Jefferson and Wills Eye Launch World's First Center Focused on Connections Between the Eye and the Brain

May 10,  2019

First-of-its-Kind Center Holds Hope for Novel Treatments and Diagnoses of Neurological Diseases

PHILADELPHIA — Poets have called eyes the windows to the soul. Now, Jefferson and Wills Eye researchers will be able to use eyes as windows into debilitating diseases of the brain.

Thomas Jefferson University, in partnership with Wills Eye Hospital and thanks to the generosity of several prescient philanthropists, has launched the world’s first center focused on the visual signatures of neurological diseases. The William H. Annesley, Jr., MD ’48 EyeBrain Center will explore the connections between the retina, optic nerve, and disorders of the brain, potentially revealing novel treatments for confounding diseases such as stroke, Alzheimer’s, Parkinson’s, multiple sclerosis, and dementia.

“Because of the anatomic and physiological connections between the eye and brain, ophthalmology and neurology are inextricably linked,” said Robert C. Sergott, MD, an international expert in neuro-ophthalmology and the Center’s founding Executive Director. “This is the perfect synergy. The Annesley EyeBrain Center will leverage the strengths of the region’s most extensive neuroscience network with the nation’s leading hospital for vision care.”

Named in honor of ophthalmology pioneer and Jefferson alumnus William H. Annesley, Jr., MD, the Annesley EyeBrain Center will be housed within Jefferson’s renowned Vickie and Jack Farber Institute for Neuroscience. Initial funding for the Center was provided by philanthropic gifts from friends and family of the late Dr. Annesley, including lead benefactor Margaret Annesley Hayne.

“If you want to change the world, you have to think differently, and that’s what the team at the Annesley EyeBrain Center will do,” said Stephen K. Klasko, MD, MBA, President, Thomas Jefferson University and CEO, Jefferson Health. “At a time when far too many individuals are falling victim to debilitating, incurable disorders of the brain, the Annesley EyeBrain Center will be more than a destination for premier neuro-ophthalmologic research and care—it will serve as a powerful beacon of hope. We are incredibly grateful to Margaret Annesley Hayne and the early philanthropic investors for their visionary support.”

“As the first center exploring the connections between the retina and disorders of the brain, the Annesley EyeBrain Center will revolutionize ophthalmic and neurological care and establish a new frontier in neuro-ophthalmology,” said Julia A. Haller, MD, the William Tasman, MD Endowed Chair and Ophthalmologist-in-Chief of Wills Eye Hospital and Professor and Chair of the Department of Ophthalmology at Sidney Kimmel Medical College of Thomas Jefferson University. “And as a tribute to the remarkable life and career of Dr. Annesley, it will cement his legacy of excellence, preserving his values and reputation for generations to come. “

One of the Annesley EyeBrain Center’s revolutionary areas of research involves mitochondrial function in the retina. Mitochondria are the main producers of energy for all types of cells, and their malfunction is implicated as the final common pathway in many neurologic and ophthalmic diseases. Mitochondria produce flavoprotein, a compound that emits a green light when excited by a blue light. When more green light is visible, the mitochondria are working harder to maintain retinal and neurologic function. Using Multi-Color Optical Coherence Tomography (OCT), a breakthrough technology, researchers can now see mitochondrial function disruption before there is cell-death or even disease symptoms, opening an entirely new frontier in the diagnosis and treatment of devastating neurological disorders such as multiple sclerosis, ALS, Alzheimer’s and Parkinson’s disease.

“There are tremendous advantages to creating a Center like this that is the first of its kind,” said Robert H. Rosenwasser, MD, the Jewell L. Osterholm, MD, Professor and Chair of the Department of Neurological Surgery at Thomas Jefferson University and the President, Vickie and Jack Farber Institute for Neuroscience. “We’ll be in a unique position to capitalize on and potentially develop new technologies and techniques. It’s an opportunity to innovate and utilize our entrepreneurial expertise.”

