Do YOU kick and punch in your sleep? It could be an early sign of Parkinson's disease: People who thrash around in bed are 'more likely to develop the condition'

16 April 2015    BY MADLEN DAVIES FOR MAILONLINE

Lashing out in sleep is a sign of 'rapid eye movement behaviour disorder'

• Half of people with this condition will go on to develop Parkinson's disease
• Up to 90% of people will develop another neurological disorder within 10 years
• Sleep disorder occurs due to a brain malfunction  - meaning the brain doesn't paralyse the body's muscles during the period of sleep when people dream
• 
  

Kicking, punching and moving around during sleep might be an early sign of Parkinson's disease, a new review suggests.

Moving around in sleep, and seeming to 'act out' dreams is a characteristic of a condition called rapid eye movement sleep behaviour disorder (RBD).

Researchers have discovered about half of people with RBD will develop Parkinson's disease or another neurological disorder within a decade of being diagnosed, LiveScience reports.

People with rapid eye movement sleep behaviour disorder (RBD) move around in their sleep and 'act out' their dreams. Up to 90 per cent of people with the condition will develop a neurological condition, a study found

Ultimately, 81 to 90 per cent of patients with RBG with develop a neurodegenerative disorder, they found.

'If you get this disorder and live long enough, you will almost certainly get Parkinson's disease or a condition similar to it — it's an early warning sign,' said Professor Michael Howell, of the University of Minnesota, and co-author of the study.

People with RBD describe having vivid dreams, and they act them out theatrically while asleep.

They can be fighting enemies, or fleeing danger, and actually act out these dreams in their beds.

This can range from making small hand movements to thrashing around, punching, kicking and jumping out of bed.

Sometimes, people with the condition can injure themselves or anyone sharing a bed with them.

'It's very important to make the bedroom environment [as] safe as possible' by removing objects that can be picked up or used as a weapon, such as guns, Professor Howell said.

People with RBD move around during the rapid eye movement period of sleep, when most dreaming occurs but the body's muscles are usually paralysed by the brain stem.

Those with the condition are believed to have a malfunction in their brain-stem which allows them to move around during REM sleep, and therefore act out their dreams.

WHAT IS RAPID EYE MOVEMENT SLEEP DISORDER?

For most people, dreaming is purely a 'mental' activity: dreams occur in the mind while the body is at rest. 

But people who suffer from REM behavior disorder (RBD) act out their dreams. 

They physically move limbs or even get up and engage in activities associated with waking. Some engage in sleep talking, shouting, screaming, hittting or punching. 

Some even jump out of bed while sleeping.

RBD is usually noticed when it causes danger to the sleeping person, their bed partner, or others they encounter.

People with RBD move around during the rapid eye movement period of sleep, when most dreaming occurs but the body's muscles are usually paralysed by the brain stem.

Those with the condition are believed to have a malfunction in their brain-stem which allows them to move around during REM sleep, and therefore act out their dreams.

RBD is not curable, but it can be treated with high doses of the sleep aid or low doses of the anti-anxiety drug clonazepam.

 Source: National Sleep Foundation

It is a different condition from sleepwalking, Professor Howell explained, as sleepwalkers are confused when they wake up.

It is normally easy to awaken someone with RBD, and they will recall clear details of the vivid dream.

RBD affects 0.5 per cent of the population or 35 million people worldwide.

While it is incurable, it can be managed with high doses of the sleep hormone melatonin or low doses of the anti-anxiety drug clonazepam.

As part of the study, Professor Howell and his colleagues reviewed 500 studies published between 1986 and 2014 that explored the link between RBD and Parkinson's.

They found between 81 and 91 per cent of patients with RBD developed a degenerative brain disorder during their lifetimes.

Parkinson's disease, a condition in which part of the brain becomes progressively damaged, is characterised by a tremor, slow movement and stiff and inflexible muscles.

It is caused by the breakdown of certain proteins in the brain cells that produce dopamine, a chemical that produces pleasurable feelings in response to rewarding activities.

It could be that RBD results from the early stages of the breakdown of the proteins in the brain cells, meaning it could be a useful warning sign of Parkinson's disease, Professor Howell said.

However, not everyone who develops Parkinson's will have RBD first.

Nevertheless, the findings could help doctors find a way to catch Parkinson's early and treat Parkinson's disease while it is in its early stages, Professor Howell added.

The condition is not curable, but it can be managed with drugs.

An experimental therapy called deep brain simulation has shown promise in some patients.

The study was published in the journal JAMA Neurology.

