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Saturday, June 22, 2019

Former LSU School of Music professor reconnects with former student for unexpected reasons

Lynne Bunch         Jun 21, 2019   

(left to right) Sarah Perez and Jan Grimes reconnected after 13 years when they both attended the 2017 Pennington Biomedical’s Parkinson’s Disease Conference. 


As a professional in residence in the LSU School of Music for nearly 30 years, Jan Grimes has accompanied more than 600 students in their performances. One student, Sarah Perez, a 2004 graduate whose specialty was the clarinet, proved to stand out from the others when a conference in 2017 brought the two back together in unexpected ways.
While Grimes continued her life’s dedication to music, Perez decided return to LSU to pursue another field — medicine. After taking her science requirements and the MCAT exam, she moved to the LSU Health Sciences Center in New Orleans for medical school.
In 2006, Grimes noticed a tremor in her thumb, leading her to her own world of medicine. Unable to find an answer in Baton Rouge, she sought help from Baylor Medical School in Houston where she found a doctor who provided her with a diagnosis.
“When I got back in the chair he said, ‘I think you have Parkinsonism,’” she told LSU in an interview. “He said that I didn’t swing my left arm as much as my right. I am glad I found out what it was and to confront it. But I spent a lot of time on that river of denial.”
Parkinsonism is a neurological condition that causes a combination of the movement abnormalities seen in Parkinson's disease. Symptoms can include  tremors, slow movement, impaired speech or muscle stiffness.
Perez, unaware of what was happening in Grimes’ life, was going to medical school for neurology, the same field that covers Parkinsonism and other neurological disorders. After graduating medical school and a fellowship at the University of Alabama, she moved back to Louisiana, where she was reunited with her former accompanist.
Grimes and Perez reconnected at Pennington Biomedical’s Parkinson’s Disease Conference. Grimes found out about the conference after speaking at the Louisiana Federation of Music Club and was invited by a woman who just so happened to be Perez’ mother-in-law.
“A woman came up to me and said, 'You've got to meet my daughter-in-law, Sarah Perez,’” Grimes said. And we talked about Sarah. But little did I know, it was the same Sarah because I knew her as Sarah Roberts. So I looked her up and realized I knew her and couldn’t believe she was a neurologist. It was fabulously shocking and great news.”
When Grimes and Perez reunited at the conference, both of them were able to share their passion for music and life of neurological science. The friendship provided Grimes with a neurologist she’s close with and gave Perez a chance to play the clarinet again.
“[Grimes] was an answer to my prayers. Literally a few weeks beforehand I had prayed for an opportunity to play again,” Perez said. “I missed it so much. And two weeks later, I was reunited with Jan. I couldn’t believe it,” she said.
Grimes and Perez continue to bring their story to people throughout Louisiana, including performing at the LSU Science Café on May 28. The performance, called “Full Circle: Music, Struggle, Reunion & Inspiration,” included five compositions as well as the retelling of their story.
“We use this as a platform,” Perez said. “The real message we want to convey is that there is hope — there is life after a diagnosis of Parkinson’s. [Grimes] is living beautifully with Parkinson’s, just as she lived beautifully anyway.”
The eighth annual Parkinson’s Conference will be held on July 30 from 8:30 a.m. to 2 p.m. at Pennington Biomedical’s Conference Center in Baton Rouge.
http://www.lsureveille.com/daily/former-lsu-school-of-music-professor-reconnects-with-former-student/article_19d51ed6-9145-11e9-9a99-c3c09177f052.html