About William H. Annesley, Jr., MD

A graduate of the Sidney Kimmel Medical College (formerly Jefferson Medical College) in the class of 1948, Dr. Annesley was a pioneer in Ophthalmology, pushing the boundaries of the field all his life to provide the latest and best therapies for his patients, and mentoring a generation of residents and retina fellows. Dr. Annesley was a founder of the Retina Service at Wills Eye Hospital, and served as its Director for over 16 years. He was a trailblazer who recognized the need for retina-based subspecialties and collaborated to create a number of dedicated units at Wills, including: the ocular oncology unit (first in the United States); the intravenous fluorescein angiography unit; the retinal vascular disease unit; and the first division dedicated to retinal research in Philadelphia.

https://hospitals.jefferson.edu/news/2019/05/eye-brain-connections.html

Details emerge surrounding controversial change to Death with Dignity Act

Elizabeth Hayes     May 10, 2019

A change to the Death with Dignity law would allow the drugs to be administered intravenously.   DOUGLAS SACHA

If a bill to expand Oregon’s 25-year-old Death with Dignity Act passes into law, terminally ill patients would be able to take the lethal drugs by a method other than swallowing.

The details of how that would work are coming into clearer focus.

Dr. Charles Blanke, a physician at Oregon Health & Science University and supporter of the proposed House Bill 2217,outlined a method to self-administer the drugs by IV that would be the first of its kind. It would be available to those who qualify to use the act but who are no longer able to swallow, or whose hands are too shaky to attach a syringe to their feeding tube.

Some are terrified they’ll only be able to force down a nonfatal dose and will wake up in a partial coma, Blanke said.

"We don't offer them dignity or autonomy or control," said Blanke, who wrote more prescriptions under the Death with Dignity Act than any other physician in Oregon last year.

Blanke is vetting the regimen with a team of anesthesiologists and pharmacists. He contemplates a multi-channel infusion pump that the patient would turn on by hitting a button with their hand, elbow or wrist. The drugs would be liquid, not gas.

“It requires motion but not dexterity,” he said in an interview. "We need something 100 percent reliable and effective."

Euthanasia is allowed in Canada and Europe, but nowhere in the U.S., and HB 2217 wouldn't change that, Blanke said. As he sees it, physicians would not have a bigger role than they have currently.

Those who voluntarily participate in the Death with Dignity Act must write the prescription and often place a feeding tube or empty secobarbital into a glass of water for the patient.

“The question raised was, is it euthanasia? Absolutely not,” Blanke said. “Are patient protections in place? Yes. The only thing that changes is the route.”

To qualify to use the act, a patient must be an Oregon resident of at least 18 years old, capable of making and communicating health care decisions for themselves and diagnosed with a terminal illness that will lead to death within six months.

The Senate Committee on the Judiciary heard from a parade of opponents during a Thursday public hearing. They argued the bill goes beyond being merely a technical fix.

“The bill, as written, will allow legal murder,” said Margaret Dore, an attorney from Seattle who said she’s testified against Death with Dignity bills in 20 states. “The cause of death will be listed as terminal illness. It creates a perfect crime.”

Bruce Yelle, who has three terminal illness diagnoses, including Parkinson’s disease, testified in favor.

“I’m afraid I won’t be able to swallow or move my arms to my mouth,” Yelle said. “Please don’t make my choices for me.”

https://www.bizjournals.com/portland/news/2019/05/10/details-emerge-surrounding-controversial-change-to.html

#AANAM – Data Recorded from PKG Wearable Device May Help Clinicians Choose Better Treatment, Study Says

 MAY 10, 2019       BY CATARINA SILVA 

A wearable device called Personal KinetiGraph (PKG) can continuously and objectively monitor motor symptoms in people with Parkinson’s disease, which can help clinicians select the most appropriate management therapy and assess treatment impact, a study finds.

The study, “Objective Data in Parkinson’s Disease: A Description of Over 27,000 Parkinson’s Symptom Scores Across the World Using the Personal KinetiGraph® (PKG®),” was presented as a scientific poster during the 2019 American Academy of Neurology’s (AAN) Annual Meeting in Philadelphia.

