com/news/2017-09-genetic-clues-candidates-parkinson-surgery.html

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FoxFeed Blog: Stem Cells Safe in Pre-Clinical Parkinson's Disease Study

 Posted by  Kristen Teesdale, August 31, 2017

A new stem cell study, published in the journal Nature, builds on the potential for this therapy in Parkinson's, but it's still early days and much work remains to be done. A team of researchers demonstrated that human induced pluripotent stem cells (iPSCs) -- "man-made" stem cells created by reprogramming mature adult cells -- are safe and efficacious in a Parkinson's disease (PD) pre-clinical model.

Scientists engineered dopamine-producing brain cells from iPSCs of people both with and without PD, and then implanted them into the brains of PD pre-clinical models. The grafted cells were safe and functional, and movement improved.

"This work is an important piece in the puzzle for where Parkinson's is and where it's headed," says Brian Fiske, PhD, senior vice president of research programs at The Michael J. Fox Foundation. "These proof-of-concept approaches may have symptomatic benefits for people with PD, but more testing is needed."

Potential Symptomatic Therapy 

Stem cells are an important avenue to pursue for the treatment of Parkinson's motor symptoms. But even if we are able to replace the lost dopamine cells, it may not address non-motor symptoms (which often are due to non-dopamine brain chemical problems) or be a cure (because the underlying disease is still present). Still, it would represent a significant advance and another therapeutic route.

"Pursuing varied approaches for Parkinson's can speed more treatment options," says Dr. Fiske. "Stem cell therapy is one route we're following to potentially meet patients' unmet needs."

In 2004, MJFF funded the pre-clinical embryonic stem cell study of Jun Takahashi, MD, PhD, one of the researchers involved in this publication. The current study -- using iPSCs -- is the natural evolution of that work.

The Foundation also is backing other efforts to examine stem cell safety and efficacy in pre-clinical models.

Insight into Disease Process

Stem cells aren't just a possible therapy, they're a research tool, as well. Dopamine cells from iPSCs can mimic the Parkinson's disease process in experiments. Scientists can use this resource to, for example, investigate the impact of genetic mutations and environmental factors, or the effects of drug compounds. To further these efforts, the MJFF-sponsored Parkinson's Progression Markers Initiative (PPMI), an observational study of people with and without PD, is making iPSCs available to the researcher community.

Not a Proven Therapy 

We're a step closer, but we still have a ways to go to prove the safety and efficacy of stem cells in people with Parkinson's.

Currently, there are no approved or accepted stem cell treatments for Parkinson's disease, and so, The Michael J. Fox Foundation urges people with PD to view so-called clinics offering stem cell therapies for PD with 'buyer beware' skepticism. At the same time, we are optimistic about the role of stem cells in Parkinson's research, and their potential role in Parkinson's treatment, especially around dopamine replacement. We are actively monitoring the field for progress and potential challenges where MJFF action can support the field.

https://www.michaeljfox.org/foundation/news-detail.php?stem-cells-safe-in-pre-clinical-parkinson-disease-study

Parkinson's: Stem cells restore nerve function in monkeys

August 31, 2017   Ana Sandoiu

A new study shows promise for using stem cells to create neurons that can replace the ones damaged by Parkinson's disease

Using stem cells, scientists have managed to restore nerve function in monkeys with Parkinson's disease. The findings may change therapeutic practices in humans. 

A new study recently published in the journal Nature Communications shows promise for treating Pariknson's disease with induced pluripotent stem cells (iPSCs).

iPSCs are cells that have been taken from a child or an adult's tissue and genetically modified to resemble embryonic stem cells - that is, to be able to take the form of any other adult cell types. 

In the case of Parkinson's, scientists have been using iPSCs to form a certain type of brain cell that is damaged by the condition: the so-called dopaminergic neurons located in the midbrain. 

These brain cells are the primary source of dopamine - the neurotransmitter that helps to regulate voluntary movement, mood, stress, and reward, among other things. 

Previously, researchers have been able to restore motor function in rats and primates with Parkinson's-like symptoms by implanting dopaminergic neurons derived from human iPSCs. But until now, no studies have investigated the long-term impact of such a practice in primates.

