How cats and dogs are helping doctors predict dementia in people with Parkinson’s

15 OCTOBER 2017

• Sarah Knapton, science editor 

A distorted image of a dog  CREDIT: UCL

Security images inviting users to type words, or click on pictures, to prove they are ‘not a robot’ are undoubtedly frustrating for many.

But scientists have discovered that some people with Parkinson’s disease struggle more than most at the task, and it could point to important changes happening in the brain.

Around 165,000 people are living with Parkinson’s disease in Britain, and up to half will also develop dementia within 10 years of diagnosis. But currently doctors are unable to predict who is at most risk.Now Dr Rimona Weil, of University College London, has developed a quick and simple test to determine which people with early-stage Parkinson’s are likely to develop dementia.It involves distorted pictures of cats and dogs and works in a similar way to CAPTCHA images, the online security check using distorted text to tell humans and computers apart.“Parkinson’s is the second most common neurodegenerative disorder after Alzheimer’s disease, but what isn’t widely known is half of people will go on to get dementia,” said Dr Weil.“People are terrified about developing dementia so we think it is really important to be able to distinguish who is most at risk.“A colleague told me that patients struggled to read CAPTCHA images and I started wondering whether if there was a point of distortion which the brain could no longer tolerate, which might suggest that dementia was more likely.“We found that there was a point where they could no longer tell whether an animal was a car or a dog anymore. We think it might be to do with changes in the wiring of certain areas of the brain.” However Dr Weil said people should not be concerned if they struggled with the images.

“Not being able to see just one picture isn’t a problem, and our test looks at many images over time,” she added.

“We’re hoping that once we can tell who is likely to go on to develop dementia we can put them forward for trials of new drugs. In future, when drugs for dementia are available it will also help to spot early on the people who will benefit.”

The researchers have just launched a large, three year longitudinal study to see how well the Cats-and-Dogs test predicts cognitive decline over time, as measured by brain scanning and retinal imaging.

Anyone wanting to join the study should email a.costantini@ucl.ac.uk if you are outside of the London, and   l.leyland@ucl.ac.uk if you live within the M25.The study was published in the journal Movement Disorders.Tests involving 20 people with Parkinson’s and 11 controls showed those who struggled to tell whether the image was that of a dog or a cat also did poorly on tests measuring overall cognitive performance. The Cats-and-Dogs test is quicker and better at spotting problems in visual processing that precedes dementia.

http://www.telegraph.co.uk/science/2017/10/15/cats-dogs-helping-doctors-predict-dementia-people-parkinsons/

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Friends are high priority

October 14, 2017

Sometimes your priorities are determined for you.

I have been trying to master the Dragon NaturallySpeaking, a voice to text system on the computer, so that I can continue to write. I write verbally by dictating my columns and have them appear as written text on the computer screen.

Things keep getting in the way of getting it done. Unresponsive customer service at Nuance, the producers of Dragon Naturally Speaking, difficulty with my telephone (my fault), or my microphone not working so that I am unable to dictate. It’s one thing after another.

At the same time, friends were experiencing problems where I can be of help. It was an elder abuse problem. I also gave moral support to a dear friend who may have a serious operation.

That became a much higher priority than any administrative details with Dragon. I still have time to help my friends and do the Dragon thing.

Larry Welch is the dear friend who needs help and encouragement. Larry is a Vietnam veteran with all the Agent Orange symptoms, which resulted from exposure to the chemical. It causes different varieties of cancer, Parkinson’s disease – you name it. Because he tends to believe that no one owes him anything, he has never had a VA evaluation of his conditions.

Well, he is taking me to Martinez for a review of my vision problems at the VA clinic there. While there, he will begin the evaluation process. At last!

Larry has been hauling me around for the past five or six months. He takes me to the Kroc Center for exercising, the “Old Deplorables” weekly breakfast, and any other place I need to go. Now, it’s my turn.

In addition to the Martinez evaluation, Larry is being reviewed by Kaiser orthopedic surgeons, Drs. Ming and Chung. They are considering operations on his feet to correct ankle problems caused by flat feet. I will be with him at both Ming and Chung appointments.

The things I can do relate to helping define recovery problems, such as when and how long. What kind of changes are needed in home facilities? When can he drive again? When can he become mobile again?

