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Friday, November 23, 2018

Scientists discover a tiny hidden region in the brain that is UNIQUE to humans and could help cure Parkinson's and motor neurone disease

By Phoebe Weston For Mailonline - November 23rd 2018

  • For thirty years, researchers suspected this region existed but could not see it
  • Scientists found the region thanks to better staining and imaging techniques
  • The discovery of the region may help researchers explore cures for diseases 
Scientists have found a tiny new region of the brain that only humans have - and they believe it could be what makes our species unique.
Researchers say the incredible find could help find a treatment for Parkinson's and motor neurone disease.
For thirty years scientists - who have likened the discovery to finding a new star - suspected this region existed but were unable to see it.
Scientists have found a new region of the brain that only humans have - and they believe it could be what makes our species unique. The new region is called Endorestiform Nucleus

Professor George Paxinos from Neuroscience Research Australia (NeuRA) found the hidden region.
He was able to find the region, called the Endorestiform Nucleus, thanks to better staining and imaging techniques.
'The region is intriguing because it seems to be absent in the rhesus monkey and other animals that we have studied,' said Professor Paxinos.
'This region could be what makes humans unique besides our larger brain size', he said.
The region is found near the brain-spinal cord junction.
This is an area that integrates sensory and motor information to refine our posture, balance and fine motor movements.
For thirty years scientists - who have likened the discovery to finding a new star - suspected this region existed but were unable to see it
For thirty years scientists - who have likened the discovery to finding a new star - suspected this region existed but were unable to see it
Professor George Paxinos from Neuroscience Research Australia (NeuRA) found the hidden region. He was able to find the region, called the Endorestiform Nucleus, thanks to better staining and imaging techniques
Professor George Paxinos from Neuroscience Research Australia (NeuRA) found the hidden region. He was able to find the region, called the Endorestiform Nucleus, thanks to better staining and imaging techniques
'I can only guess as to its function, but given the part of the brain where it has been found, it might be involved in fine motor control,' said Professor Paxinos.
The discovery of the region may help researchers explore cures for diseases including Parkinson's disease and motor neurone disease.

Parkinson’s disease affects one in 500 people, and around 127,000 people in the UK live with the condition. 

It causes muscle stiffness, slowness of movement, tremors, sleep disturbance, chronic fatigue, an impaired quality of life and can lead to severe disability.

Motor neurone disease is when specialist nerve cells in the brain and spinal cord called motor neurones stop working properly. Neuroscientists researching neurological or psychiatric diseases already use Professor Paxinos' maps to guide their work.


The discovery of the region may help researchers explore cures for diseases including Parkinson's disease and motor neurone disease

His brain atlases are heralded as the most accurate for the identification of brain structures and are also used in neurosurgery.

'Professor Paxinos' atlases showing detailed morphology and connections of the human brain and spinal cord, provide a critical framework for researchers to test hypotheses from synaptic function to treatments for diseases of the brain,' said Professor Peter Schofield, CEO at NeuRA.

Professor Paxinos is the author of the most cited publication in neuroscience and another 52 books of highly detailed maps of the brain.

The maps chart the course for neurosurgery and neuroscience research, enabling exploration, discovery and the development of treatments for diseases and disorders of the brain.

His new findings are revealed in his latest book, Human Brainstem: Cytoarchitecture, Chemoarchitecture, Myeloarchitecture.


WHAT IS PARKINSON'S? THE INCURABLE DISEASE THAT STRUCK BOXER MUHAMMAD ALI

Parkinson’s disease affects one in 500 people, and around 127,000 people in the UK live with the condition.
Figures also suggest one million Americans also suffer.
It causes muscle stiffness, slowness of movement, tremors, sleep disturbance, chronic fatigue, an impaired quality of life and can lead to severe disability.
It is a progressive neurological condition that destroys cells in the part of the brain that controls movement.
Sufferers are known to have diminished supplies of dopamine because nerve cells that make it have died.
There is currently no cure and no way of stopping the progression of the disease, but hundreds of scientific trials are underway to try and change that.  
The disease claimed the life of boxing legend Muhammad Ali in 2016.
To see video go to:
https://www.dailymail.co.uk/sciencetech/article-6421517/Newly-discovered-region-brain-help-scientists-treatment-Parkinsons.html?ns_mchannel=rss&ito=1490&ns_campaign=1490