In this context, a team of researchers led by Jun Takahashi, of the Center for iPS Cell Research and Application at the Kyoto University in Japan, set out to implant these neurons in the brains of long-tailed macaques and evaluate the safety and functionality of such a practice over time.

Therapy safe and effective in monkeys

Takahashi and colleagues transplanted cells from both healthy human adults and adults with Parkinson's into the primates' brains. To simulate Parkinson's disease in the primates, the researchers treated them with MPTP - a neurotoxin commonly used to induce Parkinsonian syndrome in animals. 

The scientists used a neurological rating scale to assess the neurological effect of the transplant, as well as video recordings to analyze the primates' spontaneous movements.

Additionally, to evaluate the "survival, expansion, and function" of the transplanted neurons and the immune response from the primates' brain, the researchers used magnetic resonance imaging (MRI) and positron emission tomography (PET).

To assess the safety of the procedure, the researchers clinically followed the primates for 2 years. 

Cell analyses revealed that the dopaminergic neurons, when they reached maturity, extended their axons and dendrites into the striatum of the host.

The researchers found that "human [iPSC-]derived dopaminergic progenitor cells survived and functioned as midbrain dopaminergic neurons, [increasing] spontaneous movement of the monkeys after transplantation."

Additionally, over a period of 2 years, Takahashi and team did not find any cell-derived tumors in the brain of the primates, nor did they register any strong immune response to the transplant. 

In another article published in the journal Nature Communications, the authors show how the immune response can be improved even further. 

By matching a group of proteins called major histocompatibility complex proteins (MHCs) of the iPSCs to the MHC of the host, the neuron survival is improved, and the immune response against the neurons is reduced, write the researchers.

Overall, the findings suggest that, although more research is needed, such translational techniques could soon be used to treat human patients. The authors conclude:

"This preclinical study using a primate model indicates that human iPS cell-derived dopaminergic progenitors are clinically applicable for the treatment of patients with PD."

http://www.medicalnewstoday.com/articles/319172.php?utm_source=newsletter&utm_medium=email&utm_campaign=daily-us 

Arizona Researchers Develop Blood Test to Diagnose Early Alzheimer’s Disease

AUGUST 31, 2017  BY MAGDALENA KEGEL IN NEWS.

Alzheimer’s disease leaves traces in the white blood cells of its patients that could be used to diagnose the disease. So says a study by researchers at Arizona State University (ASU) who used a blood test to correctly distinguish between patients with early Alzheimer’s, Parkinson’s disease and healthy people.

More importantly, the method identify people with a family history of Alzheimer’s who are likely to get the disease later in life.

The study, “Multivariate analyses of peripheral blood leukocyte transcripts distinguish Alzheimer’s, Parkinson’s, control, and those at risk for developing Alzheimer’s,” appeared in the journal Neurobiology of Aging.

Unlike other studies that have tried to develop Alzheimer’s diagnostic tools, these findings are considered solid. Researchers at ASU’s Banner Neurodegenerative Disease Research Center repeated their tests in different patient groups, and even varied the technology involved in an effort to validate their findings.

“What we’ve done in our paper is to replicate our own work multiple times with different populations and even using different technologies,” Dr. Paul Coleman, the study’s leader, said in a press release. “We also presented data showing the ability to detect people at risk of a future diagnosis for Alzheimer’s disease.”

This is a particularly alluring part of the findings. Currently, those being diagnosed with Alzheimer’s have had disease processes going on in their brain for years, even decades. researchers believe that identifying those at risk earlier will give doctors a better chance of finding treatments that could delay, or even prevent Alzheimer’s from developing.

The Banner research team made use of the fact that in Alzheimer’s, numerous genes involved in inflammation and cellular stress are activated. This process is not  only going on in the brain. White blood cells also show changes in the activity of these genes, and a simple blood test could be enough to spot them, they figured.

To find out, they divided 177 blood samples and 27 brain samples from deceased patients into several groups.

By analyzing amounts of various messenger RNAs — the intermediate molecule between a gene and its encoded protein — they were able to identify people with early Alzheimer’s among a group that also consisted of healthy people and those with Parkinson’s. The test easily distinguished between people with and without a family history, but its ability to predict who among those with a family history that would develop disease was somewhat lower.

It could also spot people with the Alzheimer’s risk gene APOE4 who had not developed dementia, when compared to APOE4 carrier with early Alzheimer’s and people without the risk gene.