I can’t make a difference, but I can help get information out on the table so that Larry will know what to expect, and better prepare himself for the ordeal.

Larry is more than just a friend. He is Mr. Rockville Corners, and all of Rockville. He’s the former president of the homeowners association and the historical society. He’s a tour guide for innocents like me.

If you want to know anything about Rockville and the surrounding area, the people who influenced the area’s creation and being, just ask Larry. Mare Island, too.

All of this description is just words. Larry is the real thing. He has a big heart. He is constantly reaching out to people who need help (including me). He will be embarrassed by what I have written. So what?

I think you can see why helping Larry is far more important that getting a computer program fixed.

Helping my other friend keep his assets is also important and deserves more immediate attention than does the Dragon. When the Higher Power is ready for me to master the computer program, I will. It will become the high priority item on my list of things to do, but probably after I get my estate affairs in order.

I’ll be listening and looking for doors to open.

http://www.dailyrepublic.com/solano-news/local-features/local-lifestyle-columns/friends-are-high-priority/

NY City Bar Leader Prepares for Race of a Lifetime

 Christine Simmons, New York Law Journal   October 13, 2017 

Bret Parker

Bret Parker, executive director of the New York City Bar Association, is preparing for a competition unlike any other: running seven marathons on seven continents in seven days.

It’s called the World Marathon Challenge. While Parker, 49, will be joined by up to 60 other participants in the race, he said he is the only participant who has Parkinson's disease. His goal is to increase awareness about the affliction and raise money for research.

Parker, who was an associate general counsel at cosmetics and fragrance company Elizabeth Arden Inc. before moving to the City Bar in 2013, sits on the Patient Council of The Michael J. Fox Foundation for Parkinson's Research.

“Many people don’t understand that Parkinson’s is not just a disease for older people. Many people can get Parkinson’s when they’re still trying to work and raise families,” said Parker, a father to two teenage boys who is married to Katharine Parker, a former Proskauer Rose partner who left the firm a year ago to become a federal magistrate judge in the U.S. District Court for the Southern District of New York.

Participants in the World Marathon Challenge begin their first race in Antarctica in January. They run the standard 26.2-mile distance on that frozen landscape before heading to six other continents.

Q: Where does the money from your fundraising effort go? What does it support?

A: My efforts support The Michael J. Fox Foundation, an organization focused on finding a cure for Parkinson's disease. Parkinson’s is a chronic, degenerative neurological disorder that affects one in 100 people over 60, but people have been diagnosed as young as 18. I was diagnosed over 10 years ago at 38. Approximately one million people in the U.S., and more than five million worldwide, have Parkinson's disease.

My fundraising is part of the grassroots community fundraising effort called Team Fox. Each year, thousands of Team Fox members raise money and awareness for the foundation through various events and athletic feats. I’ve done a triathlon, marathons, a mountain climb and even a skydive. The best part is that every penny donated for Team Fox members like me goes straight to the foundation’s research programs to help find a cure for Parkinson's disease, as well as better treatments for symptoms of Parkinson's disease.

Q: Why are you running the World Marathon Challenge? Is it only for fundraising?

A: For fun of course. Doesn’t everyone want to run seven marathons on seven continents in seven straight days starting in Antarctica and ending in Miami? But seriously, I’m attempting this challenge for a number of reasons beyond just raising money for research. My website contains more information about my goals. I’m trying to raise awareness about the disease, the lack of a cure and the fact that Parkinson’s is not just a condition that impacts older people. It’s also important for me to keep living life to the fullest as long as I can. Tackling a challenge like this is a reminder to me and others that I may have Parkinson’s, but for now it doesn’t have me or define me.

Q: What do your doctors think about your plans to run the race?

A: They think I’m a bit crazy to be trying this, but exercise has been demonstrated to help with Parkinson’s symptoms, so if this is what it takes to get me to work out, they are OK with it. I do have to be careful about calibrating my medications during big runs, and the symptoms of Parkinson’s make training tougher than “normal” at times. Fortunately, my doctors don’t have any health concerns that are directly tied to Parkinson’s.

Q: What have you been doing to prepare?

