How Does Manganese Enter the Brain?

By Staff Editor     Aug 24, 2018 

(HealthNewsDigest.com) - BUFFALO, N.Y. — New information from the University at Buffalo on how manganese, an essential nutrient, gets into the brain, is helping shed light on a neurological disorder usually associated with industrial overexposure to the metal.

In June, Brittany Steimle, a doctoral candidate in biochemistry at UB, received the award for outstanding poster for her presentation on how proteins transport manganese in the brain at the international “Trace Elements in Biology and Medicine” conference, sponsored by the Federation of American Societies for Experimental Biology in Tahoe City, California.

Steimle conducts research in the laboratory of Daniel J. Kosman, PhD, SUNY Distinguished Professor in the Department of Biochemistry in the Jacobs School of Medicine and Biomedical Sciences at UB, where the focus is on the regulation of manganese and other essential nutrients in the brain.

She explained that manganese is essential for bone formation, brain development and metabolizing carbohydrates, cholesterol and amino acids.

However, she noted, workers in the welding, mining and ore-crushing industries may be susceptible to overexposure by inhaling manganese, which can induce neurological disorders like manganism, a condition that resembles Parkinson’s disease with symptoms like tremors, difficulty walking and facial spasms. The similarity between the two has led to proposals that manganese may also play a role in Parkinson’s disease.

“To develop therapeutics for manganese-induced neurological diseases, we must first understand how manganese enters the brain,” said Steimle.

Her study focused on how dietary manganese crosses into the brain through the blood-brain barrier, (BBB), an impermeable barrier that regulates passage of nutrients into the brain. Brain microvascular endothelial cells make up the basis of the BBB through the formation of tight junctions between endothelial cells.

“Due to the restrictive nature of this barrier, nutrients can only pass into the brain through transporters and chaperone proteins expressed by these endothelial cells,” she said. “Our objective is to characterize the transport systems that regulate manganese uptake into the brain and to further investigate how such mechanisms protect against manganese-induced neurotoxicity.”

In Kosman’s lab, Steimle and her colleagues do this using an in vitro model of the BBB, developed by Ryan McCarthy, PhD, previously a graduate student in the lab. In the model, the brain microvascular endothelial cells are grown under conditions that imitate the in vivo environment of the BBB.

“Understanding how manganese accumulates into the brain through the blood-brain barrier may serve as a key to designing drug targets for individuals who may have been overexposed to manganese in the environment or in whom manganese metabolism has somehow become dysregulated,” she said.

http://www.healthnewsdigest.com/news/brain0/How-Does-Manganese-Enter-the-Brain.shtml

Cognitive, Pathological Changes Seen in Parkinson’s and Dementia with Lewy Bodies, Rat Study Shows

AUGUST 24, 2018    BY JOSE MARQUES LOPES, PHD IN NEWS.

A newly developed rat model combining elevated levels of alpha synuclein — a key protein in both Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) — and related pathological changes may provide new insights into both disorders, according to a new study.

The research, “Cognitive and histopathological phenotypes in new rat models of cortical synucleinopathy,” was presented during the 2018 World Congress on Parkinson’s Disease and Related Disorders (IAPRD), held in Lyon, France.

Both PDD and DLB patients typically exhibit Lewy bodies, which are aggregates primarily formed by long strands, or fibrils, of alpha-synuclein, in the cerebral cortex. However, whether these clumps are associated with cognitive decline remains unknown.

To gain better insight of this potential link, scientists need new animal models where induction of cortical alpha-synuclein-mediated mechanisms can be induced under controlled conditions.

The team at Lund University, in Sweden, evaluated two rat models. One consisted of bilateral injections of modified, harmless viruses called adeno-associated viral vectors (AAV), that contained the gene coding for a normal human alpha-synuclein (AAV-syn). The injections were made directly into the rats’ medial prefrontal cortex (mPFC), a brain region with key importance in memory.