Thursday, November 22, 2018

Christmas Gift Ideas for Your Loved One with Parkinson’s

NOVEMBER 21, 2018 BY "SHERRI WOODBRIDGE"



Christmas is just around the corner. Black Friday and Cyber Monday are even sooner. For your convenience, I have made a list — and checked it twice — of perfect gift ideas for your favorite person with Parkinson’s disease (PD). 
  • A reacher/grabber bar: Many disabilities limit mobility, so bending over to pick something up can be especially challenging. An aluminum reacher/grabber bar promotes independence in your loved one as they won’t need to ask for help to retrieve dropped items.
  • A terry cloth bathrobe: Any bathrobe would be nice, but I specify terry cloth because it is like a bath towel. The robe can be worn immediately after a shower, and by the time they brush their teeth and brush or dry their hair, they are ready to get dressed. It’s also nice to have a warm robe to wear on cold evenings.
  • An herbal neck wrap: This type of wrap works wonders on stiff necks. It is super simple to make if you like crafts.
  • A Nook or Kindle reader: Fine motor skills, such as page-turning, are challenging for those with Parkinson’s. A touch screen for reading may help. Why not add a gift certificate to cover their first book purchase?
  • A manicure: Personal care tasks such as blow-drying hair and taking care of nails become more difficult as the disease progresses. Why not give your loved one a voucher for a professional manicure? A basic treatment is not too pricey and often includes a hand massage.
  • A smart cane: If you seek peace of mind, the Dring Smart Cane alerts caregivers of falls.
Following are more practical gift ideas:
  • Chapstick (a good stocking filler)
  • slipper socks with treads to prevent slips and falls
  • hand warmer
  • stress balls or hand exercisers
  • gloves, winter hat, and neck scarf
  • electric mattress pad, blanket, or throw
  • heating pad
  • at-home foot spa
  • gel sole shoe inserts
  • neck pillow
  • night lights
  • purifying salt lamp
  • essential oil diffuser
  • humidifier
  • postage stamps and notecards
  • movie voucher
  • ice cream or lunch gift certificates
  • gift certificates for dance, voice, or other PD-specific “exercise” classes
  • Rock Steady Boxing membership
  • lap tray or desk
  • wheelchair tray or pocket bag
  • weighted eating utensils
  • puzzle books or brain teaser puzzles
  • colored pencils and adult coloring books
  • Roomba robot vacuum
These are just some of my ideas for Christmas gifts for your loved ones. I’d love to hear your suggestions.
***
Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.
https://parkinsonsnewstoday.com/2018/11/21/parkinsons-christmas-gift-ideas-loved-one-grabber-bar-smartcane-kindle-neck-wrap-bathrobe/

PF-360 Provides Some Benefits But Does Not Improve Dopaminergic Function, Mouse Study Shows