Currently, Alzheimer’s is often an uncertain diagnosis. Although new brain scans can detect amyloid-beta plaque in the brain, these are available only at specialized clinics. But with a rising elderly population — and increasing dementia rates in its wake —  the research team wanted to develop a tool that could be used in a primary care setting. And so, they chose to work with a blood test.

https://alzheimersnewstoday.com/2017/08/31/early-alzheimers-diagnostic-blood-test-developed-by-researchers-at-arizona-state/

Tributes as brave campaigner leaves her brain to aid scientists battling Parkinson's

August 31, 2017

BRAVE: Phillippa King

TRIBUTES have been paid to a brave campaigner who pledged to donate her brain to scientists conducting research into a crippling disease.

Phillippa King was featured on the front page of the Bridport News in April 2009 and her dying wish has now been fulfilled.

She passed away on August 22 at Wymondley Nursing Home in Hertfordshire aged 78.

In a statement, her family said her many friends and family living in Bridport will be ‘much comforted’ by the news of her successful brain donation to the Parkinson’s Brain Bank.

Phillippa moved to Bridport after she retired, with her late husband Tony King, living there up until 2014. Due to the worsening of the Parkinson’s disease she then moved to Wymondley Nursing Home in the village of Little Wymondley to be near her children and grandchildren, who all live in Stevenage. 

Her family said: “Phillippa's last wish has been fulfilled: to donate her brain to the Parkinson's Brain Bank who are undertaking research into this crippling disease. We the family are of course grieving her loss but we are happy in the knowledge that her passing may contribute to finding a cure to the debilitating illness that she fought for twenty years. 

“At first Phillippa was not sure whether to donate her brain but the campaign by the Parkinson's Disease Society overcame her doubts. The harsh reality of living with a disease without a cure is terrible. Nevertheless Phillippa always had a strong spirit, loved to stay active and to socialise and was always supported by her loving family. 

“Her generous donation will hopefully help researchers to find a treatment to overcome this horrendous disease.”

They added that they hoped her bravery would encourage others to donate their organs to help eradicated diseases.

In a letter to the family, Ville Pitkaaho, a research nurse at Parkinson’s UK Brain Bank, said: “I hope that you will find some comfort in being reminded that it is only through the generosity and forethought of donors such as your mother, that we can gain a better understanding of the cause and treatment of Parkinson’s.”

Speaking in 2009, Phillippa said choosing to donate her brain was one of the hardest decisions she had ever had to make.

She spoke out to raise awareness of a campaign run by the Parkinson’s disease Society (PDS) to persuade more people to sign up as brain donors.

Phillipa's daughter Amanda said her mum was a 'big extrovert' whose generosity and love of people encouraged her decision to donate. 

Amanda said: "Mum was a big personality and was generous and caring. She loved meeting people. 

"What she has done is fantastic and we are all so proud of her; her donation will be used for all kinds of research into this unpredictable and debilitating disease. 

"I would recommend that other people with Parkinsons disease sign up to the register because it is a lasting legacy. How else will we find a cure? Mum fought the disease for 17 years even now she's still fighting back."

Her funeral will be held at 3pm on September 4 at St Hilda’s Church in Stevenage and all acquaintances of Phillippa are welcome to attend.

http://www.dorsetecho.co.uk/news/15504404.Tributes_as_brave_campaigner_leaves_her_brain_to_aid_scientists_battling_Parkinson_s/

Critical connections among brain cells

August 31, 2017

Charles Ducrot

Making connections is not only important for people’s emotional well-being – it is also critical for healthy brains. As researchers are now discovering, the synapses, or the connections that convey signals and information from one neuron to another, may hold clues about what causes Parkinson’s disease.

At the University of Montreal, molecular biologist Charles Ducrot investigates the role synapses play in the reason that dopamine-producing neurons in one part of the brain are more vulnerable to death than those in another part of the brain. His work is being funded by a $30,000, two-year Graduate Student Award from the Parkinson Canada Research Program, supported by the Quebec Research Fund* on Parkinson of Parkinson Quebec and Parkinson Society British Columbia.