The other model also included AAV injections, which were followed shortly by administration of fibrils of human alpha-synuclein into another different brain area called striatum, which is critical in the control of movement and in cognition. Injection of alpha-synuclein fibrils is a common strategy (called seeding) to induce alpha-synuclein pathology in animal studies.

Two tests of prefrontal cognitive functions were conducted. The team also evaluated the levels of neurons, human alpha-synuclein, and a specific form — called phosphorylated — of alpha-synuclein, previously implicated in neurodegeneration in preclinical studies of Parkinson’s.

The results showed that while rats undergoing AAV-syn injections exhibited unchanged performance in their cognitive tasks, those given AAV-syn and alpha-synuclein fibrils revealed significant deficits in both tests.

Alpha-synuclein levels were high in cell bodies and nerve fibers of medial prefrontal cortex neurons (associated with memory) in both models. Analysis of phosphorylated alpha-synuclein revealed extensive cell body and nerve fibers’ aggregates in rats administered with both AAV-syn and fibrils, while in those injected with AAV-syn, these aggregates were restricted to medial prefrontal cortex cell bodies (the area into which they were directly injected).

Also, rats injected with AAV-syn and fibrils showed abundant degeneration of dendrites — a type of extension on nerve cells that receives stimulation for the cell to become active — and a marked decrease of medial prefrontal cortex neurons.

“Our data suggest that cortical overexpression of human [alpha-synuclein] is not sufficient to produce cognitive dysfunction,” researchers wrote.

They added that the combination of alpha-synuclein over-expression and pathology induced by the fibrils leads to both cognitive and tissue changes “that are relevant to PDD/DLB.”

https://parkinsonsnewstoday.com/2018/08/24/rodent-study-examines-cognitive-pathological-changes-parkinsons-dementia/

Phase 2 Trial Shows Nilotinib Potential to Modulate Dopamine in Parkinson’s

AUGUST 24, 2018   BY ALICE MELÃO 

Nilotinib can modulate dopamine levels and metabolism, as well as prevent the formation of toxic alpha-synuclein aggregates, according to recent data from a Phase 2 clinical trial.

These findings suggest that Novartis’ investigational therapy has the potential to promote long-term benefits in patients with Parkinson’s disease.

The study, “Nilotinib increases dopamine metabolism and reduces oligomeric: total alpha-synuclein ratio in Parkinson’s disease,” was recently presented during the 2018 World Congress on Parkinson’s Disease and Related Disorders (IAPRD), Lyon, France.

Nilotinib is available under the brand name Tasigna as an approved treatment for certain types of leukemia. It blocks the activity of a protein called BCR-ABL that is known to support cancer development. But this protein also is intimately linked to several mechanisms in the brain, such as oxidative stress and alpha-synuclein-induced neurodegeneration, which play critical roles in Parkinson’s and other brain disorders.

Results of a small proof-of-concept Phase 1 trial (NCT02281474) performed at Georgetown University in Washington, D.C., revealed that treatment with two different doses of Nilotinib — 150 mg and 300 mg — could improve Parkinson’s patients’ motor skills and cognitive abilities. In addition, the treatment showed the potential to reduce levels of the protein alpha-synuclein, which is believed to contribute to destruction of brain nerve cells in Parkinson’s disease.

In the ongoing Phase 2 trial (NCT02954978) a total of 75 patients with mid-stage Parkinson’s disease with mild cognitive impairment were randomized to take one of four tested oral doses of Nilotinib -—150 mg, 200 mg, 300 mg, and 400 mg — or a placebo.

After a single treatment researchers evaluated several biomarkers of the disease, including the levels of alpha-synuclein and dopamine derivate compounds in patients’ cerebrospinal fluid (CSF).

The data revealed a significant increase in homovanillic acid (HVA) and DOPAC levels, suggestive of enhanced production and metabolism of dopamine just one to four hours after treatment.

Although researchers could not find significant changes in CSF total alpha-synuclein levels, low-dose Nilotinib therapy (150 mg and 200 mg) resulted in a reduction of the levels of abnormally clustered and toxic alpha-synuclein.