World Parkinson Congress 2019: Best of the Blog Reports



World Parkinson Congress 2019 in Kyoto was educational, inspirational, and a great excuse to visit Japan again. And in 3 years time, it’ll give us an excuse to return to Barcelona for WPC 2022. Held every 3 years, the event was a bit smaller than WPC 2016 in Portland Oregon (USA), drawing around 3,000 attendees compared to 4,500 at the previous event. Undoubtedly, this was not due to a lack of interest, but due to more expensive and more difficult travel for those interested in attending.
WPC draws an eclectic mix of medical professionals, neurologists, physical therapists, researchers, charities, support organizations, people with Parkinson’s, caregivers, and pharmaceutical reps.
It’s actually quite amazing that the event organizers are able to develop a program that engages this diverse audience.
If there was one disappointing thing about the conference, I’d have to say that the WPC Official Blogger program was a bust. From what I can tell, only 25% of the official bloggers have posted anything about WPC 2019. A couple of them did post some excellent reports, and perhaps the others are still polishing their essays.
Thankfully, the Science of Parkinson’s website fills the void with extremely thorough reporting on the conference.

Science of Parkinson’s Disease – Simon Stott
Too much to copy and paste,to view and read please go to:
https://parkinson.fit/world-parkinson-congress-2019-blogs/

Riverside congressman’s bill could mean benefits for Vietnam veterans who were stationed offshore

June 22, 2019  By 


Riverside congressman’s bill could mean benefits for Vietnam veterans who were stationed offshore
Rep. Mark Takano, D-Riverside, sponsored a bill ensuring medical benefits for offshore Vietnam veterans. The bill passed the Senate unanimously and is on its way to the President’s desk. (Courtesy of Mark Takano)


He couldn’t taste it. He couldn’t smell it. He couldn’t even see it.
But when Riverside-area resident George Swift, a Vietnam veteran and President of Vietnam Veterans of America Chapter 47, saw Inland chapter members develop Parkinson’s Disease, cancers and more, he realized Agent Orange was around him during the Vietnam War — though he never stepped foot in the country.
“I served on ships … (and) we made our fresh water from sea water,” he said. “The sea water was the water that we drank and we bathed in. That water was contaminated.”
Despite seeing similar symptoms as veterans who served on land, Swift says his fellow veterans were denied medical benefits from the Department of Veterans Affairs because they were offshore.
Now, in a new bill sponsored by Rep. Mark Takano, D-Riverside, Vietnam veterans such as Swift — called Blue Water Veterans because of their deployment off the coast of Vietnam — could receive federal medical benefits for being exposed to the toxic chemical.
The Blue Water Navy Vietnam Veterans Act of 2019, which is Takano’s first standalone bill, unanimously passed the U.S. Senate on Wednesday, June 12, and is a presidential signature away from becoming law. The bill from Takano, chair of the House Veterans’ Affairs Committee, passed the House unanimously.
“Tonight, we can finally tell the tens of thousands of veterans who were exposed to Agent Orange during the Vietnam War but wrongly denied benefits that justice is finally coming,” Takano said in a June 12 statement.
The bill would ensure benefits for all soldiers stationed within a certain boundary off the coast of Vietnam who may have come into contact with the substance through drinking water, contaminated air or other means.
The chemical, which contains the known carcinogen dioxin, was used to burn nearly 12,000 square miles of dense forest cover during the Vietnam War and is linked to cancer, birth defects and immune system difficulty in humans. Millions of Vietnamese people are still suffering from Agent Orange exposure; for former U.S. soldiers, that number is far less.
Previously, Blue Water veterans had to prove they were exposed to Agent Orange. Now, the bill states, the VA would have to presume they were — just as it already does for Vietnam veterans who served on land and rivers in the country.
For Swift, who lives in the Woodcrest community, that would mean finally looking into medical benefits from his skin cancer that may have been caused by Agent Orange.
“I always wondered if I was exposed,” he said. “It’s just really good that it finally got a legislator to put some sense into this whole thing.”
Takano’s bill is similar to one that was introduced in last year’s Congress but stalled in the Senate over financial concerns. But earlier this year, a case in the U.S. Court of Appeals may have made the effort redundant: A 9-2 decision in January ruled that the VA can’t deny benefits to Blue Water vets.
Still, Takano said in an emailed statement, the bill is necessary to make sure veterans get their benefits.
“(The decision) was a huge step forward, but we need more,” he said. “Our bill includes crucial ‘geocoordinates’ that clarify the territory off the coast of Vietnam that (the) VA must recognize when deciding claims for disability compensation for herbicide-related diseases.”
In addition, the bill would guarantee benefits for soldiers deployed in or near the Korean Demilitarized Zone from September 1967 through August 1971 and for children with spina bifida whose parents served in Thailand during the Vietnam War. An add-on to the bill also made changes to VA home loan program.
“Now we call on President Trump to sign HR 299 and finally finish this fight,” Takano said in a statement. “These veterans have waited long enough.”
It is not known when the bill will reach President Donald Trump’s desk.
“(The decision) was a huge step forward, but we need more,” he said. “Our bill includes crucial ‘geocoordinates’ that clarify the territory off the coast of Vietnam that (the) VA must recognize when deciding claims for disability compensation for herbicide-related diseases.”
In addition, the bill would guarantee benefits for soldiers deployed in or near the Korean Demilitarized Zone from September 1967 through August 1971 and for children with spina bifida whose parents served in Thailand during the Vietnam War. An add-on to the bill also made changes to VA home loan program.
“Now we call on President Trump to sign HR 299 and finally finish this fight,” Takano said in a statement. “These veterans have waited long enough.”
It is not known when the bill will reach President Donald Trump’s desk.
Editor’s note: This story has been updated to clarify that Rep. Mark Takano made the statement explaining why he thinks the bill is necessary.
https://www.pe.com/2019/06/22/riverside-congressmans-bill-could-mean-benefits-for-vietnam-veterans-who-were-stationed-offshore/