NOVEMBER 21, 2018 BY CATARINA SILVA 



Treatment with PF-360, an investigational leucine-rich repeat kinase 2 (LRRK2) inhibitor, can efficiently decrease LRRK2’s phosphorylation levels, known to be elevated in Parkinson’s patients, in the brains of a mouse model of Parkinson’s disease, a preclinical study reports.
However, despite some observed dose-dependent therapeutic effects, including gait improvement, no robust changes in dopaminergic function were observed.
Results of the study were recently presented during the Society for Neuroscience’s 2018 conference in San Diego in a poster titled “Assessment of the Anti-parkinsonian Effects of the Potent and Selective LRRK2 Kinase Inhibitor PF-360 in the AAV-A53T Mouse Model of Parkinson’s Disease.”
The study was the result of a collaboration between several institutions including Charles River DiscoveryMerckPfizerAtuka Inc., and The Michael J. Fox Foundation for Parkinson’s Research.
The LRRK2 gene provides instructions for making a kinase, which is a protein that regulates the function of other molecules. Mutations in this gene put the protein into an overly activated state.
Mutations in the LRRK2 gene are one of the most commonly known genetic causes of Parkinson’s disease and usually result in the malfunctioning of lysosomes — special compartments within cells that digest and recycle different types of molecules. Lysosomal dysfunction is involved in the formation of Lewy body protein aggregates and, therefore, neurodegeneration.
Scientists believe that blocking LRRK2’s activity has the potential to slow disease progression.
Using a selective LRRK2 inhibitor called PF-360, researchers studied the dose-response efficacy of the potential therapy in two different mouse models (C57BL/6J and LRRK2-G2019S) that were injected with a “biological cocktail” of an adeno-associated virus combined with a human mutated A53T alpha-synuclein (AAV-A53T) — the major component of protein clumps called Lewy bodies, a hallmark of Parkinson’s.
They used 90 C57BL/6J mice 10-12 weeks old and 105 LRRK2-G2019S mice, 75 of which were 11-12 weeks old and 30 were 5-6 months old. In mouse “time,” 12 weeks is equal to adulthood.
This induced the degeneration of dopaminergic neurons in an area of the brain called the substantia nigra and decreased dopamine and tyrosine hydroxylase — the enzyme responsible for catalyzing levels of L-DOPA, the precursor to dopamine — in the striatum, mimicking Parkinson’s disease.
Mice were treated for 42 days with a diet containing PF-360 or a placebo (control), which was begun seven days prior to AAV-A53T injections.
PF-360 inhibited LRRK2 phosphorylation in the animals’ brain cortex and lungs at a specific site of the protein called serine 935 (serine is an amino acid, or the proteins’ building block). This protein region is required for interaction of LRRK2 with other molecules.
Phosphorylation (the adding of a phosphate group) alters a protein’s structure turning it, for instance, into an activated or deactivated state. As such, phosphorylation is the most common mechanism of regulating protein function and transmitting signals throughout the cell.
Pronounced therapeutic effects were observed with increasing doses (1 mg/kg, 3 mg/kg, 10 mg/kg, 30 mg/kg, and 60 mg/kg of PF-360) in both animal strains and age groups.
AAV-A53T injection led to motor impairments such as decreased speed (longer stride duration, shorter step length), slower swing speed, and reduced hind limb protraction (forward extension).
LRRK2-G2019S mice at 11-12 weeks old recovered their hind limb protraction and retraction with 10 mg/kg of PF-360, while older animals at 5-6 weeks of age had their overall speed (stride duration and swing speeds) improved with 30 mg/kg of the treatment.
No gait changes were observed after 42 days of PF-360 treatment in C57BL/6J mice. However, there was an insignificant treatment-related trend toward increased tyrosine hydroxylase-positive cells in the substantia nigra of C57BL/6J animals.
After treatment, a significantly higher number of tyrosine hydroxylase-positive cells were observed in older LRRK2-G2019S mice.
An increase in tyrosine hydroxylase-positive cells is indicative of an increase in the number of nerve cells that can produce either L-DOPA or dopamine.
Neurochemical analysis revealed that PF-360 delivery to younger animals did not improve striatum levels of dopamine or the intermediate end products of dopamine’s metabolism (3,4-dihydroxyphenylacetic acid and homovanillic acid).
However, treatment significantly increased homovanillic acid levels in older LRRK2-G2019S mice.
Given that most evidence suggests an LRRK2 contribution to Parkinson’s disease via abnormal phosphorylation, this study shows that although PF-360 can reduce LRRK2 phosphorylation levels, both in the brain and in the periphery, it failed to show robust improvements in dopaminergic function.
https://parkinsonsnewstoday.com/2018/11/21/pf-360-shows-limited-therapeutic-effects-parkinsons-mouse-model/

CXCL12/CXCR4 Blood Levels Can Help Diagnose Inflammation Linked to Parkinson’s, Study Suggests