“The significant reduction of oligomeric alpha-synuclein, which is expected to increase in the CSF of Parkinson’s disease patients as the disease progresses, suggests that Nilotinib may reduce misfolded alpha-synuclein accumulation and have a long-term disease modifying effect,” researchers wrote.

“These results suggest Nilotinib, in a dose dependent manner, may have a symptomatic effect through modulation of brain dopamine levels. Additionally, the significant reduction of oligomeric alpha-synuclein, which is expected to increase in the CSF of PD patients as the disease progresses, suggests that Nilotinib may reduce misfolded alpha-synuclein accumulation and have a long-term disease modifying effect,” researchers wrote.

The team will continue the analysis of the collected data to further explore the impact of Nilotinib treatment on disease biomarkers’ levels both in the blood and CSF, after a single administration and 52-week daily treatment regimen.

A new Phase 2 trial, NILO-PD (NCT03205488), currently recruiting 135 participants, will further investigate the potential of Nilotinib in patients with moderate-to-advanced Parkinson’s symptoms.

The study will take place at 25 sites across the United States. It will compare the safety and effects on patients’ motor functions of once-daily Nilotinib versus placebo treatment, for up to 12 months.

https://parkinsonsnewstoday.com/2018/08/24/phase-2-trial-shows-nilotinib-potential-to-modulate-dopamine-in-parkinsons-patients/

Young-onset Parkinson's patients defy stereotypes

August 24,  2018      Laura Genn

Kristin Ognjanovac and her family. From left: Liam,3, Julian,12, Coldyn,9, Tyler,19, and husband, Dan pose for a photo in Alloentown, Pa. Kristin was diagnosed with Parkinson's disease 10 years ago.

 (Art Gentile / Bucks County Courier Times / AP)

What comes to mind when you think of Parkinson's disease?

Many people know an older friend or relative who was diagnosed with Parkinson's, and it's no surprise — according to Medical News Today, 1 million adults in America live with Parkinson's, and about 10 million people worldwide have the disorder. The diagnosis is frequently associated with specific symptoms, such as a tremor, and with high-profile patients, such as Michael J. Fox and Alan Alda.

Not every Parkinson's patient, however, has the classic symptoms, and many aren't the expected age. When Parkinson's is diagnosed in a patient younger than 50, it's considered young-onset, which brings its own unique set of challenges — not the least of which is getting the correct diagnosis in the first place.

According to the American Parkinson Disease Association, 10 percent to 20 percent of Parkinson's patients are young-onset. For many people, that number is much more than a statistic.

Kristin Ognjanovac, now 40, is an Allentown resident who defies every Parkinson's stereotype. She was diagnosed six years ago at 34. Of all her symptoms, the classic tremor is the least prominent. And she's still raising her four sons, all between the ages of four and 19, two of which are on the autism spectrum. (She even became pregnant with the youngest after her diagnosis, though she called the pregnancy very similar to her previous three.)

"It pretty much started out with simple things that a lot of people have," Ognjanovac said. She had chalked up her rising anxiety and insomnia to stress. "But then I started feeling like an invisible ghost was pushing me forward. I was getting dizzy spells ... I felt like I was being pushed forward or I was completely frozen. There was no in between."

One day, while buying flowers at Lowe's, Ognjanovac found herself unable to lift her feet in the store. That incident frightened her enough that she called her first neurologist. Over the following year, Ognjanovac would see several additional neurologists before confirming the Parkinson's diagnosis, ultimately choosing Dr. Nancy L. Diaz — a movement disorder specialist at St. Luke's Hospital who practices in Quakertown, Allentown and Bethlehem — as her ongoing partner in fighting the disease.

"For a younger patient, a lot of times there's a delay in their diagnosis," Diaz said. Her youngest Parkinson's patient was 28 at diagnosis. "They may develop symptoms like shoulder pain, or while they're running, their foot feels awkward, so they'll see other doctors first, and commonly come to someone like me maybe a year or two into their symptoms because they become worse, and someone is finally thinking about Parkinson's disease or another neurological disorder."