People seeking help and support with Parkinson’s Disease now have answers

June 21, 2019    by: Caroline Morse

"I'm Doing This in Her Honor"



                   


HAGERSTOWN, Md. (WDVM) — Hagerstown’s Parkinson’s Support Group raised awareness for the community Friday morning on how to support families and loved ones who are living with Parkinson’s.
“We believe that the social aspects are just as important as the educational aspects, so the more people we can reach in the community in the four-state area actually, the better off the community will be,” said Co-Facilitator of Hagerstown Parkinson’s Support Group Art Guyer.
According to the MedIfocus Guidebook to Parkinson’s, about 50,000 people each year are diagnosed with Parkinson’s and may live with it for a period of time without knowing. And, more than half-a-million people are affected by Parkinson’s through a family member or friend.
“I’ve been doing this 11 years now, and my wife died a year ago this month basically from a fall,” said Guyer. “Parkinson’s people have a tendency to lose balance and fall, so she broke her hip and never fully recovered from that. I’m still working Parkinson’s groups, travel to Parkinson’s meetings and seminars in her honor.”
There are many signs and symptoms of Parkinson’s disease, but the most common signs are having slight tremors in the hands or feet, muscle stiffness, voice changes and loss of fine motor skills.
“It helps to interact with people, you know my husband has lost his taste, his smell, it’s nice but not nice to hear that other people had the same problems that he’s not alone,” said Hagerstown Resident Cindy Swales.
Stay tuned for a more in-depth look during WDVM’s “In focus- Parkinson’s Disease” special that will be airing next Thursday night.

To view video:
https://www.localdvm.com/news/maryland/people-seeking-help-and-support-with-parkinsons-disease-now-have-answers/

Asleep Deep Brain Stimulation changing lives of hundreds of patients with Parkinson’s disease