The PKG system, developed by Global Kinetics Corporation, is a wrist-worn movement recording device that collects data on the person’s motor symptoms, including tremors, slowness of movement (bradykinesia), and abnormal involuntary movements (dyskinesia).

The technology also assesses patients’ daytime somnolence (sleepiness), studies their likelihood for developing impulsive behaviors, and provides information on medication compliance, motor fluctuations, and immobility.

The device has been cleared by the U.S. Food and Drug Administration (FDA), and holds CE certification, meaning it meets EU safety, health and environmental protection requirements.

Previous validation studies have correlated PKG objective scores with other standard Parkinson’s scales, like the Unified Parkinson’s Disease Rating Scale (UPDRS). However, there still is no consensus about the indications for PKG and which patients should wear the device.

To learn more, researchers studied 27,834 complete PKGs — with any identifying data removed — recorded worldwide between January 2012 and March 2018.

Analysis showed 54% of patients had uncontrolled, but likely treatable, slowness of movement, while 10% had uncontrolled, but also likely treatable, dyskinesia. Individuals who used their PKG device regularly had their PKG scores improve, meaning their symptoms became more controllable. That suggests the technology may help to improve clinical decisions, and consequently disease management.

Data from another study, “An Observational Study of PKG Movement Recording System Use in Routine Clinical Care of Patients with Parkinson’s Disease,” was presented in April at the 2019 Parkinson Study Group (PSG) Annual Meeting. That data showed that using Global Kinetics’ technology improved dialogue with patients in more than half of the cases, and enhanced clinicians’ ability to assess treatment impact.

“At Global Kinetics, we are committed to serving the Parkinson’s disease community and providing access to our PKG, which can provide objective measurement in the clinical care setting and help optimize care in this neurodegenerative disease. These presentations underscore the value of PKG in providing valuable information about Parkinson’s movement symptoms and allowing neurologists and movement disorder specialists to have more meaningful conversations with their patients, which translates to optimized care,” John Schellhorn, CEO of Global Kinetics Corporation, said in a press release.

More than 40,000 patient PKG reports have been recorded so far, which has helped more than 200 Parkinson’s specialist clinics to adjust treatment choice and improve management for their patients, according to the release.

Global Kinetics now is enrolling participants in APPRISE, a prospective, multi-center, controlled trial (NCT03741920) designed to evaluate the utility of PKG movement recording system data in the clinical management of Parkinson’s disease in routine clinical care.

Researchers believe PKG recording positively influences clinical decisions, enabling better disease control. In APPRISE, treatment changes with or without the use of PKG data will be evaluated. Participants will have to wear the device for 90 days. Scientists plan to enroll 438 participants across 10 U.S. Movement Disorder clinics. Enrollment is by invitation only.

https://parkinsonsnewstoday.com/2019/05/10/aanam-data-pkg-device-may-help-parkinsons-clinicians-choose-better-treatment/

#AANAM – Promising Blood Pressure Medicine Fails to Slow Parkinson’s Progression, Trial Results Show

 MAY 10, 2019  BY CATARINA SILVA 

In contrast to what was observed in mice, a hypertension medicine called Dynacirc(isradipine) failed to slow Parkinson’s disease progression in humans, according to Phase 3 clinical trial results.

However, “the study did not fail,” according to Tanya Simuni, MD, who presented “A Phase 3 study of isradipine as a disease modifying agent in patients with early Parkinson’s disease (STEADY-PD III): Final study results” during the 2019 American Academy of Neurology Annual Meeting in Philadelphia. Instead, the study’s negative results are important to understand how to fine-tune future approaches for effective treatments, Simuni said.

Belonging to a class of medications called calcium channel blockers, Dynacirc is used to treat high blood pressure (hypertension). The medicine relaxes blood vessels so the heart does not have to pump as hard, ultimately reducing blood pressure. Importantly, Dynacirc can penetrate the central nervous system and reach the brain, where it needs to exert its effects.