Mary Jane Barr-Silk, a speech therapist at Doylestown Hospital, runs a support group for Parkinson's patients, in which she says many of the symptoms are far from stereotypical. "In particular with my area, the swallowing and speech can be quite affected," she said. "A certain percentage of people also have cognitive issues ... memory, reasoning, higher-level cognitive skills."

Kristin Ognjanovac has been living with Parkinson's disease for 10 years and has to use a walker to help her get around at times during the day.(Art Gentile / Bucks County Courier Times / AP)

Doctors are still trying to determine the cause of Parkinson's disease. There isn't a definitive test to confirm the diagnosis, but if symptoms are present and a DAT scan (a specialized CAT scan) reveals a lack of dopamine in the brain, that's enough for a doctor to presume Parkinson's. If a patient responds to Parkinson's medication, that confirms the presumption.

The lack of dopamine leads to Parkinson's hallmark tremors and muscle rigidity, but it also can cause a vast array of less recognized symptoms that are equally frustrating for patients.

"Especially with younger patients," Diaz said, "they may develop depression, anxiety, sleep disturbances, restless leg, things like that, early on, and then start developing more of the highly recognized motor symptoms later."

In Ognjanovac's case, she hardly ever experiences the expected tremor unless she's especially upset or anxious, which can aggravate symptoms. On the other hand, she's experienced everything from neck pain to stomach cramps to losing her sense of smell, none of which the average person would associate with Parkinson's disease, but all of which are related.

The only predictable symptom in Parkinson's is its unpredictability.

"I'm either a sloth or a roadrunner," Ognjanovac said. "Our body now dictates when we can and cannot do things."

Since intense exercise is one of the best ways to manage Parkinson's symptoms, Ognjanovac takes advantage of every opportunity her body affords to stay moving. "My oldest son is like, 'Why are you cleaning the floors at 3 in the morning?' I'm like, 'A: I can't sleep. And B: I can move!' "

The primary Parkinson's medications — levodopa and carbidopa — can have side effects after long-term use, such as dyskinesia, or involuntary muscle movements, often visible in Michael J. Fox. Since young-onset patients are likely to be on medication long into the future, they try to limit their medications while still managing their symptoms.

Medication can be further limited through what's called the Deep Brain Stimulation procedure, which involves placing an implant in the brain that sends electronic signals to control symptoms. While it may sound invasive, it can actually be performed while the patient is awake, and it makes a profound difference in controlling symptoms without excessive (or any) medication, according to doctors.

In addition, according to Diaz, "Dystonia, or posture issues, is much more common in young onset Parkinson's; they'll develop a posturing of a muscle, so when they're walking their foot might cramp into tiptoeing, or a stiff shoulder from not moving their arm as much when they walk."

For many young-onset patients, however, the biggest challenge isn't the long road to a diagnosis, the symptoms, or the side-effects of medication — it's the reactions of friends and strangers alike who don't know how to respond to young people with Parkinson's. It's difficult to explain, for example, when symptoms become apparent at a birthday party for one of her children's friends.

"They don't understand how quickly — in my case, maybe 15 minutes after I take medication, my meds kick in," Ognjanovac said. "I'll be parked in a handicapped spot at the grocery store and there's been times when I need one of those electronic wheelchairs, and then half an hour later, my meds kick in, and I don't need it anymore, so people think that you're faking, especially because you look young."

Despite lack of understanding, there are many resources (both local and online) for young-onset Parkinson's patients. Ognjanovac attends at support group at St. Luke's, where she's admittedly among the youngest but nevertheless not alone. She's in several online support groups, both through Facebook and the national Parkinson's Foundation.

Diaz also recommended PD Steps, an educational group in which monthly speakers educate on different Parkinson's topics, and the "Big and Loud" program, a physical therapy program that focuses on maintaining big movements and loud voices — also providing participants with a home exercise program.

For more resources, Parkinson's patients are encouraged to contact their local hospitals to ask about support groups, physical therapy programs and more.

