USING CELL PHONES TO MONITOR PARKINSON'S DISEASE

29th January 2013



IEEE Transactions on Biomedical Engineering (submitted) [2013] (A.Tsanas, M.A.Little, P.E.McSharry, L.O. Ramig) 

Dysphonia is an impairment in the ability to produce vocal sounds that can occur in Parkinson's Disease. A wide range of dysphonia measures have been used to predict Parkinson's Disease severity using speech signals. Researchers demonstrated that this method can match standard methods of diagnosing Parkinson's Disease.

Telephone monitoring of Parkinson’s Disease has attracted interest as a potential means of assessing this. Purpose built devices have been developed that record various signals that can be associated with symptom severity, as quantified on standard Parkinson's Disease scores such as the Unified Parkinson’s Disease Rating Scale (UPDRS). Previous studies have demonstrated replication of UPDRS scores to within less than 2 points of a clinical raters’ assessment of symptom severity, using solely high-quality speech signals.

This study investigated using the cellular mobile telephone networks for Parkinson's Disease monitoring. The Parkinson's Disease (UPDRS) symptom score could be estimated to within about 3.5 points difference from the clinicians’ assessment, which is useful because even different clinicians vary by as much as 4 to 5 points. This provides evidence that the phone network is adequate for inexpensive, mass-scale Parkinson's Disease symptom monitoring.

SALIVA GLAND TEST FOR PARKINSON'S DISEASE

11th January 2013 -

New research has suggested that testing a portion of a person's saliva gland may be a means of diagnosing Parkinson's Disease. It was previously shown in autopsies of people with Parkinson's Disease that the abnormal proteins associated with Parkinson's are consistently found in the submandibular saliva glands, which are found under the lower jaw.

The study involved 15 people with an average age of 68 who had Parkinson's disease for an average of 12 years, who responded to Parkinson's medication and who did not have known saliva gland disorders. Biopsies were taken of two different saliva glands. The abnormal Parkinson's protein was detected in nine of the 11 patients who had enough tissue to study. This is the first study demonstrating the value of testing a portion of the saliva gland to diagnose a living person with Parkinson's Disease.

PARKINSON'S DISEASE DOES NOT CAUSE COMPULSIONS

12th January 2013 - New research



Neurology [2013] 80 (2) : 176-180 (Weintraub D, Papay K, Siderowf A)

Although compulsions can often occur in Parkinson's Disease, Parkinson's Disease does not actually cause compulsions or related problems. When people with Parkinson's Disease were compared with people who do not have Parkinson's Disease the frequencies of compulsions were little different : gambling (1.2% v 0.7%), buying (3% v 2%), sexual behaviour (4.2% v 3.5%), eating (7% v 10%), punding (prolonged, purposeless, and stereotyped behaviour) (5% v 2%), hobbyism (5% v 12%), walkabout (0.6% v 0.7%), any compulsions (18% v 20%).

The fact that Parkinson's Disease itself does not seem to cause an increased risk of developing compulsions or related behaviour further reinforces the reported association between Parkinson's Disease drugs and causing compulsions. Given that approximately 20% of people with newly diagnosed Parkinson's Disease report some impulse control or related behaviour symptoms, long-term follow-up is needed to determine whether such people are at increased risk for impulse control disorder development once Parkinson's Disease drugs are initiated. 

PREVALENCE OF PARKINSON'S DISEASE IN CANADA

 September 13, 2012

Parkinsonism Related Disorders [2012] 18 (4) : 327-331 (Allyson Jones C, Wayne Martin WR, Wieler M, King-Jesso P, Voaklander DC.) 

The prevalence of Parkinson's Disease in Canada has been found to be one of the highest of any country in the world. The study was carried out in British Columbia, Canada. The prevalence rates amongst men were found to be 396-207 per 100,000 for men, and 259 to 127 per 100,000 for women. Combining the figures for both men and women gives figures of around 317 to 167 per 100,00.

These figures are just about higher than those in the U.S.A., which has one of the highest prevalence rates of any country. The only countries with higher prevalence rates than Canada are Albania and Egypt, where the prevalence rates are exceptionally high. The ratio of men to women with Parkinson's Disease in Canada is 1.56. As in most countries in the world, in Canada there are more men than women with Parkinson's Disease.