A preclinical study demonstrated that upon treatment with Dynacirc dopaminergic neurons — those that are lost as a consequence of Parkinson’s — had levels lower of oxidative stress than those of untreated mice, suggesting the medicine could have a protective role against oxidative stress damage.

Oxidative stress is an imbalance between the production of free radicals and the ability of cells to detoxify them, resulting in cellular damage as a consequence of high levels of oxidant molecules. Importantly, the molecular phenomenon has been implicated in the degeneration of dopamine-producing neurons.

Researchers believe dynacirc can protect neurons by blocking calcium channels on the surface of dopaminergic nerve cells. Normally these cells are continuously flooded with calcium, fueling cells’ powerhouses (mitochondria), which ends up contributing to harmful oxidative stress and, consequently, nerve cell death.

STEADY‐PD III was a 36-month, Phase 3, placebo‐controlled study (NCT02168842) assessing the effectiveness of Dynacirc 10 mg daily (two daily 5 mg doses) in 336 participants with early Parkinson’s disease who were not receiving dopaminergic therapy.

Participants were assigned randomly to receive Dynacirc or placebo for three years. Subjects had to complete 12 in-person and four telephone visits, during which researchers evaluated patients’ motor, neuropsychiatric, and cognitive skills. Blood and urine samples also were collected.

There were a total of 68 serious adverse events among treatment groups, six of which were deemed possibly related to treatment.

Although considered safe and well-tolerated, the treatment failed to slow progression of Parkinson’s disability. Researchers believe this may have been due to several reasons, including late intervention or inappropriate dosing, as the dose was selected based on tolerability and may not have effectively blocked the desired calcium channels.

Another hypothesis is that this target might not be the leading cause of human Parkinson’s development, or that a single target may not be sufficient to treat or slow disease progression.

“Unfortunately, the people who were taking isradipine did not have any difference in their Parkinson’s symptoms over the three years of the study compared to the people who took a placebo,” Simuni said in a press release. “Of course, this is disappointing news for everyone with Parkinson’s disease and their families, as well as the research community.”

“However, negative results are important because they provide a clear answer, especially for the drug that is commercially available. We will all continue to work to find a treatment that can slow down or even cure this disease,” she added.

https://parkinsonsnewstoday.com/2019/05/10/aanam-dynacirc-fails-slow-parkinsons-progression/

Nanotubes enable travel of Huntington's protein

MAY 10, 2019     by The Scripps Research Institute

Scripps Research neuroscientists Srinivasa Subramaniam, PhD, and Manish Sharma, PhD, review confocal microscope images of the Huntington's protein moving between neurons via nanotube. Credit: Scripps Research

A toxic protein linked to Huntington's disease can move from neuron to neuron through a nanotube tunnel whose construction is initiated by a protein called Rhes, say scientists at Scripps ResearchThe finding, by Scripps Research neuroscientist Srinivasa Subramaniam, Ph.D., improves understanding of how and why this disease attacks and destroys certain braincells. The research was published Friday, May 10 in the Journal of Cell Biology.

"We are excited about this result because it may explain why the patient gets the disease in this area of the brain called the striatum," says Subramaniam, an associate professor in the Department of Neuroscience at Scripps Research-Florida.

People with Huntington's disease inherit a damaged protein that is somehow complicit in destroying brain cells. Scientists discovered this protein in 1993 but are still piecing together its role in this degenerative disease. Scans show Huntington's disease brains are shrunken and degraded. As the neurons deteriorate, people lose motor control, they can have emotional problems and their thinking and memory suffer. Symptoms usually begin around age 30 to 40 and last 15 to 20 years until death. A rarer and more aggressive form of the disease affects children, cutting their childhood and lives short.

About 3 to 7 people out of 100,000 have the disease and it has mostly affected those with European ancestry. However, Subramaniam believes the disease is underreported in other areas, including India.

"There is a lot of stigma associated with the disease," says Subramaniam.