Asked what she might say to a newly diagnosed young-onset Parkinson's patient, Diaz said, "Patients that withdraw, especially if they don't have a support system at home, can have a quicker progression than someone who's sharing with others and trying to live with Parkinson's. You can live the rest of your life with Parkinson's. You have to stay educated about it, see your doctors, form a plan, stay active, and take a different point of view."

Ognjanovac admitted to fearing the future, but said she chooses to appreciate the little moments of the present: walking her hyperactive dog, fishing with her children, and visiting Dorney Park so often that her sons have started to complain.

"Life is worth living, not existing," she said. "There is support out there. You're not alone."

http://www.chicagotribune.com/lifestyles/health/ct-young-onset-parkinsons-20180824-story.html

Heart Risks Tied to Parkinson’s Disease

Aug. 24, 2018

Abdominal obesity, high triglycerides, high cholesterol, high blood pressure and high glucose readings were linked to an increased risk of developing Parkinson’s disease.

Symptoms of poor cardiovascular health may be linked to an increased risk for Parkinson’s disease, a new study has found.

Researchers used data on 17,163,560 South Koreans over 40 years old and found 44,205 cases of Parkinson’s over the course of a five-year follow-up. They looked for five cardiovascular risk factors that define the metabolic syndrome: abdominal obesity, high triglycerides, high cholesterol, high blood pressure and high glucose readings. The study is in PLOS Medicine.

After controlling for age, sex, smoking, alcohol consumption, physical activity, income, body mass index and history of stroke, they found that each component of the metabolic syndrome significantly increased the risk for Parkinson’s disease.

The more risk factors a person had, the greater the risk. Compared with having none of the risk factors, having all five was associated with a 66 percent increased risk for Parkinson’s disease. The association was particularly strong for people over 65.

There are about 60,000 new diagnoses of Parkinson’s each year in the United States, and about a million Americans are living with the disease.

“The metabolic syndrome and its components are independent risk factors for Parkinson’s,” the authors wrote. “Future studies are warranted to examine whether control of metabolic syndrome and its components can decrease the risk of Parkinson’s disease development.”

https://www.nytimes.com/2018/08/24/well/eat/heart-risks-tied-to-parkinsons-disease.html

Volunteers step forward: Belgian scientists look for poo donors

August 24, 2018   By Julia Echikson

A scientist manipulates a bag that contains faeces in a laboratory at the University of Ghent, Belgium August 23, 2018. 

GHENT, Belgium (Reuters) - Belgian scientists are looking for people to donate their faeces to help with research into illnesses ranging from bowel disorders and allergies to neurological diseases.

At Ghent University hospital, researchers are performing fecal microbiota transplants on patients. They extract good microbiota, tiny organisms living in the colon, from donors to transfer it to sick patients in hope of repopulating their guts.

"How do we find donors? That's not so easy. People do not always want to donate their faeces. It is also hard to talk about, but we started this campaign in the press here in Flanders," said biomedical researcher Hannelore Hamerlinck.

Beyond bowel disorders, faeces may prove to be an asset in finding remedies for many other diseases, scientists say.

Over the past decade, a growing number of studies have suggested an association between disruptions in gut microbiota and illness, including allergies and cancer.

"Microbes are at the center of the system. The bacteria in the gut produce hormones that will affect the brain. They also help us to clear out the bad ones and digest certain things," Hamerlinck said.

Donors must be in good health to participate in the research. They first have to fill out an extensive questionnaire and must be tested over a three month period before becoming eligible to donate.

Often people come forward as donors when a loved one has struggled with bowel diseases, said Hamerlinck.

(Reporting by Julia Echikson; Editing by Ros Russell)

https://whbl.com/news/articles/2018/aug/24/volunteers-step-forward-belgian-scientists-look-for-poo-donors/

Former Missouri Teacher Trying a New Program to Counter Parkinson's Disease

August 23, 2018

https://youtu.be/G6CtC56JK50

COLUMBIA, Mo. - A Former Kindergarten Teacher, who has been diagnosed with Parkinson's Disease, is trying a new program to counter the disease, that involves lacing up a pair of gloves and whacking a heavy punching bag.