THE SAFETY AND TOLERABILITY OF NEUPRO

9th September 2012 -

 

Parkinsonism Related Disorders [2012] Sep 3 [Epub ahead of print] (Oertel W, Lewitt P, Giladi N, Ghys L, Grieger F, Boroojerdi B.) 

Although dopamine agonists are sometimes perceived as poorly tolerated by the elderly, there is little clinical evidence to support these concerns. So the safety and tolerability of rotigotine transdermal system have been assessed in four 6-month studies. : two in early Parkinson's Disease and two in advanced Parkinson's Disease.Neupro® (Rotigotine Transdermal System) is a dopamine

For most adverse events no age-related differences in were observed. In early Parkinson's Disease those symptoms more common in those younger than 65 in comparison to those who were 65 were : nausea (38% v 30%) and headache (15% v 9%). In another study, amongst older patients, those symptoms more common in those younger than 75 in comparison to those who were 75 were : nausea (36% v 21%), and dizziness (15% v 28%). In people with advanced Parkinson's Disease it was still the younger patients that more commonly had nausea (24% v 19%). It was only falls that were more common in older patients (13% v 8%). So oddly, the adverse events of this dopamine agonists were generally less rather than greater with age, as if the adverse events were adapted to.

NFL PLAYERS TREBLE THE RISK OF PARKINSON'S DISEASE

 September  2012 - New research

 

Neurology [2012] Sep 5 [Epub ahead of print] (Lehman EJ, Hein MJ, Baron SL, Gersic CM.) 

Players in the NFL ("American" Football's National Football League) were found to have treble the risk of haiving a neurodegenerative disease generally. This included Parkinson's Disease, Alzheimer's Disease and ALS. The figures for Alzheimer's Disease were more than three times more likely, and the figures for ALS were more than four times more likely. The likelihood of developing Parkinson's Disease was less than these. Although the research suggests that concussions and repeated blows to the head are likely to blame for the increased risk, the researcher says multiple studies are needed to definitively blame concussions.

George H.W. Bush can no longer walk on his own: Parkinson's struggle revealed with new HBO documentary

Sarah Rufca
culturemap.com - With a documentary on the life of George H.W. Bush set to air on HBO, friends and family are opening up about the Houstonian and 41st president.

Speaking to Charlie Rose on CBS, son Jeb Bush revealed that his father at 87 year of age can no longer walk on his own, instead relying on a wheelchair and a stroller to get around

"That's hard for a guy who's been so vital and vigorous in life," said Jeb Bush, who also called his father his "hero" and added, "I've never met a man as near perfect as George H.W. Bush."

Bush has been known for his vitality despite his advanced age, famously going skydiving to celebrate turning 75, 80 and 85 years old.

On Good Morning America, documentary producer and Bush family friend Jerry Weintraub said that Bush has struggled increasingly with the symptoms of Parkinson's disease in recent years.

"He's not doing great, he's not terrible but he's not doing great. He's a very active guy and when you get Parkinson's and all of a sudden you're riding around in a wheelchair and this and that and he can't do things for himself . . . it's tough."

The HBO documentary, titled simply 41, features unprecedented access to the former president, filmed over 17 months from September 2009 to February 2011. In his own words, the typically reticent Bush speaks about his life, from childhood summers in Kennebunkport and meeting his wife to his experiences as a naval aviator in World War II to his run as a wildcatter in Texas and his rise to the top of politics.

"It shows him as a man. It's not just a documentary about a president. It's not him making big speeches out there, rallying the troops and so on and so forth, it's about his life and his service," Weintraub said.