His laboratory investigates the molecular mechanics of Huntington's disease and other neurodegenerative illnesses, including Alzheimer's and Parkinson's disease, to find potential therapy targets.

"In the case of Huntington's, the question is can we block this transport, and does it have any benefit or effect?" says Subramaniam.

For this study, Subramaniam and colleague Manish Sharma, Ph.D., looked at mouse neurons under a confocal microscope and saw that the cells formed sticky, string-like protrusions around 150 microns long which floated above the cells, connecting them.

"When I saw Rhes making these tunnel-like tubes between the cells I was excited and at the same time perplexed," says Sharma, the first author of the study.

"They may have been missed before because they are on a different plane," says Subramaniam. "You have to be really looking for it. It's like a bridge over a lake. If you are on the lake, you may not see the bridge above, but if you are on shore, you can see the bridge."

Scientists first described another type of tunneling nanotube in rat neurons in 2004. Since then, a number of researchers have observed them in cancer and other types of cells. But how they form and what they do was less clear.

To find out, Subramaniam and Sharma tracked cell cargo moving through this tunnel bridge. They inserted the Huntington human disease protein into the mouse brain cells, tagged it with fluorescence and then watched as it crossed over and crawled up to enter the neighboring cell. Once the tunnel delivered its shipment it released and sprang back. Lysosomes and endosomes, cellular cargo bins that transport cell pieces or waste, also travel these intercellular highways, Subramaniam says.

The Rhes protein exists in both mouse and human brains sick with Huntington's disease. Knocking out the Rhes gene in diseased mice results in less brain damage. In 2009 study, Subramaniam found that Rhes also alters the Huntington disease protein's structure making it more toxic to brain cells.

"The Rhes protein makes its own road. That is what is surprising to us," says Subramaniam. "But it not only transports itself. Once the road is made, many things can be transported."

Subramaniam's group continues to investigate what other proteins may be helping with tunnel construction and if other disease proteins move along these membranous highways. His laboratory is also developing ways to identify how the Huntington's disease protein travels in the live brain.

More information: Manish Sharma et al. Rhes travels from cell to cell and transports Huntington disease protein via TNT-like protrusion, The Journal of Cell Biology (2019). DOI: 10.1083/jcb.201807068

Journal information: Journal of Cell Biology 

https://medicalxpress.com/news/2019-05-nanotubes-enable-huntington-protein.html

Inflamed monkey guts produce Parkinson's-related proteins

MAY 10, 2019    by Chris Barncard, University of Wisconsin-Madison

Common marmosets at the Wisconsin National Primate Research Center. A new study found that marmosets whose medical histories included inflamed colons had more of a Parkinson’s disease-related protein in their intestines. Credit: Jordana Lenon / WNPRC

The intestinal linings of monkeys with inflamed bowels show chemical alterations similar to abnormal protein deposits in the brains of Parkinson's patients, lending support to the idea that inflammation may play a key role in the development of the degenerative neurological disorder.

A study published by University of Wisconsin–Madison researchers today in the Journal of Inflammation Research found phosphorylated alpha-synuclein—a modified version of a protein common to nerve cells—in samples from common marmosets kept in a tissue bank at the Wisconsin National Primate Research Center.

"It's not entirely clear what its function is, but the typical version of the protein alpha-synuclein occurs normally in all neurons," says Marina Emborg, a professor of medical physics in the UW School of Medicine and Public Health and a Parkinson's disease researcher. "A lot of neurodegenerative disorders seem to be related to the aggregation of certain proteins. When you have Parkinson's, alpha-synuclein changes its shape and aggregates with other proteins into masses called Lewy bodies."

The Lewy bodies aren't necessarily a cause of Parkinson's, but they are a hallmark of the disease, which affects more than 10 million people worldwide. Parkinson's progressively degrades the nervous system, causing characteristic tremors and dangerous loss of muscle control.

Parkinson's patients also suffer gastrointestinal problems, symptoms described in detail as early as 1817 by James Parkinson in his original essay on the disorder that would come to bear his name.