Susan Vittone is enrolled in a specialized workout called Rock Steady Boxing, at Mizzou's Healthcare and Human Performance Institute.

Her neurologist said she should give it a try and credits the program for keeping her symptoms of Parkinson's at bay.

Many participants in the class struggle with spatial awareness, which is the ability to navigate in a given space.

However, the repetition of punches is a part of an effort to keep the brain active while making large movements.

Dr. Junaid Siddiqui, an MU Healthcare Neurologist, says, "Exercise, especially aerobic exercise, help your symptoms.  It sort of helps just like medications, without side effects."

Becky Edwards, Certified Rock Steady Coach, says, "The principles of boxing, really they work on all deficits that we see in Parkinson's.  It is balanced, it is the core strength, it is movement fluidity.  All of those things go into boxing training."

Vittone still drives and maintains an active lifestyle and she has gained confidence from the workouts. 

There is no cure for Parkinson's but Rock Steady Boxing is designed to slow the disease progression

https://www.ozarksfirst.com/news/former-missouri-teacher-trying-a-new-program-to-counter-parkinson-s-disease/1392123058

Guernsey puppies to be trained to detect diseases

24 August 2018 

A Guernsey woman is sending 4 of her puppies to Milton Keynes to be trained at the charity Medical Detection Dogs.

The group teaches dogs to detect the odour of human diseases like cancer through samples like urine, breath and swabs. 

Andie Fuller will send her dogs to the charity where they will be taught to detect even the slightest of changes in an individual's personal odour when it is triggered by a disease. 

The charity say that all dogs and breeds have the ability to detect cancer and other diseases but they will select certain breeds that that have a high hunting instinct. 

The length of time it takes for a dog to be trained can be up to 8 months but the charity say it depends on the dog. 

Using dogs can help in detecting diseases like prostate cancer that are usually difficult to diagnose. 

The group are also researching into whether dogs can detect other illnesses like Parkinson's disease, malaria and bacterial infections.

http://www.itv.com/news/channel/2018-08-24/guernsey-puppies-to-be-trained-to-detect-diseases/

The night shift at age 15: Grace chooses to care for her grandmother with Parkinson's, dementia

Thursday, August 23rd 2018

“I stay up until three or four in the morning with her,” said Grace. “In case she has to get up and go to the bathroom, I'm there to help her. In case she wanders around." (Source: WECT)

CAROLINA BEACH, NC (WECT) -

A typical day for Grace Eason, 15, starts a little before noon. She sleeps in because she cares for her grandmother, Martha, late into the night.

“I stay up until three or four in the morning with her,” Grace explained. “In case she has to get up and go to the bathroom, I'm there to help her. In case she wanders around."

Grace’s schedule is different from most other teenagers. She is a 10th grade student in an online high school, which gives her the flexibility and choice to help her grandmother with everyday activities, which are difficult because of Parkinson’s disease and dementia.

Dementia is a general term for a decline in memory, mental skills, and overall thinking abilities. Most dementia cases, 60 to 80 percent, are caused by Alzheimer's disease, according to UpToDate, but a variety of other conditions can cause dementia, including blood vessel problems from a stroke, Parkinson's disease, brain trauma, and unknown causes.

“She has days where she can walk, walk, walk,” said Grace about her 81-year old grandmother. “And then other days she can't hardly get out of bed. As far as the... delusions that she has, that's almost an everyday thing."

Grace's mother, Shari, said caring for her mother is her primary burden, and she said Grace has really stepped up the plate to help.

"My mom is my responsibility," said Shari. "(Grace) is a tremendous amount of help to me. If it were just me, I don't think I could do it. It's a roller coaster ride."

Shari said Grace has the freedom to spend time with friends and relatives when she chooses to. But Grace embraces her role as a caregiver for her grandmother.