A: Last year I ran the New York City Marathon to make sure I could still complete one marathon. I had completed it four other times. Once I finished that, I started training again to run the Chicago Marathon, which I just completed. To increase my endurance, I’m running the Marine Corps Marathon just two weeks after the Chicago Marathon. Starting in November, the mileage and back-to-back long runs get more intense; plus I’m trying to add diet and cross-training to my regimen. The toughest training week before the World Marathon Challenge covers 71 miles, including a four-day stretch of 10-, 15-, 18- and 20-mile runs in a row.

Q: Do you have to do anything different compared with other participants during the race?

A: I take a lot of pills for my Parkinson’s during long training runs and throughout the race. Because sleep and stress make my symptoms worse, I need to take care of myself, including getting rest and massages when possible. Unfortunately, lack of sleep is also a symptom of Parkinson’s, so I’m still trying to find a solution for that. Occasionally, some of the worst symptoms are painful cramps in my feet or legs, which can stop me in my tracks and cause me to wait for the pain to subside. The symptoms can be unpredictable and there are times when you would have no idea that I have Parkinson’s, while other times I may look like I’m walking with a limp.

Q: What do you do on the Fox Foundation’s Patient Council and have you met Michael J. Fox?

A: The Patient Council is a way for the foundation to solicit input from Parkinson’s disease patients and the broader Parkinson's community. We advise the foundation on programming for patients and caregivers and patient priorities for research. We also are involved in patient education, advocacy and outreach relevant to the foundation’s mission to find a cure. I met Michael several years ago and see him every so often, including giving him a sweaty hug on the route of the New York City Marathon last year. He’s as nice and genuine as you would think from watching him in movies and TV shows.

Q: How does Parkinson’s affect you today, physically and day-to-day?

A: The main symptoms are stiffness and rigidity in my legs and arms on my right side. I have a tremor at times in my right hand, as well as cramps in both legs and feet. Lesser-known symptoms include difficulty with fine motor skills, making my handwriting completely illegible, even to me. I sleep horribly—some nights only three hours—and I have occasional fatigue, not just from not sleeping, an extremely diminished sense of smell and sometimes I feel like my memory for certain things is not as strong as it used to be. For example, a name or word is on the tip of my tongue and I just can’t pull it out, although some of that comes with age.

Q: How do you think Parkinson’s has affected your work, first as an in-house lawyer and then as executive director of the City Bar?

A: So far, knock on wood, my Parkinson’s has not impacted my ability to work. By the end of the week, I’m fairly fatigued and I use the weekends to recharge my batteries. But facing a serious disease like this also caused me to think about my role in the world and making a difference with a greater sense of urgency and purpose, making my work at the City Bar even more rewarding.

Q: Have you gained any unique experience or perspective?

A: I think having a disease like this has made me more empathetic to the various personal issues we all grapple with and appreciative of the differences that we all have. I’m also more keenly aware of the challenges people face when trying to maintain work-life balance.

Q: Do you ever imagine a time that Parkinson’s will interfere with your work at the City Bar or generally your legal career?

A: Unless we find a cure and treatments to reverse the disease, by definition my Parkinson’s will continue to progress and eventually I won’t be able to continue working in the same kind of positions. When I was diagnosed, I worried that the deterioration would be quick and I would have to stop working quickly, but it turns out that my disease is progressing relatively slowly and staying engaged with work probably helps.

Q: When you were first diagnosed with the disease, why did you stay silent and what made you ultimately speak openly about it?

A: When I was first diagnosed, my symptoms were so minor that most people couldn’t even notice. I didn’t want to over-worry people, at work or among friends, or have my career impacted by the stigma of the disease. So I didn’t disclose my illness to most people for about five years. Then, as my symptoms started to progress and I knew people would notice and wonder, I wrote a blog for the Forbes website and told people to go read it. I decided that it was time to reveal it because the stress of the secrecy actually made me feel worse and being open about it allowed me to publicly work toward raising awareness and fundraising for a cure.  Sharing the news was incredibly liberating.

Q: How would you describe the state of Parkinson’s medication and research now?

A: They are making progress, but Parkinson’s is a complicated disease of the brain and the same drugs used by patients 40 years ago are still the most common medications. There is a ton of unfunded research, as well as studies that require participants—not just Parkinson’s patients, but also “healthy” control subjects.