NOVEMBER 21, 2018 BY ALICE MELÃO 



Measuring blood levels of the signaling molecule CXCL12 and its receptor CXCR4 may help identify active inflammation in Parkinson’s disease patients, a study suggests.
CXCL12 is a small protein called a chemokine that triggers immune cells to the site of inflammation where they can exert their pro-inflammatory activity.
Previous studies have shown that CXCL12 proteins are increased in inflammatory diseases including inflammatory bowel disease and rheumatoid arthritis, and inhibiting its receptor, CXCR4, may hold therapeutic potential for these diseases.
In addition, CXCL12 has also been shown to contribute to the development of neurodegenerative disorders, such as multiple sclerosis. Preventing the migration of immune cells to lesion sites in the brain could block the progression of such damaging disorders.
“These observations reinforce the significant role of the CXCL12/CXCR4 axis in inflammatory responses,” the researchers wrote.
Parkinson’s disease is characterized by reduced levels of dopamine in the brain caused by the death of dopamine-producing nerve cells. Although it is not fully understood what promotes the death of this particular subset of brain cells, several studies have demonstrated that oxidative stress — cellular damage as a consequence of high levels of oxidant molecules — and increased inflammation are critical players.
Iranian researchers have now investigated the role of CXCL12 and its receptor in Parkinson’s disease.
They evaluated blood samples collected from 30 patients with confirmed Parkinson’s disease and 40 age- and sex-matched healthy volunteers. The patients had the disease for a mean duration of 4.17 years.
The analysis revealed that levels of CXCL12 were 2.4 times higher in Parkinson’s patients over the control group. In addition, CXCR4 levels in peripheral blood mononuclear cells (PBMC, consisting of major immune cells, like T- and B-cells) were found to be approximately three times higher in Parkinson’s patients.
Based on these findings, the researchers believe that CXCL12 signals mediated by CXCR4 could contribute to the activation of immune cells, inflammation, and neurotoxicity linked to Parkinson’s disease.
Importantly, “CXCR4 expression in PBMC or CXCL12 serum levels may be potential biomarkers of inflammation in PD [Parkinson’s disease] patients,” the researchers wrote.
However, the team notes that some studies have found contrasting results, suggesting that CXCL12 signals could be protective for the central nervous system. This highlights the need for further studies to clarify the exact role of CXCL12/CXCR4 signals in the progression of Parkinson’s disease.
https://parkinsonsnewstoday.com/2018/11/21/cxcl12-cxcr4-blood-levels-can-help-diagnose-parkinsons-linked-inflammation/

How a Phoenix neurologist persuaded Muhammad Ali to become face of Parkinson's disease

November 21, 2018    Stephanie Innes



Muhammad Ali did not want to be the face of Parkinson's disease.
He was The Champ, The Greatest, an elite athlete. He wasn't an illness.
But if anyone could persuade the cocky heavyweight boxing legend to embrace the progressive neurological disease that was causing his slurred speech and deteriorating physical condition, it was neurologist and friend, Dr. Abraham Lieberman.
The two forged a bond over years of appointments, consultations and conversations. Eventually, after persistent cajoling from Lieberman that involved both a house call and a poem — yes, a poem — their connection led to the 1997 founding of the Muhammad Ali Parkinson and Movement Disorders Center at Barrow Neurological Institute in Phoenix.
Ali and Lieberman remained friends and confidants until Ali's 2016 death in Scottsdale at age 74.

Ali's friend Dr. Lieberman is retiring

Next month, Lieberman, 80, plans to retire from his work treating Parkinson's patients.
"He was a doctor to Muhammad, but he also befriended him," Ali's widow, Lonnie Ali, told The Arizona Republic. "It was a little bit more than being his doctor. ... Muhammad trusted him implicitly."
Staff members at the Muhammad Ali center are driven by a mission that came directly from its namesake:
To give all patients with Parkinson's disease the same kind of high-quality treatment that Muhammad Ali always received throughout the course of his illness, regardless of their ability to pay.
That means that at the Ali center, patients can get all their Parkinson's care in one place, whether it's counseling, physical therapy, family support or medications.