"It's teaching her responsibility," said Shari. "That's what family is supposed to be about... I encourage her, as long as it doesn't drag her down."

After waking up, Grace gives Martha medications that help treat her Parkinson’s disease, which causes stiffness and difficulty with balance, coordination, and walking.

Helping Martha with everyday life is a full-time job, said Grace. A hired caregiver Monday through Friday helps the family during the day, but after 6 p.m. and into the night, Grace 

takes over while her parents work long days in their full-time jobs.

Weekends are split between Grace, her parents, and another hired caregiver.

“It’s a 24/7 job,” Grace said.

An aging population means more caregivers

Grace and her grandmother are just one story of the ‘Silver Tsumani’ sweeping the United States.

A baby born in 2016 is expected on average to live to the age of 79, according to data from the World Health Organization.

About 10,000 baby boomers turn 65 every day, according to the Pew Research Center. More than half of them will eventually need long-term care, found a 2016 study by the U.S. Department of Health and Human Services.

And who will take care of them? Assisted living facilities are a solution, but many are turning to younger, more-able family members for help.

In May, the American Association of Retired Persons (AARP) explored the increase in younger caregivers in a special report.

Every year in the United States, about 40 million American adults care for an older person, with one in four being a Millenial, the report said.

Grace and her grandmother

"I usually finish my school work. That's my number one priority,” said Grace, who hopes to pursue a career in healthcare. "I definitely want to become something in the medical field. And taking care of her makes me have the urge to do that more.”

Grace takes her grandmother’s blood pressure, helps her use the bathroom with a portable toilet, gives her a shower twice a week, cooks for her, takes her on walks, out shopping, and more.

"I give her a shower, make sure she smells good, and make sure she looks presentable before she goes out in public,” Grace said.

The teenager’s caregiving responsibilities began about a year ago when Martha moved in with the family from an assisted living facility.

"She called my mom one day and said, I'm ready to come home,’” Grace explained. “We've had some tough days with her. As sweet as she can be is as mean as she can be."

"She was a really strong woman,” said Grace about her grandmother. “She liked to have a good time... Her and her husband. Her husband passed about eight or nine years ago of cancer. So that's when things started going downhill from there."

Martha suffered from a heart attack a week after moving in with the family. And six months ago, she had an accident during the night.

“She thought two police officers were at the door. And she dreamed that she had a gun in her hand,” said Grace. “She walked down these stairs, and didn't know they were there and fell, and broke three places in her shoulder. So she can't hardly move her arm because of that situation."

Despite the challengers, Grace has a mature perspective and embraces her role as a caregiver.

"If I were there one day, I would want somebody to take care of me, and I try to do it to the best of my abilities. I try to give it 100 percent when I take care of her,” said Grace.

“Sometimes you have to accept reality the way it is, and that's a situation that you definitely have to accept reality. That she is getting older and she won't get better, because both of her diseases that she has, they will never be cured."

Taking care of an older family member is sometimes difficult, Grace admits. She wants others to understand the toll it can take.

"My biggest thing is criticism and judgement from people. We get a lot of that. They'll talk to her on the phone for five minutes, and say there's nothing wrong with her, but they're not here when she's hallucinating," Grace said, adding that patience is often required when helping her grandmother.

"My message is to make memories. Remember the good ones. There's going to be bad ones, but enjoy the good ones."

Video:

http://www.wect.com/story/38948873/the-night-shift-at-age-15grace-chooses-to-care-for-her-grandmother-with-parkinsons-dementia

'American Ninja Warrior' athlete with Parkinson's turns obstacles into relief

August 23,  2018     Emily DeCiccio

https://youtu.be/rAO01BNEJkk

How athlete with Parkinson's became American Ninja Warrior

A look at Parkinson's disease and how one man fought depression and the disease and became a marathoner, mud runner, and American Ninja Warrior

A Parkinson’s diagnosis was not part of the plan for 27-year-old Jimmy Choi. He was a scratch golfer, newly married, and a computer software developer. Life as he knew it came to a screeching halt following a routine physical when a nurse noticed some irregular movements from Choi. It prompted him to investigate the irregularity further, until he received his Parkinson’s diagnosis.