All interviews are condensed and edited for style, grammar and clarity.

http://www.newyorklawjournal.com/id=1202800411904/NY-City-Bar-Leader-Prepares-for-Race-of-a-Lifetime?slreturn=20170914174704

$3.7 million to help research neurological disorders linked to manganese

by Tamara Bhandari•October 13, 2017

Focus in South Africa, where most manganese found

A slag heap of manganese ore fills the sky in the picture above. Researchers at Washington University School of Medicine in St. Louis are studying whether people living near a manganese smelter are at increased risk of neurological problems.

Manganese – found in smoke from steel production and coal fires – has been linked to a range of neurological problems often seen with Parkinson’s disease: slowness, stiffness, tremors, anxiety, depression, cognitive changes, and difficulty walking and speaking.

Decades ago, federal environmental and public health agencies established manganese-concentration levels of concern for human health, but some scientists suspect that these levels should be lower.

Now, the National Institute of Environmental Health Sciences of the National Institutes of Health (NIH) is funding a $3.7 million study led by Washington University School of Medicine in St. Louis to determine whether people develop neurological damage from manganese at levels currently deemed safe.

“A pretty large area of the Midwest and the East has high industrial manganese exposures,” said Brad A. Racette, MD, the Robert Allan Finke Professor of Neurology and the study’s principal investigator. “A good percentage of our population, particularly those living in the Rust Belt, could have significant personal exposures.”

Racette teamed up with Gill Nelson, PhD, a professor at the University of the Witwatersrand School of Public Health in South Africa. Eighty percent of the world’s manganese is found in South Africa. Manganese mines dot the country’s Northern Cape region, and much of the metal is processed in one of the largest manganese smelters in the world, about 30 miles south of Johannesburg. The communities near the smelter have raised concerns about the metal, which is emitted into the air and eventually settles into the surrounding soil and water. In the United States, a similar process has contaminated land around iron- and steelworking facilities.

Racette and Nelson are studying a low-income community near the smelter to determine if residents living close to it have more difficulty with certain brain functions than those living farther from the smelter.

“We’re not looking for full-blown disease, but at a continuum of dysfunction that would preclude somebody from being able to function as well as someone without manganese exposure,” Racette said.

More than 300 people have enrolled in the study, and the researchers plan to enroll 700 more. The researchers have spent a year developing assessment tools in the four languages most commonly spoken in the area: Sotho, Xhosa, Zulu and Afrikaans.

A team of seven South Africans – all fluent in one or more of the local languages – administers questionnaires on anxiety and depression. They also ask participants to perform tasks such as memorizing and reciting sequences of numbers. Such tasks can identify cognitive deficits that suggest damage to the basal ganglia, a part of the brain involved in memory, paying attention and planning.

“Say you work in a factory and your job involves a complex series of steps,” Racette said. “Somebody who has been exposed to manganese may not be able to do all those steps as quickly or as accurately. He or she would have trouble holding that kind of a job.”

A board-certified neurologist and movement disorders specialist, Racette also examines each participant for problems with movement such as muscle stiffness, gait instability, reduced facial expressions and slow movement.

To estimate each individual’s lifetime exposure, the researchers are combining detailed occupational and residential histories with hourly air measurements of manganese, as well as soil levels and historical records on weather patterns.

“Manganese isn’t retained in any tissue, except the brain, for long enough to determine someone’s lifetime manganese exposure, so you can’t just draw blood or take hair clippings and find out how much manganese they’ve been exposed to in their lives,” Racette said.

Saliva, though, may contain information needed to estimate lifetime manganese exposure. Bits of genetic material known as microRNAs are found in saliva, and various patterns of microRNAs have been associated with several chronic diseases, including Parkinson’s.

The researchers hope to find out whether the collection of microRNA fragments in people’s saliva reflects the lifetime manganese exposure calculated from their work and geographical histories, or predicts their neurological health.

“Right now, people with mild neurological problems would only be identified if they went through a full examination with a qualified neurologist,” Racette said. “In a medically underserved community like this, people are unlikely to see a doctor until their symptoms become severe. It would be really helpful if we could identify who is on track to develop neurological problems based on just spitting in a cup.”

The study will continue for another three years. The smelter continues to release manganese, but even if the plant were to shut down, the effects of previous exposure would remain.