People who suffer from inflammatory bowel disorders are more likely to be diagnosed with Parkinson's—one of several clues that inflammation and oxidative stress may be involved in the disease. Inflammation had been proposed as a possible trigger for the alteration of normal alpha-synuclein into the phosphorylated alpha-synuclein found in Lewy bodies.

"The colon, the gastrointestinal tract overall, has this dense network of nervous tissue, the enteric nervous system, which is sometimes called the gut brain," says Emborg, whose work is supported by the National Institutes of Health and the Parkinson's Foundation. "This has lots of neurons, and those neurons—like all neurons—have alpha-synuclein."

When the Emborg research group heard from primate center pathologists that marmosets sometimes deal with inflamed bowel problems like colitis, they decided to test marmoset tissue samples for changes in alpha-synuclein. The researchers found that marmosets whose medical histories included inflamed colons had more of the phosphorylated alpha-synuclein in their intestines.

"It shows us the relationship between inflammation and Parkinson's-like alpha-synuclein pathology," says Emborg. "It doesn't mean if you have inflammatory bowel disorder, you will get Parkinson's. The development of a neurodegenerative disorder is multifactorial. But this could be a contributing factor."

Provided by University of Wisconsin-Madison

https://medicalxpress.com/news/2019-05-inflamed-monkey-guts-parkinson-related-proteins.html

Dance: A surprising source of therapy for Oklahomans with Parkinson’s disease

 Janelle Archer   May 9, 2019

Erica Portell, a dance instructor at Oklahoma City Ballet, leads a Dance for Parkinson’s class. 

People who suffer from Parkinson's disease, a progressive disease of the nervous system, struggle with movement. With symptoms like tremors, difficulty of speech, and difficulty in walking, Parkinson’s disease can cause sufferers to lose trust in their body’s ability to function properly. One Oklahoman is working to give those with Parkinson's disease a revitalized sense of confidence and increased mobility – through dance.

Erica Portell is a dance instructor at Oklahoma City Ballet, and cannot remember a time in her life when she was not dancing. She grew up training in New York City and performed on television, on cruise lines, and in Las Vegas. When she moved to Oklahoma City to teach for Oklahoma City Ballet, her father was diagnosed with Parkinson’s disease. 

“When my dad was in his early fifties, he was diagnosed with Parkinson’s disease,” Portell said. “It was a rapid progression from there - he needed a walker to move and it was difficult for him to speak and eat. However, we discovered music and dancing made a positive impact on his ability to function. It made walking easier for him and overall movement.”

That was when Portell began researching specialized dance classes for those with Parkinson's disease and learned that they were happening across the country and were incredibly effective. 

“I knew I wanted to make this happen in Oklahoma, but I didn’t know how,” Portell said. “But then, we received a grant and I was able to go to a specialized training in New York City, taught by professionals who were doing this in other states, to bring a Dance for Parkinson’s class to Oklahoma.”

According to Portell, when she finally brought the class to Oklahoma City in August of 2017, it proved to be an amazing success beyond her wildest dreams.

“I knew that dance had an amazing impact on my life. It taught me all of the happiest things, the lessons that made me successful as an adult, and to find beauty in things that are difficult,” Portell said. “People with Parkinson’s disease are in situations where they do not trust their bodies to do what it is supposed to do, and dance teaches you to trust your body again and have a new respect for it through movement. We dance because we are human beings.”

A typical class begins in a circle, with the option to sit or stand. Using upbeat and fun music, the Dance for Parkinson’s class encourages fluidity and accessibility to the participant. Participants can use walkers, stay seated, or move around if they choose. Portell says that a goal of the class is for the participants to feel more regained control of their bodies and to translate the movements they learn into everyday life while having fun at the same time. 

“At no point during this method of interacting is there a patient-doctor relationship – they aren’t seen as broken and need to be fixed,” Portell said. “It’s therapeutic in its results, but not in the way of ‘you’re broken and I need to fix you’ – we are just dancing together and being free human beings without judgment. I love that this class gives them this opportunity to be productive without being seen as if something is wrong with them.”

https://youtu.be/zMIs-btSZIg

While teaching a class like this has been a major success for Portell, it does not come without challenges.   