JUNE 21, 2019          BY REBECCA GANNON


Brian Richards is one of nearly 1 million people in the United States with Parkinson's.
KANSAS CITY, Mo. -- For anyone battling Parkinson’s disease, epilepsy or essential tremor, there have been a few medical interventions over the years.
Sometimes it’s in the form of better drugs; other times it’s in the form of surgical innovations.
One of the most common surgical interventions is deep brain stimulation surgery. Usually it’s done while the patient is wide awake, hearing everything that’s happening over the course of 4-5 hours.
Thanks to improved technology, a growing number of surgeons are learning how to do the same surgery while the patient is asleep.
Three health systems in the Kansas City area do Asleep Deep Brain Stimulation surgery. More than 1,300 metro residents have had their lives changed by it.
Brian Richards is about to join that group.
Richards recently sat at his dining room table in Olathe, still with the exception of his right hand. It's shaking was the most obvious sign of his Parkinson’s disease. He's one of nearly one million people in the United States with Parkinson’s.
“It's a real slow disease,” he said. “Nothing happens really fast.”
“I heard someone explain it as a snowflake effect where it just slowly accumulates,” he continued. “You don't notice them as a single blow, but there's an accumulation.”
For Richards, the effect began with a small, intermittent shake to his hand. The accumulation was a shake that grew in frequency and strength. That lead to difficulty writing, using his smartphone and eventually using the computer -- which meant it was difficult to do his job.
That lead Richards to chose early retirement.
“If I didn't have to, I wasn't going to spend the last years of my mobility at work,” he said candidly.
Since retiring, Richards walk has become unsteady, and his voice has gotten softer. But the hallmark of Parkinson’s disease is tremors.
“I've seen Parkinson's,” Richards said. “I've seen Michael J. Fox on TV.”
While some people can control the shaking symptoms with drugs, Richards wasn’t one of them. Surgery was his only option.
“I understand it is brain surgery,” Richards said at his dining room table, his hand still shaking. “But its low-risk. And at this point, I felt like if I could get rid of some of these tremors, if it helps me walk better, if it helps me smile -- if I can get back some of these things, for at least a little while, I think I’ll give it a shot.”
And so, on a day in mid-May, Richards gave it a shot.
Over the course of a week, Richards underwent two separate Deep Brain Stimulation (DBS) operations.
“I'm ready,” he said. “I'm just ready to get it done and see what's on the other side. It doesn't stop the disease -- it keeps on trucking.  But if I can do without some of the more obvious symptoms, I'll go for that.”
He was dressed in a hospital gown, laying in a hospital bed, waiting to go into surgery at Saint Luke’s on the Plaza. His wife Susan sat beside him with a bag of his clothing. Monitors making line graphs and electronic beeps surrounded the area at the head of the bed.
Richards smiled.
“I feel pretty good,” he said, “though a little nervous.”
Moments later, he and Susan said goodbye, and he was wheeled out. Susan went to the waiting room.
Over the course of a week, he underwent two separate Deep Brain Stimulation operations.
The first operation involved implanting two nodes deep into his brain and running transmission wires down the side of his skull to his ears. The second operation involved running the wires the rest of the way to his heart and then to a receiver implanted near his heart.
Photo from a provided video of the surgery, courtesy of St. Luke's

Dr. Stephen Griffith was the neurosurgeon who operated on Richards. At his office before the surgery, he sat at his desk with an easy smile and laughed.
“It's really not a big deal.  It's pretty easy," he said.
Not everyone would say brain surgery is easy. But Griffith has done more than 300 of these surgeries. Because while DBS surgery is not unusual, what Griffith does is.
Normally, DBS surgery is done with the patient awake.
As Griffith described it, “You're awake for the smell of the cautery, you're awake for the sound of the drilling.”
For years, surgeons couldn’t see the precise location of the surgery. Patients had to be kept awake so physicians would know what part of the brain was being operated on; patients would be asked to move their foot or finger, or blink on command. This would ensure the surgeon was operating on the right location.