“Once you have a certain amount of exposure, the neurological damage doesn’t really reverse,” Racette said. “Even without ongoing exposure, the symptoms actually may continue to progress. This is a problem that’s not going away.”

A manganese smelting plant in South Africa belches out white smoke. Neurologist Brad Racette, MD, has teamed up with a South African public health expert to study whether people living near such plants show signs of neurological disorders.

Washington University School of Medicine‘s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked seventh in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

https://medicine.wustl.edu/news/3-7-million-to-help-research-neurological-disorders-linked-to-manganese/

Magic Mushrooms May ‘Reset’ Brains of Depressed Patients

NEUROSCIENCE NEWS   OCTOBER 13, 2017

Summary: A new study adds to growing evidence supporting the benefits of psychedelics to treat mental illnesses. Researchers report psilocybin, the psychoactive compound in magic mushrooms, is effective in reducing symptoms for people with treatment resistant depression. The study reveals the compound resets the activity of a brain network associated with depression, helping to improve symptoms in patients for up to 5 weeks following treatment.

Source: Imperial College London.

Whole-brain cerebral blood flow maps for baseline versus one-day post-treatment, plus the difference map. Correlation chart shows post-Treatment changes in bilateral amygdala CBF versus changes in depressive symptoms (r = 0.59, p = 0.01). One patient failed to completed the scan 2 QIDS-SR16 rating, reducing the sample size to n = 15 for the correlation analysis. In all of the images, the left of the brain is shown on the left.NeuroscienceNews.com image is credited to Carhart Harris, R et al. Scientific Reports 2017.

Patients taking psilocybin to treat depression show reduced symptoms weeks after treatment following a ‘reset’ of their brain activity.

The findings come from a study in which researchers from Imperial College London used psilocybin – the psychoactive compound that occurs naturally in magic mushrooms – to treat a small number of patients with depression in whom conventional treatment had failed.

In a paper, published today in the journal Scientific Reports, the researchers describe patient-reported benefits lasting up to five weeks after treatment, and believe the psychedelic compound may effectively reset the activity of key brain circuits known to play a role in depression.

Comparison of images of patients’ brains before and one day after they received the drug treatment revealed changes in brain activity that were associated with marked and lasting reductions in depressive symptoms.

The authors note that while the initial results of the experimental therapy are exciting, they are limited by the small sample size as well as the absence of a control group – such as a placebo group – to directly contrast with the patients.

Dr Robin Carhart-Harris, Head of Psychedelic Research at Imperial, who led the study, said: “We have shown for the first time clear changes in brain activity in depressed people treated with psilocybin after failing to respond to conventional treatments.

“Several of our patients described feeling ‘reset’ after the treatment and often used computer analogies. For example, one said he felt like his brain had been ‘defragged’ like a computer hard drive, and another said he felt ‘rebooted’. Psilocybin may be giving these individuals the temporary ‘kick start’ they need to break out of their depressive states and these imaging results do tentatively support a ‘reset’ analogy. Similar brain effects to these have been seen with electroconvulsive therapy.”

Over the last decade or so, a number of clinical trials have been conducted into the safety and effectiveness of psychedelics in patients with conditions such as depression and addictions, yielding promising results.

In the recent Imperial trial, the first with psilocybin in depression, 20 patients with treatment-resistant form of the disorder were given two doses of psilocybin (10 mg and 25 mg), with the second dose a week after the first.

Nineteen of these underwent initial brain imaging and then a second scan one day after the high dose treatment. Carhart-Harris and team used two main brain imaging methods to measure changes in blood flow and the crosstalk between brain regions, with patients reporting their depressive symptoms through completing clinical questionnaires.

Immediately following treatment with psilocybin, patients reported a decrease in depressive symptoms – corresponding with anecdotal reports of an ‘after-glow’ effect characterised by improvements in mood and stress relief.

Functional MRI imaging revealed reduced blood flow in areas of the brain, including the amygdala, a small, almond-shaped region of the brain known to be involved in processing emotional responses, stress and fear. They also found increased stability in another brain network, previously linked to psilocybin’s immediate effects as well as to depression itself.

These findings provide a new window into what happens in the brains of people after they have ‘come down’ from a psychedelic, where an initial disintegration of brain networks during the drug ‘trip’, is followed by a re-integration afterwards.