Still no cure for Parkinson's

Research suggests about 60 percent of Parkinson's patients experience depression, anxiety or apathy. The center has always put a big emphasis on helping patients and their families adjust after a diagnosis.
There's still no cure for Parkinson's disease — the second most common neurodegenerative disease after Alzheimer’s. But center officials say they are working hard to change that.
Right now, the center has six studies underway examining therapies that could slow down progression of a disease that affects about 1 percent of people older than 60. By age 80, that percentage rises to 4 percent, the U.S. Centers for Disease Control and Prevention says.
It's less common, but Parkinson's affects younger people, too. Lieberman has Parkinson's patients who are in their 20s and has cared for patients with Parkinson's who go through pregnancies. 

Ali took punches to the head in ring

Ali was diagnosed with Parkinsonism — signs and symptoms associated with Parkinson's disease — at age 42.
Yet, he may have been showing symptoms for years beforehand. 
In "Ali," his 2017 biography of the boxer, author Jonathan Eig cited an Arizona State University study he co-authored that found Ali's ability to articulate words declined "significantly" between ages 25 and 40,
Eig and others have written about Ali's boxing and chronic traumatic encephalopathy, or CTE, a brain condition caused by repeated blows to the head. CTE has been linked with dementia and Parkinson's disease.
Although years of getting his head punched in the boxing ring put him at higher risk of developing Parkinson's there's no definite proof that it was boxing that caused his illness, researchers at the Phoenix Parkinson's center maintain.
Signature symptoms of the disease include tremors, voice changes and slow movements. The disease affects at least 10,000 Maricopa County residents, the Parkinson Network of Arizona says.
"We didn't want this to look like a hospital facility. There are pictures on the walls, the colors are nice," Lieberman said. "Lonnie knew from Muhammad that you had to have a taller chair, so some of the chairs are higher, so that you don't have to catapult yourself out. She was very involved in picking the furniture."
For patients who can't make it there physically, the center has a broad program of providing health care and education via computer teleconferencing in both English and Spanish.Dr. Abraham Lieberman is retiring from the Muhammad Ali Parkinson Center in Phoenix, which center he founded with his friend and former patient Muhammad Ali. (Photo: Rob Schumacher/The Republic)

Ali's name meant it 'had to be the best'

Dr. Abraham Lieberman is retiring from the Muhammad Ali Parkinson Center in Phoenix, which center he founded with his friend and former patient Muhammad Ali. (Photo: Rob Schumacher/The Republic)