Griffith is one of the first physicians in the U.S. to do asleep DBS surgery.
Dr. Stephen Griffith was the neurosurgeon who operated on Richards, and one of the first physicians in America to do Asleep Deep Brain Stimulation.
“You go to sleep, and when you wake up, it's done,” he explained simply. “This operation went from taking, say, even as much as 4-5 hours to do a case with the patient awake to now, we can do a patient case in under 2 hours with the patient asleep.”
“We know that technology always wins," he explained. "We see that in every aspect of our lives, from cell phones to our computers to our medical technology and medical innovations.  And so we now have MRI technology that is even more superior to things we had even as recently as 10 years ago.”
“Now we can clearly see the nucleus, the deep structures within the brain, where we want to place these electrodes," Griffith continued. "Now we can use complicated technology such as neuro-navigation technology to get these electrodes to the right spot.  So we no longer need the patient to be awake. The patient can now be asleep -- hence asleep deep brain stimulation.”
Griffith points out that the infection rate is also much lower. He noted that nationally, the rate of infection for awake DBS surgery is around 5%.
At St. Luke’s and other facilities doing asleep DBS, where the timeline is twice as quick, Griffith quoted a 1% infection rate.
“We know this is proven neurosurgery,” he noted.  “We know that if patients have Parkinson's disease, or essential tremor, and they come to us for treatment, soon enough we know that once we perform surgery on them, that they have an opportunity to do better for longer.”
When we checked back in, it was almost Memorial Day weekend. More than two weeks had passed since Richards had his first surgery. At 8 a.m., in his neurologist’s office on Barry Road, Richards learned if the operations worked.
Richards was nervous and it showed. His hand was shaking more than normal.
“The tremor is kind of aggravated right now,” said Dr. Stanley Fisher as he examined his patient, gesturing to the extra eyes watching: the medical device team, the nurses and camera crew.
Fisher asked Richards to hold his hand up and completely relax. Fisher and the medical device team spent a few minutes hovering around a tablet, fine-tuning numbers and frequencies.
The neurologist again asked Richards to hold his hand straight up, then completely relax.
Fisher’s face breaks into a grin and he proudly states, “The tremors are gone.”
The tremor that plagued Richards for years vanished in seconds.
Richards looked down at his right hand and smiled. He pulled out his cell phone and typed a text -- something he hasn’t been able to do easily for more than two years.
But he was cautiously optimistic.
“If this sticks with me for the day after that, and the day after that, and all the days after that, I'm in good shape," he said.
In early June, at the same dining room table where we first met him, Richards was sitting still. All of him was still. He’s had the device implanted, and on, for two weeks.
“It's like the last few years didn't happen,” he said matter-of-factly.
He reflected back to that late May day in Dr. Fisher’s office.
“It just seems kind of normal," he said. "It just seemed like as soon as he hit the switch, I didn't have tremors. They were largely gone. It was just the most natural feeling in the world.”
The tremors can come back, and Richards' seem to arise when he's under stress. But the implanted device gives him the ability to regulate the frequencies and control the tremors.
But this device is only for physical tremors.
“It’s important to recognize this is not a cure for Parkinson's disease,” Griffith said. “It is what I prefer to call it -- a lifestyle improvement tool.”
“While we cannot cure Parkinson's disease,” he added, “if we can decrease the physical effects the disease that Parkinson's has on their lives -- meaning their ability to maintain their independence, to assist in their own care, to perform their activities of daily living -- then I call that a win for the patient.”
Richards considers it a win, too.
After years of struggling with using forks, and phones, and computers, losing his tremors was as simple as going to sleep … and waking up.

Three health systems in the Kansas City area perform Asleep DBS.
The University of Kansas Health System estimates it has done more than 1,000 DBS surgeries over the last 25 years for Parkinson’s disease and essential tremors. It recently added DBS for epilepsy to its offerings.
Saint Luke’s notes that Dr. Griffith has done more than 300 Asleep DBS surgeries. The health system has group dedicated to treating Parkinson’s disease and movement disorders.
Children’s Mercy Hospitals also does Asleep DBS. Since 2012, the pediatric hospital has done roughly 30 DBS surgeries. A hospital spokeswoman said, “the large majority, 21, have been for dystonia. We have done two for intractable Tourette syndrome and five for tremor.”