Dr Carhart-Harris explained: “Through collecting these imaging data we have been able to provide a window into the after effects of psilocybin treatment in the brains of patients with chronic depression. Based on what we know from various brain imaging studies with psychedelics, as well as taking heed of what people say about their experiences, it may be that psychedelics do indeed ‘reset’ the brain networks associated with depression, effectively enabling them to be lifted from the depressed state.

The authors warn that while the initial findings are encouraging, the research is at an early stage and that patients with depression should not attempt to self-medicate, as the team provided a special therapeutic context for the drug experience and things may go awry if the extensive psychological component of the treatment is neglected. They add that future studies will include more robust designs and currently plan to test psilocybin against a leading antidepressant in a trial set to start early next year.

Professor David Nutt, Edmond J. Safra Professor of Neuropsychopharmacology and director of the Neuropsychopharmacology Unit in the Division of Brain Sciences, and senior author of the paper, added: “Larger studies are needed to see if this positive effect can be reproduced in more patients. But these initial findings are exciting and provide another treatment avenue to explore.”

ABOUT THIS NEUROSCIENCE RESEARCH ARTICLE

Funding: The research was supported by the Medical Research Council, the Alex Mosley Charitable Trust and the Safra Foundation.

Source: Ryan O’Hare – Imperial College London

Image Source: NeuroscienceNews.com images is credited to Carhart Harris, R et al. Scientific Reports 2017.

Original Research: Full open access research for “Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms” by Robin L Carhart-Harris, Leor Roseman, Mark Bolstridge, Lysia Demetriou, J Nienke Pannekoek, Matthew B Wall, Mark Tanner, Mendel Kaelen, John McGonigle, Kevin Murphy, Robert Leech, H Valerie Curran & David J Nutt in Scientific Reports. Published online October 13 2017 doi:10.1038/s41598-017-13282-7

Abstract

Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms

Psilocybin with psychological support is showing promise as a treatment model in psychiatry but its therapeutic mechanisms are poorly understood. Here, cerebral blood flow (CBF) and blood oxygen-level dependent (BOLD) resting-state functional connectivity (RSFC) were measured with functional magnetic resonance imaging (fMRI) before and after treatment with psilocybin (serotonin agonist) for treatment-resistant depression (TRD). Quality pre and post treatment fMRI data were collected from 16 of 19 patients. Decreased depressive symptoms were observed in all 19 patients at 1-week post-treatment and 47% met criteria for response at 5 weeks. Whole-brain analyses revealed post-treatment decreases in CBF in the temporal cortex, including the amygdala. Decreased amygdala CBF correlated with reduced depressive symptoms. Focusing on a priori selected circuitry for RSFC analyses, increased RSFC was observed within the default-mode network (DMN) post-treatment. Increased ventromedial prefrontal cortex-bilateral inferior lateral parietal cortex RSFC was predictive of treatment response at 5-weeks, as was decreased parahippocampal-prefrontal cortex RSFC. These data fill an important knowledge gap regarding the post-treatment brain effects of psilocybin, and are the first in depressed patients. The post-treatment brain changes are different to previously observed acute effects of psilocybin and other ‘psychedelics’ yet were related to clinical outcomes. A ‘reset’ therapeutic mechanism is proposed.

“Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms” by Robin L Carhart-Harris, Leor Roseman, Mark Bolstridge, Lysia Demetriou, J Nienke Pannekoek, Matthew B Wall, Mark Tanner, Mendel Kaelen, John McGonigle, Kevin Murphy, Robert Leech, H Valerie Curran & David J Nutt in Scientific Reports. Published online October 13 2017 doi:10.1038/s41598-017-13282-7

http://neurosciencenews.com/magic-mushrooms-may-reset-brains-depressed-patients/

Fighting Parkinson's: Boxing program helps mobility, mindset

October 14, 2017

BOWLING GREEN, KY. 

While singing the chorus of "When The Saints Go Marching In", Mary Alice Oliver rhythmically strikes the black Everlast punching bag with a left-right combination, her eyes focused on the target and her arms extending with each blow.

Moments later, Rock Steady Boxing Bowling Green head coach Jill Steffey begins counting down the seconds before her fighters will switch stations. As time elapses, Oliver takes one last swing, and her jab leaves the bag vibrating from the impact.