"It had Muhammad's name on it and because of that (Lieberman) felt it had to be the best, to do the best and to be there for every Parkinson patient who needed help," Lonnie Ali told the Republic. "I have no doubt this center will continue to grow and help a vast number of people and continue to make Dr. Lieberman proud. He made sure of that. That's why he's 80 and just retiring."
Lieberman says age and health are driving his decision to retire. He had polio as a child and was for a time paralyzed below the waist. He mostly recovered, except for a lingering limp.
About 18 years ago, he developed a progressive disease called post-polio syndrome, which required him to use a medical walking stick. He now uses two. In 2015, he gave up directorship of the center to neurologist Dr. Holly Shill; in December he'll leave the center for good.
"It's hard to get around. I can't really walk distances. At my retirement party I was in a wheelchair," said Lieberman, who came to Arizona from New York in 1988. "It's become very hard. It's hard to travel. If you are running a center like this, you've got to go to meetings, you've got to make contacts. It is time to step down."
After her husband died, Lonnie gave his wheelchair to Lieberman.
"Who better to have it? I had it at home. It was something I was keeping of Muhammad's and it was hard to part with, just because he was in that chair so much," Lonnie said. "But who better to have that chair than Dr. Lieberman? And he deserved it. He deserved that chair. I just hope Muhammad's energy is still there where he can feel it."
Through the years, the star-studded Celebrity Fight Night fundraiser in Arizona has become synonymous with Muhammad Ali. Ali died June 3, 2016, and the 2017 event will celebrate the champ's life. Wochit
Lieberman and Ali first met in New York City the mid-1980s, shortly after Ali was diagnosed. Lieberman was working at New York University and was not a boxing devotee. He was both astounded and impressed by the near "saintlike" status Ali commanded.
"I was called to go and see Muhammad. I had a good reputation in Parkinson's, I'd published papers. ... I went to the faculty practice area and there was just this long line of people who worked at the center — they all wanted to see Muhammad," Lieberman said. 
"I had no idea at that time how well-loved he was," Lieberman added. "I really didn't follow boxing closely, but I was just overwhelmed by how many people wanted to see Muhammad Ali."
Lieberman described Ali as an extrovert who derived joy from meeting other people.
"You can't explain it, You spend two minutes with him and you felt like lifelong friends," he said. "He treated everyone with respect, a very nice person."
The Muhammad Ali center's genesis was a charity event that began in Phoenix in 1994 as Fight Night with celebrities and professional athletes. It is now called Celebrity Fight Night and has a reputation for attracting A-list guests and musical stars such as Jennifer Lopez, Carrie Underwood and Andrea Bocelli.
When Fight Night creator Jimmy Walker decided he wanted Ali to participate, Ali and his wife, Lonnie, told him he needed to connect with Lieberman, a neurologist in Phoenix they both respected. Walker and Lieberman met over lunch at the old Ritz-Carlton Phoenix at 24th Street and Camelback Road. 
Lieberman knew Ali's name could help raise money for Parkinson's disease research at Barrow. But getting Ali to allow his franchised name to be used for the fight against Parkinson's was no easy task. 
Muhammad Ali is escorted onstage by his wife, Lonnie, during Celebrity Fight Night XVII at JW Marriott Desert Ridge Resort & Spa in Phoenix on Saturday, March 19, 2011. (Photo: Ralph Freso/Special for the Republic)
Barrow Neurological Institute was well-known in the neurology community, but Ali's name was universal.
The problem was, Ali liked to focus on the positive. He was emphatic about not wanting to become known for Parkinson's disease.
Moreover, Ali was known for his athletic prowess and his physical beauty, Lonnie said. He didn't spend a lot of time thinking about Parkinson's and he didn't want others thinking about Muhammad Ali and Parkinson's together, either.
"Muhammad was fluid and beautiful in the ring. It was almost like ballet, the way he danced around the ring," she told TheRepublic. "To be diminished in some way because of this illness, he didn't want anything to do with that."
Imploring the boxer to reconsider, Lieberman visited Ali at his home in Michigan. The answer was no.
Lieberman tried again. This time, he penned a poem.
"The image, the legend, the symbol of Muhammad Ali is ageless," Lieberman wrote. "A part of the world, like the pyramids, and the Grand Canyon. This can never change."
The poem also says Ali was given a unique combination of "grace, guile and power," and that avoiding involvement with Parkinson's disease is the opposite of stinging like a bee.
He was referring to a phrase Ali used to say before entering the ring: "Float like a butterfly, sting like a bee."
"You have the ability to help people with Parkinson/And you must meet this challenge," Lieberman wrote. "When you go to your grave, as we all must/It will not be enough that you were the greatest champion in history/If Parkinson disease lives on."
Ali immediately changed his mind.
"Muhammad was always impressed with somebody who wrote poetry. And he liked it even more because it talked about him," Lonnie said. 
The first year Ali participated in Fight Night, the event raised $130,000 for Barrow Neurological Institute. The next year, it raised a quarter of a million dollars. 