To view video:https://fox4kc.com/2019/06/21/asleep-deep-brain-stimulation-changing-lives-of-hundreds-of-patients-with-parkinsons-disease/

Researchers Discover The Earliest Signs of Parkinson's Disease in The Brain (Continued)

 HEATHER WILSON & MARIOS POLITIS, THE CONVERSATION    21 JUN 2019




About 100 people have a rare mutation in a gene called SNCA that puts them at almost certain risk of getting Parkinson's disease. This makes them ideal subjects for studying the root causes of this debilitating condition. Most of these people live in the northern Peloponnese in Greece, and a handful live in Campania, Italy. We were lucky enough to have 14 of these people agree to travel to London so we could study their brains.

More than 6 million people, globally, have Parkinson's disease; it is the second most common neurodegenerative disorder after Alzheimer disease.
The symptoms, which worsen over time, include motor symptoms such as stiffness, slowness and shaking, as well as non-motor symptoms, such as memory problems. Researchers have been trying to find a reliable marker for the disease so that people at risk can be identified before the motor symptoms start.
There are no cures for Parkinson's disease, but symptoms are treated with drugs that restore a brain chemical called dopamine to normal levels. Dopamine has long been considered a prime culprit in Parkinson's disease as low levels cause problems with movement. But another brain chemical called serotonin has also been implicated in the disease.
But we didn't know how early and to what extent changes in serotonin occur and if these changes are related to disease onset. To help answer this, we needed to study those Greek and Italian subjects with the SNCA gene mutation.
Studying these gene carriers before they develop Parkinson's disease is a unique opportunity to understand what comes first in the cascade of events that eventually leads to a diagnosis of Parkinson's disease. This knowledge is critical so that we can develop sensitive markers to track the progression of the disease.
People with the mutation tend to display symptoms of Parkinson's disease in their 40s or 50s, so we wanted to study subjects in their 20s and 30s to see if there were any brain changes a decade or more before symptoms started.
Seven of our volunteers, who kindly visited our lab for ten days of brain imaging and neurological tests, had no motor symptoms and seven had been diagnosed with Parkinson's disease.
We also examined 25 patients with sporadic Parkinson's disease (Parkinson's disease without a genetic cause) and 25 healthy volunteers.
All participant had three brain scans: one to measure dopamine, one to measure serotonin, and another to study anatomical regions in the brain.
We also carried out a series of clinical tests to investigate motor and non-motor symptoms. The volunteers wore an electronic device on their wrist for seven days to pick up any movements associated with Parkinson's disease – movement that might be too subtle to be detected by a neurologist with the naked eye.
These tests confirmed that the seven subjects with the gene mutation who had no motor symptoms were, indeed, Parkinson's free.

Early serotonin loss

Comparing data from the different groups allowed us to measure the severity of dopamine and serotonin loss at different stages of the disease, from people without symptoms to people with a diagnosis.
It also allowed us to compare changes seen in the gene carriers with changes seen in those with sporadic Parkinson's disease. This helped us translate our findings in the gene carriers into the more common sporadic form of Parkinson's disease.
We discovered that gene carriers without symptoms had depleted serotonin, while their dopamine neurons appeared to remain intact. So the changes in the serotonin system that we identified are likely to start very early and precede the onset of motor symptoms by some years.
Our study, published in Lancet Neurology, suggests that changes to the serotonin system come first, occurring many years before patients show symptoms. This important finding could lead to the development of new drugs to slow or even stop disease progression.
Our findings also suggest that brain scans of the serotonin system could be used as a tool for screening and monitoring disease progression. But these scans are expensive, so we need more work to develop affordable technology.
We also need more research into genetic forms of Parkinson's which could further unlock the earliest changes underlying this awful disease.The Conversation
Heather Wilson, Research Associate, King's College London and Marios Politis, Lily Safra Professor of Neurology and Neuroimaging, King's College London.
https://www.sciencealert.com/scientists-find-the-earliest-roots-of-parkinson-s-disease-in-the-brain

Parkinson’s disease: scientists find the earliest roots in the brain

 June 20, 2019


An array of positron emission tomography or PET images.