“My dad passed away last year from complications from Parkinson’s,” Portell said. “Teaching the class is the thing that heals me the most but also breaks me the most. When I see my students have symptoms that he had, it brings me joy that I can be healing with them, but it also reminds me of him and his struggles with the disease.

Honoring her father in this way feels like a special gift to Portell.

“It is incredibly rewarding to see the students come and participate,” Portell said. “Some students want a physical challenge and go all in, and some just want to sit and watch and not participate, but then they hear music that they are familiar with and realize that it will be physically challenging but also fun at the same time. Through this class, they have built communities where they are supportive of each other.”

Each class ends with the participants standing/sitting in a circle, squeezing each other’s hands one by one and looking into one another’s eyes as they do so, signifying they are not alone in their struggles.

“When they leave class, every single student shows an increase in basic functions like opening doors and maneuvering, and they have more confidence doing those things because of the trust they have in their bodies,” Portell said. “I love seeing the difference between when they leave and when they come into class."

According to those watching the class, the participants gain so much confidence through dance that their symptoms sometimes cannot be seen while they are participating. 

“We had a woman come in to watch the class to see if she wanted to participate,” Portell said. “After seeing how the class went, she said ‘this class looks so fun, but when is the class for people with Parkinson’s?’ and I told her that it was the class for people with Parkinson’s. 

She was shocked by the mobility that the participants had gained through dancing in the class.”Oklahoma City Ballet, site of the Dance for Parkinson’s class, is an Allied Arts member organization.

“Because of Allied Arts grants, this class is offered for free,” Portell said. “Parkinson’s disease care is expensive. In addition to the expenses, they also have a lot on their plates in their day-to-day lives. You can simply come to class – you don’t need to register or pay a fee – we like to keep it simple.”

Additionally, community funds provided Portell with the opportunity to learn from professionals who work with people with Parkinson’s disease, ensuring that she can provide them optimal care through the class.

“Being able to go to the training was what made this class possible,” Portell said. “Knowing how to do this safely and how to best serve them has made a big difference in how I can serve and teach them. It is a miracle that Allied Arts has been able to make this possible. I would not have been able to make this happen without the proper training.

”As a united arts fund, Allied Arts works to increase support for the arts by raising financial support for cultural organizations, encouraging participation and attendance, advocating for arts education and promoting excellence in the arts and arts management. The organization has served as the champion of central Oklahoma’s arts community and raised more than $67 million on behalf of arts organizations since 1971.

A donation to Allied Arts supports more than 40 organizations that are championing the arts in the community. 

This means access to the arts for youth, the elderly, veterans, the sick and hospitalized, and other underserved groups. Funding from the Allied Arts annual campaign for the arts, which runs through June, reaches more than 1 million people each year in all 77 Oklahoma counties.

According to Portell, donating to Allied Arts is a way to support people who have invested their time, resources and expertise to benefit our community and  are now in need.

“These people have lived long, rich lives,” Portell said. “I have a doctor, a lawyer, a professor,  and teachers in my class – they have raised families and supported communities. This is a chance for us to support them and make their lives and our community richer. There is no other outlet like this. So much of Parkinson’s disease is heartbreak and challenge for those who suffer with it. Art can be such a source of healing for these people. Without Allied Arts, we wouldn't even be able to have this program, and that would be such a loss.”

Every gift to Allied Arts makes a difference in increasing access to the arts for more Oklahomans: $25 covers 50 dance lessons for an underserved student whose family cannot afford dance training, while $100 employs a sign language interpreter to bring performances to life for hearing-impaired patrons. $500 provides Alzheimer’s or dementia patients with healing hands-on visual arts experiences and $1,000 provides scholarships to a week-long art camp for five children from economically disadvantaged families.