Earlier research has already established the death of those dopamine-producing neurons as central to Parkinson’s disease. Now Ducrot, a PhD student, is testing a theory that the less vulnerable neurons in the brain’s ventral tegmental area (VTA) stay alive longer than those in the substantia nigra because the VTA neurons establish more synapses that release a chemical messenger called glutamate. Such synapses may allow them to communicate better with their target cells and receive signals that facilitate their survival.

Ducrot wants to find out if dopamine-producing brain cells in the substantia nigra die because they have fewer glutamate synapses, and can’t receive as many survival signals.

To test his theory, Ducrot and his colleagues have identified key proteins involved in forming these connections, or synapses. Using cell cultures, he will increase or decrease the amount of these proteins expressed in the cells, to change the number of synapses the neurons form. Then he will expose the cells to toxins that produce Parkinson-like symptoms, to see if the brain cells with fewer synapses are more vulnerable and die.

“We know that synaptic contacts are very important, and in some way involved in survival,” Ducrot says.  He believes that “if we increase the expression of these proteins, we increase the number of synapses, and we might decrease the vulnerability of neurons in Parkinson’s disease.”

If Ducrot can prove his theory, he hopes to lay the foundation for a new type of gene therapy.

Ever since his first year in university, when he learned about dopaminergic neurons, Ducrot has been fascinated with discovering the causes of Parkinson’s disease. “It’s a common disease, and I want to know and understand more about it,” he says.

Quebec Research Fund on Parkinson is funded notably, by the Saucier-van Berkom Parkinson Quebec Research Fund.

http://parkinsonpost.com/critical-connections-among-brain-cells/

30 Questions Everyone with Parkinson’s Should Ask Themselves

By Allison Smith—August 31, 2017 

Site of:ParkinsonsDisease.net

Being diagnosed with Parkinson’s disease at age 32 has made me reevaluate my existence. I don’t think that I’m alone here either… many of us Parkies have faced this conundrum. When having such an impactful condition hurled into your life, there is a sense of loss. You grieve for who you were before the diagnosis and fear of what you might become as you recognize symptoms of deterioration.

Nobody knows you like you know yourself, but now with Parkinson’s messing with your head, you doubt you will ever be the same. The things that defined you might be slowly fading away. It’s almost as if your life isn’t yours anymore. Family and friends take over the activities that you can no longer do. You lose control over your life in some ways and have to make sacrifices or modifications just to feel somewhat normal.

Self-discovery questions

Ask yourself the question, “Who am I?” I have included 30 questions that might help your in your own self-discovery now that Parkinson’s’ disease has become a large part of who you are. Some questions might be difficult to answer, but don’t filter your responses by what others think… be your authentic self.

1. What have you done in your life that you’re most proud of?
2. What activity in your life brings you the most happiness?
3. What is something that you always love doing even when your Parkinson’s symptoms are bad?
4. Are there any relationships in your life that are toxic?
5. If you could have one wish granted, what would it be?
6. What could your friends and family do to help you cope with your diagnosis?
7. What kind of legacy to you want to leave behind?
8. How confident are you in making decisions for yourself?
9. What activity do you still do even though Parkinson’s has made it unsafe for you?
10. Who is the most important person in your life?
11. How do you feel about your current treatment for Parkinson’s?
12. How comfortable are you with your own mortality?
13. What is your greatest fear about having Parkinson’s disease?
14. What do you believe is possible for you?
15. What are 3 things that you should be doing to slow the progression of your PD?
16. To your best knowledge, how do people perceive you?
17. List 3 words that describe who you are?
18. What impact do your feelings and stress have on your PD?
19. Who understand how you feel about your health?
20. Describe your strengths, interests, and abilities that continue despite of your Parkinson’s?
21. What are some things that you wished that you had done before your diagnosis?
22. Do you believe your destiny is pre-determined or in your hands to shape however you wish?
23. If you woke up tomorrow and were cured of Parkinson’s disease, what would you do differently?
24. Who else do you think your should add to your Wolfpack? (team of support)
25. What are you grateful for having Parkinson’s?
26. What is one failure that you have turned into your greatest lesson?
27. List 3 things that your fear about the future?
28. What is something that is true for you no matter what?
29. Name your biggest self-limiting belief?
30. What do you believe is the meaning of your life?

https://parkinsonsdisease.net/living/30-questions/

Outstanding Site!!!