About 100 people have a rare mutation in a gene called SNCA that puts them at almost certain risk of getting Parkinson’s disease. This makes them ideal subjects for studying the root causes of this debilitating condition. Most of these people live in the northern Peloponnese in Greece, and a handful live in Campania, Italy. We were lucky enough to have 14 of these people agree to travel to London so we could study their brains.
More than 6m people, globally, have Parkinson’s disease; it is the second most common neurodegenerative disorder after Alzheimer disease. The symptoms, which worsen over time, include motor symptoms such as stiffness, slowness and shaking, as well as non-motor symptoms, such as memory problems. Researchers have been trying to find a reliable marker for the disease so that people at risk can be identified before the motor symptoms start.
There are no cures for Parkinson’s disease, but symptoms are treated with drugs that restore a brain chemical called dopamine to normal levels. Dopamine has long been considered a prime culprit in Parkinson’s disease as low levels cause problems with movement. But another brain chemical called serotonin has also been implicated in the disease. But we didn’t know how early and to what extent changes in serotonin occur and if these changes are related to disease onset. To help answer this, we needed to study those Greek and Italian subjects with the SNCA gene mutation.
People with a rare genetic mutation that causes Parkinson’s hail from the Peloponnese in Greece. 

Studying these gene carriers before they develop Parkinson’s disease is a unique opportunity to understand what comes first in the cascade of events that eventually leads to a diagnosis of Parkinson’s disease. This knowledge is critical so that we can develop sensitive markers to track the progression of the disease.
People with the mutation tend to display symptoms of Parkinson’s disease in their 40s or 50s, so we wanted to study subjects in their 20s and 30s to see if there were any brain changes a decade or more before symptoms started.
Seven of our volunteers, who kindly visited our lab for ten days of brain imaging and neurological tests, had no motor symptoms and seven had been diagnosed with Parkinson’s disease. We also examined 25 patients with sporadic Parkinson’s disease (Parkinson’s disease without a genetic cause) and 25 healthy volunteers.
All participant had three brain scans: one to measure dopamine, one to measure serotonin, and another to study anatomical regions in the brain. 
We also carried out a series of clinical tests to investigate motor and non-motor symptoms. The volunteers wore an electronic device on their wrist for seven days to pick up any movements associated with Parkinson’s disease – movement that might be too subtle to be detected by a neurologist with the naked eye. These tests confirmed that the seven subjects with the gene mutation who had no motor symptoms were, indeed, Parkinson’s free.

Early serotonin loss

Comparing data from the different groups allowed us to measure the severity of dopamine and serotonin loss at different stages of the disease, from people without symptoms to people with a diagnosis. It also allowed us to compare changes seen in the gene carriers with changes seen in those with sporadic Parkinson’s disease. This helped us translate our findings in the gene carriers into the more common sporadic form of Parkinson’s disease. 
We discovered that gene carriers without symptoms had depleted serotonin, while their dopamine neurons appeared to remain intact. So the changes in the serotonin system that we identified are likely to start very early and precede the onset of motor symptoms by some years. 
Our study, published in Lancet Neurology, suggests that changes to the serotonin system come first, occurring many years before patients show symptoms. This important finding could lead to the development of new drugs to slow or even stop disease progression.
Our findings also suggest that brain scans of the serotonin system could be used as a tool for screening and monitoring disease progression. But these scans are expensive, so we need more work to develop affordable technology. We also need more research into genetic forms of Parkinson’s which could further unlock the earliest changes underlying this awful disease.
https://theconversation.com/parkinsons-disease-scientists-find-the-earliest-roots-in-the-brain-119030

PPMI Dispatch: Findings and New Initiatives Shared at the Annual Meeting

Maggie McGuire Kuhl,Senior Associate Director • Research Communications