The Dance for Parkinson’s class takes place on Mondays from 11:00 a.m. to 12:00 p.m. and Thursdays from 2:00 p.m. to 3:00 p.m. at the Susan E. Brackett Dance Center (6800 N. Classen Boulevard). Starting on June 10, classes will take place Mondays and Thursdays from 12:45 p.m. to 1:45 p.m. For more information, contact Stephanie Pitts at Stephanie@okcballet.com.

Join Allied Arts in supporting the arts and cultural community across central Oklahoma by donating at alliedartsokc.com/donate or by calling (405)278-8944.

For more information, visit alliedartsokc.com.

http://newsok.com/article/5630958/dance-a-surprising-source-of-therapy-for-oklahomans-with-parkinsons-disease

#AANAM – L-DOPA Nasal Delivery System May Offer New Way to Manage Parkinson’s OFF Episodes

MAY 9, 2019 BY CATARINA SILVA IN NEWS.

Impel NeuroPharma has developed an inhaler to administrate a powder formulation of levodopa (L-DOPA) so people with Parkinson’s disease can more easily manage their symptoms.

Evidence of the potential of this new treatment strategy was presented at the 2019 American Academy of Neurology (AAN) annual meeting in Philadelphia, in a poster titled “Preclinical Development of a Novel Precision Olfactory Delivery (POD®) – L-dopa Drug- Device Combination Product for the Treatment of OFF Episodes in Parkinson’s Disease.”

Levodopa is the gold-standard strategy used to achieve motor symptom relief in Parkinson’s disease. It is associated with the greatest improvement in motor function in these patients when compared with other available therapies designed to work in similar ways, and overcome the low dopamine levels in the brain that cause Parkinson’s.

Dopaminergic medications, including levodopa, enable Parkinson’s motor symptom control. However, as disease progresses, patients typically need to gradually increase treatment dose for maximum benefit and even after that they may still experience reappearance or worsening of symptoms (OFF periods) due to diminishing effects of the therapy. Evidence indicates that patients need to achieve 400 ng/mL L-DOPA levels circulating in the blood for their motor symptoms to ease.

The complexity of neurological disorders, the difficult access to the brain, and the high risks and costs of drug development represent serious disadvantages for improving therapies. Nose-to-brain drug transport offers an attractive alternative strategy attempting to enhance drug penetration into the central nervous system.

The Precision Olfactory Delivery (POD) device is a nasal therapy delivery system that allows easy access to a large tissue surface well-suited for rapid and consistent absorption of therapeutic compounds. Researchers manufactured more than 50 powder L-DOPA formulations and 30 of those were evaluated in preclinical animal models.

Researchers showed that using the POD system, it was possible to achieve 400 ng/mL L-DOPA levels circulating in the blood (the amount found to be clinically necessary to effectively ease motor symptoms) in about 5 to 12 minutes in non-human primates. This represents three- to five-fold improvement in levodopa delivery in comparison to currently available formulations.

Regarding anatomy or response to therapies, no other animal species is as close to humans as primates, so they are often used to test the safety and viability of therapies. They also allow an easier and truer extrapolation of findings to the “human reality,” making scientists better equipped to identify therapies that may reverse OFF episodes in Parkinson’s patients.

These preliminary results demonstrate that “a powder formulation of L-DOPA delivered to the vascular-rich upper nasal cavity with the POD device” can provide a way for self- or caregiver- administrated therapy and “achieve consistent and rapidly effective treatment to abort OFF episodes,” researchers said. “This work has led to the selection and further evaluation of a novel formulation in a Phase 2a clinical study.”

The study (NCT03541356) is currently recruiting patients with Parkinson’s disease at four clinical sites in Australia. For more information, visit the registry page here.

Up to 36 Parkinson’s patients, age 40 and up, will be randomized to take levodopa or a placebo administrated by a POD device. Researchers will assess the ability of the new formulation to manage OFF periods of motor symptom control, as well as its safety and tolerability.

https://parkinsonsnewstoday.com/2019/05/09/aanam-pod-device-may-effectively-administrate-l-dopa-through-the-nose/