“My initial reaction was disbelief,” Choi, now 35, told Fox News. “In fact, there was so much disbelief that I told the diagnosing neurologist at the time to go stuff it.”

According to Dr. Rachel Dolhun, a movement disorder specialist at the Michael J. Fox Foundation, Parkinson’s is a complex disorder.

“At its core there is a loss of brain cells that make dopamine, and that’s why in Parkinson’s you see symptoms of movement like tremors, slowness, stiffness, and walking and balance problems,” Dolhun said.

Dolhun added that non-motor symptoms, like memory, mood changes, and sleep problems are also affected by Parkinson’s. Currently, it’s estimated that more than 6 million people worldwide live with Parkinson’s. 

As his Parkinson’s progressed, Choi became less active and increasingly frustrated. In the eight-year period that followed his diagnosis, Choi lost sight of who he was.

“Ultimately it got to the point where I weighed 250-pounds, I was walking with a cane because I kept falling since I lost balance,” Choi said. “I was preparing myself to live the rest of my life in that state.”

Choi said his rock bottom and wake-up call came when he fell down the stairs while he was carrying his 10-month old son. Thankfully, his son was unharmed, but Choi said that at that moment he knew he had a decision to make: continue living life as a burden and safety hazard to his family or try to make a switch and improve his situation.

Choi chose the latter. He began educating himself on Parkinson’s and what the disease was doing to his body. He became involved in a number of clinical trials, and then noticed that there was always a physical aspect to the trials. That pushed Choi toward physical activity as a form of treatment. 

Dolhun told Fox News that exercise is just as important as the medications taken to treat the symptoms of Parkinson’s.

“Exercise can really help the motor-symptoms of Parkinson’s including the tremors, the stiffness, the slowness, the walking, and the balance problems,” Dolhun said. “Exercise can also help the non-motor symptoms of Parkinson’s, so the mood problems including depression or anxiety, and also the sleep changes.”

Choi started by simply walking around the block with his cane, which progressed in distance and his ability to walk without a cane. He began jogging and then increased his pace to a run.

“I signed up for my first 5K in April 2012, and from then on I just kept pushing the distances and speed,” he said. “I noticed that the more running I did, the better I felt.” 

Running became Choi’s passion until his young daughter, Karina, encouraged him to start obstacle-course racing. He said the experience not only helped him bond with his daughter, but also gave him new insights into coping with Parkinson’s. 

“On obstacle races, you’re learning a lot of things that people with Parkinson’s have trouble with on a daily basis, like learning to fall, how to properly get up after you fall,” Choi said. “Everything I do has a purpose when it comes to my daily living with Parkinson’s.”

Karina pushed him to compete on one of the toughest shows on television, “American Ninja Warrior.” When she saw Allison Toepperwein, another athlete who has Parkinson’s compete on the show, Choi said that Karina immediately turned to him and asked what his excuse was.

“I had none, so I applied, and a few months later the producers called me and told me I was on,” he said.

When Choi trains for events like “American Ninja Warrior” he said that he has to approach it differently because Parkinson’s has effected the right-side of his body more. That means, for example, when he’s hanging on the monkey bars he cannot swing his right leg, so he has to compensate with his hips or left leg to generate that swing and momentum. He also notes that over-exaggeration of moves helps build muscle memory both inside and outside of the gym.

Choi told Fox News that the only difference between the version of himself who was heavier and depressed several years ago is his willingness to make a change.

“Anybody can do the things I can do,” he said. “I’m no better than anyone else who’s willing to put in the same amount of training that I do.”

Emily DeCiccio is a video producer and writer for Fox Digital Originals. Follow her on Twitter @EmilyDeCiccio

Video:

http://www.foxnews.com/health/2018/08/23/american-ninja-warrior-athlete-with-parkinsons-turns-obstacles-into-relief.html