It's time for the fighters to move to another exercise, and in the battle they're fighting, movement is everything.

Rock Steady Boxing is a nationwide nonprofit that seeks to improve the quality of life for those with Parkinson's disease by providing a venue for exercise through non-contact boxing. As Parkinson's disease impacts a person's movement, each exercise is designed to boost coordination, motor skills, balance and speech.

Read more here: http://www.bellinghamherald.com/news/article178925616.html#storylink=cpy

For Oliver and other members of the Bowling Green club, Rock Steady Boxing is also about coming together with others who are fighting Parkinson's disease for recreation and fellowship.

Read more here: http://www.bellinghamherald.com/news/article178925616.html#storylink=cpy

"It's such a congenial group. We have so much fun with each other," Oliver said.

Steffey — who is a full-time public school teacher along with coaching at Rock Steady — launched the Bowling Green chapter a year ago in October of 2016. For her, it was personal. Steffey's father had been living with Parkinson's for more than a decade before a back surgery in 2014 made his condition worsen to the point where he had to rely on a wheelchair.

Determined to help her father, Steffey learned about Rock Steady, but there wasn't a facility in south central Kentucky that offered the program. In the spring of 2015, the YMCA in Hopkinsville started a Rock Steady program and she drove her father to Christian County so he could see what it was all about.

Somewhat unsure of the idea at first, Steffey said her father asked to participate with the other fighters on the first day.

"He absolutely loved it," she said.

But it was the second trip to Hopkinsville that sealed the deal for Steffey. Once her father began the training regimen that day, she said the instructor told her to take his wheelchair back to the car because he would no longer be needing it.

"So I took the wheelchair to the car, and he hasn't been in it since" other than the occasional time when it's easier for him to use it in certain situations, she said.

It's been a long process, complete with days of training and certification and hours of labor shaping the space behind Live Active at 1249 US 31-W into a true boxing and exercise facility. But Steffey's dream has created a core group of about 20 fighters along with several volunteers who utilize Rock Steady Boxing Bowling Green.

"Every single one of them (has) improved in some fashion," Steffey said of the fighters.

While Steffey focuses on the boxing aspect of Rock Steady, assistant coach Maureen McIntyre oversees the portion of the workout where the fighters go to different stages to perform tasks such as lacing shoes, tossing bean bags into a bin and extending their legs in the air while seated. Each activity is tied to a specific way of improving motor skills, muscle function and awareness.

Like Steffey, McIntyre said she has seen first-hand how Rock Steady changes lives for those with Parkinson's disease.

"They'll show up in a wheelchair or a walker, and then in a week or two, you see them without it," she said.

It's not unusual for people to be skeptical at first, but after they come to the gym the initial time, Steffey said they are usually hooked.

Family members and friends will often accompany the fighters during their workouts, usually performing the same exercises. Kay Dillon said Oliver has been her best friend for 40 years, so when she wanted to give Rock Steady a try as a way to combat her Parkinson's symptoms, Dillon wanted to be right there with her.

"If she needs me, I'm going to be here," Dillon said, as she made her way through the exercise stations with Oliver.

Beyond the physical improvements, Steffey said a goal of the organization is to provide support for those dealing with Parkinson's as well as their friends and family members. A separate part of the nonprofit is the Partners fighting Parkinson's support group, which will hold its first meeting at 5 p.m. Thursday at the gym.

Though the facility is located in Bowling Green, people have come to train from places like Munfordville and Lewisburg. Steffey said they hope to add more fighters from southcentral Kentucky, as she added anyone with Parkinson's is invited to come and check out the program and decide if they would like an evaluation and to join Rock Steady.

Classes are held from 5 to 6:30 p.m., Monday through Thursday, with groups participating twice weekly. One group is designed for those who are more stricken with the effects of Parkinson's, while the other group is for those who have more mobility.

Joyce Devore is one of the handful of fighters who have been with Steffey and Rock Steady since the program launched in Bowling Green. Her husband recommended she try it out, and she said the upbeat spirit and energy from the program have been a real boost for her. She said beyond improving her mindset, Rock Steady has also helped her physically, including with her balance.

"I think anybody should owe it to themselves to try it," Devore said.

http://www.bellinghamherald.com/news/article178925616.html

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