41 premieres on June 14, two days after Bush's 88th birthday

FIRST VACCINE FOR PARKINSON'S DISEASE

7th June 2012 - News release

The first clinical trial for the development of a Parkinson’s Disease vaccine has been started by AFFiRiS AG. The vaccine called PD01A is directed against alpha-Synuclein, a protein considered by AFFiRis to cause the onset and progression of Parkinson's Disease. The vaccination aims to educate the immune system to generate antibodies directed against alpha-Synuclein. They believe that a reduction of the brain’s alpha-Synuclein aggregates will have a beneficial impact on the progress of Parkinson's Disease. PD01A aims to accomplish that by the induction of antibodies that are targeting alpha-Synuclein, in order to neutralize its toxic impact.

The vaccine is currently being tested on people with Parkinson’s Disease in a Phase I trial. The clinical trial is taking place in Vienna and involves up to 32 patients. The primary purpose is to assess the safety and tolerability of PD01A.

The weakness in the theory on which the method is reliant is that a lot of people with Parkinson's Disease do not accumulate alpha-Synuclein. So there is none to get rid of. Most people that have an accumulation of alpha-Synuclein in the brain do not have Parkinson's Disease either, thereby proving that alpha-Synuclein is not the cause of Parkinson's Disease.

THE EFFECT OF TAI CHI ON PARKINSON'S DISEASE

12th February 2012 - New research

New England Journal of Medicine [2012] 366 (6) : 511-519 (F.Li, P.Harmer, K.Fitzgerald, E.Eckstrom, R.Stock, J.Galver, G.Maddalozzo, S.S.Batya) People with Parkinson's Disease tend to have impaired balance, and an increased risk of falling. A clinical trial assessed the effect of Tai Chi on postural control in Parkinson's Disease. Tai Chi is a traditional Chinese martial art and form of exercise. For more information go to Tai Chi. Participants took part in 60-minute exercise sessions twice weekly for 24 weeks. Although the researchers claimed that Tai Chi performed consistently better than other methods, the improvement was only 5% better than resistance training, and 12% better than stretching exercises. The Tai Chi group performed better than the stretching group in all secondary outcomes and outperformed the resistance-training group in stride length and functional reach. Tai Chi lowered the incidence of falls when compared with stretching exercises but not when compared with resistance training.

Out of the previous studies in the medical literature concerning Tai Chi and Parkinson's Disease, four were either non-randomised or uncontrolled clinical trials. Two failed to show any effect. Only one study showed Tai Chi to be superior to conventional exercise for Parkinson's Disease. So the evidence is insufficient to suggest that Tai Chi is effective in Parkinson's Disease.

DUODENAL L-DOPA CAN CAUSE POLYNEUROPATHY

26th January 2012 - New research

Journal of Neurology [2012] Jan 24 [Epub ahead of print] (Santos-García D, de la Fuente-Fernández R, Valldeoriola F, Palasí A, Carrillo F, Grande M, Mir P, De Fabregues O, Casanova J.)  

Neurology [2011] 77 (22) : 1947-1950 (Y.A.Rajabally, J.Martey)

Reports have emerged describing the occurrence of polyneuropathy related to vitamin B12 deficiency and Guillain-Barré syndrome in people with Parkinson's Disease who are being treated with continuous duodenal L-dopa infusion. Duodenal L-dopa is administered as a gel throughout the day using a portable pump directly into the small intestine through a surgically placed tube. This ensures a flow of L-dopa that can be adjusted according to the patient's individual needs.

At least 12 cases of polyneuropathy related to vitamin B12 deficiency, and a case of Guillain-Barré syndrome have been reported in people with Parkinson's Disease treated with duodenal L-dopa infusion. L-dopa gel infusion may cause a decrease in vitamin B12 levels, leading to peripheral neuropathy. Other detrimental effects include alterations related to the metabolism of L-dopa, abnormal L-dopa absorption, and direct neurotoxicity of L-dopa at high doses. Vitamin B12 supplements may need to be considered in people with Parkinson's Disease on duodenal L-dopa infusion therapy, because vitamin B12 deficiency in people on duodenal L-dopa infusion therapy may be more frequent than the published data suggest.

In another new study, over a third (37%) of people with Parkinson's Disease were found to have neuropathy. Vitamin B12 deficiency was the most common cause. This could be made more likely by the long term use of L-dopa in any form. Many people with Parkinson's Disease who have neuropathy or Vitamin B12 deficiency are unaware of it.