Muhammad Ali center opened in 1997

In 1997, Walker, Ali and Lieberman opened the Muhammad Ali Parkinson and Movement Disorders Center.
Walker recalls Lieberman making an unforgettable comment at the opening that if a New York Jew, a Muslim from Louisville, Kentucky, and Christians from Arizona could join together to open a center at a Catholic hospital in Phoenix, it would certainly be possible to build the greatest Parkinson's center in the United States and to one day even find a cure for Parkinson's disease.
"He's such a kind man, very humble, and that was his dream. He did so much to make this happen," Walker said of Lieberman. "Because of the charity event, I still get sometimes one or two people per week telling me they have someone in their family with Parkinson's disease. I tell them they need to meet with Dr. Lieberman, go to the Muhammad Ali Parkinson Center."
Invariably, Lieberman ends up giving those patients his cellphone number, Walker said.
Ali attended approximately 20 Celebrity Fight Night events, including one the year he died. By then, Parkinson's had robbed Ali of his voice, but the people who attended didn't care. They just wanted to see him, Walker recalled.
Walker and Lieberman have been friends ever since that first meeting. and Walker was the master of ceremonies at a recent retirement and appreciation party for Lieberman.
Celebrity Fight Night has raised more than $20 million for the Muhammad Ali Parkinson Center in the last 21 years, which has helped the center fund several expansions.
Lieberman was gone from the center for a period between 1998 and 2007 for a position in academia at the University of Miami. When he left Phoenix, he left behind a practice of 3,000 Parkinson's patients, which was one of the largest in the country at that time, Barrow officials say. 
Upon returning to Phoenix, he became director of the Ali center, doubled the patient load in two years and found himself channeling his most famous patient as he tried to persuade Barrow officials to give him the space and money to expand. At first, they suggested he share a 30,000 square foot space with Barrow's ALS (amyotrophic lateral sclerosis) center.
"I started to think Muhammad Ali is Muhammad Ali, he doesn't share space with anyone," Lieberman said ."I said, 'We'll take all the space.'"
Ali and his wife by then had moved to Phoenix from Michigan and Ali enjoyed visiting the Parkinson's center, his widow recalled. 
"Muhammad loved it because it was all about him," Lonnie said. "You couldn't get him down that hallway to physical therapy because it had all those pictures of him. He would stop and look. He'd light up looking at that."

Boxing, painting & Parkinson's

Dr. Abraham Lieberman speaks June 6, 2016, during a press conference at the Muhammad Ali Parkinson Center at Dignity Health St. Joseph's, 240 W. Thomas Road. (Photo: Mark Henle, Mark Henle/The Republic)

Since the center's founding, awareness about Parkinson's disease and its effect on families has increased tremendously, Shill said.
There's no way to slow the disease's progression, but there are more ways to reduce disability and improve the quality of life for people with Parkinson's, particularly with earlier detection and regular exercise, she said.
When Alejandra Borunda was diagnosed with a genetic form of young-onset Parkinson's disease three years ago, she was devastated and spent several months researching options for what to do next. Eventually, her research led her to the Muhammad Ali Parkinson's Center, where she enrolled in a class for newly diagnosed patients.
She has since participated in other education, painting and boxing classes through the center, and a support group for Spanish speakers. Staff and many of the other patients at the center are now like a second family, she said. 
"If you have to have Parkinson's disease, Phoenix is the best place to have it. There are a lot of resources here," said Borunda, 32, who is now both a patient and certified volunteer at the center, and will be an ambassador at the World Parkinson Congress in Japan next year.
She has never met Lieberman, though she's seen him in passing. In her role as a case manager for Phoenix residents struggling with homelessness, Borunda recently helped a client get an appointment with him.
"When I checked the appointment and it said Dr. Lieberman, I told her she was going to see Muhammad Ali's doctor. She was so excited," Borunda said. "Muhammad Ali made sure that people with insufficient funds would always be able to get help there."
Borunda said the client is now on medication, living in a women's shelter and doing well. 
At Lieberman's retirement party, which was attended by friends and colleagues last month, the word 'tenacity' came up several times, Shill said.
"He says he's going to do something and he finds a way to make it happen," said Shill, who has known Lieberman since medical school and considers him a mentor.
"He at one time was the medical director for the National Parkinson's Foundation. He brought that knowledge, that way of connecting with patients and families and really expanded this place to have a national presence and now an international presence."
The center does more deep brain stimulation surgeries per year — about 100 — than any other Parkinson's center in the country, Shill said. Not all patients with Parkinson's are candidates for the surgery, but when the surgery succeeds it can help lessen symptoms, particularly problems that so many Parkinson's patients have with balance.
Shill noted that some Phoenix patients who go to the center for physical therapy are there four and five times per week. Other options for patients and their families include regular jewelry making workshops, dance and tai chi classes and a singing program called the Tremble Clefs. 
Research is conducted on site, too, she said.
"There's really nowhere like it in the world."
There are video's and more pictures at:
https://www.azcentral.com/story/news/local/arizona-health/2018/11/21/muhammad-alis-phoenix-neurologist-retiring-powerful-legacy-abraham-lieberman/1892745002/