Parkinson's disease is caused by the breakdown of proteins in brain cells, meaning that part of the brain cannot work (pictured in red). RBD could be an early warning sign of Parkinson's disease, researchers said

Read more: http://www.dailymail.co.uk/health/article-3041679/Do-kick-punch-sleep-early-sign-Parkinson-s-disease-People-thrash-bed-likely-develop-condition.html#ixzz3Xao4WH00

http://health.einnews.com/article/260415534/NnE0vgPSOVuGAnFt

Scientists uncover how molecule protects brain cells in Parkinson's disease model

 PHILIP LOGRASSO IS A PROFESSOR AT THE FLORIDA CAMPUS OF THE SCRIPPS RESEARCH INSTITUTE.

JUPITER, FL, April 15, 2015 - Scientists from the Florida campus of The Scripps Research Institute (TSRI) have found how a widely known but little-studied enzyme protects brain cells in models of Parkinson's disease.

These findings could provide valuable insight into the development of drug candidates that could protect brain cells in Parkinson's and other neurodegenerative diseases.

The study, published recently online ahead of print by the journal Molecular and Cellular Biology, focuses on the enzyme known as serum glucocorticoid kinase 1 (SGK1). 

"The overexpression of SGK1 provides neuron protection in both cell culture and in animal models," said Philip LoGrasso, a TSRI professor who led the study. "It decreases reactive oxygen species generation and alleviates mitochondrial dysfunction."

Using a neurotoxin animal model of neurodegeneration, the study showed that SGK1 protects brain cells by blocking several pathways involved in neurodegeneration, deactivating other molecules known as JNK, GSK3β and MKK4. 

Increasing SGK1 offers a potential therapeutic strategy because, as the study makes clear, there isn't enough naturally occurring SGK1 to do the job. 

"Even though the levels of naturally occurring SGK1 increases in the cell under stress, it was not enough to promote cell survival in our neurodegeneration model," said Sarah Iqbal, the first author of the study and a member of the LoGrasso lab. "On the other hand, cell survival mechanisms tend to dominate when more SGK1 is added to the neurons."

The LoGrasso lab plans to continue to explore SGK1 as a therapeutic possibility for Parkinson's disease.

###

In addition to LoGrasso and Iqbal, other authors of the study, "Serum-Glucocorticoid-Inducible Kinase 1 Confers Protection in Cell-Based and in In Vivo Neurotoxin Models Via the C-Jun N-Terminal Kinase Signaling Pathway," include Shannon Howard of TSRI. For more information on the study, see http://mcb.asm.org/content/early/2015/03/27/MCB.01510-14.full.pdf

The work was supported by the Department of Defense (grant W81XWH-12-1-0431), the National Institutes of Health (grants U01-NS057153 and GM103825), the Michael J Fox Foundation/23&Me, the Saul and Theresa Esman Foundation and a gift from the McCubbin Family.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

http://world.einnews.com/article/260209172/42VD3FC_IqmH7Zmo

Smartphones tools for analyzing medical data

Smartphones tools for analyzing medical data

FILE - In this April 10, 2015 file photo, the new Samsung Galaxy S6 smartphone is on display at a Best Buy electronics store in San Francisco. Galaxy S6 phones proved durable in the face of drops and other pressures, according to SquareTrade, a provider of extended-protection plans for gadgets. In SquareTrade’s tests, which use robots to throw and drop various phones to ensure consistency, the S6 phones had great water resistance, even though it doesn’t officially have those capabilities as last year’s Galaxy S5 did. (AP Photo/Eric Risberg)

Posted: Thursday, April 16, 2015 12:00 am | Updated: 2:16 am, Thu Apr 16, 2015.

By BRANDON BAILEY AP Technology Write

SAN FRANCISCO — Your smartphone could be a valuable tool for medical research — and for treating a variety of ailments.

IBM wants to use the power of its Watson computing system — which famously won TV's "Jeopardy" a few years back — to analyze mountains of data collected from individuals who use health-related smartphone apps, fitness bands and other gadgets. A new IBM business will provide Internet computing services for health-care companies and researchers to collect and analyze that data, along with information from patient treatment records and research trials.

By combining all that data, and then searching for trends and patterns, IBM believes researchers could gain new insights into treatment and prevention. The company promises the information will be "anonymized" to protect individuals' privacy and used only with their consent.

IBM is also working with other companies to use Watson's analytical prowess in new health services. Johnson & Johnson is developing "intelligent coaching" apps for patients recovering from surgery. Medtronic is creating programs to help diabetics monitor glucose and adjust their insulin treatment. Apple will let researchers use IBM's platform to analyze data from health apps on iPhones.

Apple already has software tools called HealthKit to help individuals track fitness and health data on their iPhones. This week, Apple launched ResearchKit for scientists to create more specialized apps for medical studies. ResearchKit had been limited to five pilot groups until now. Some of those apps gather data from iPhone sensors like the microphone, which can measure voice tremors caused by Parkinson's Disease, and the accelerometer, which can measure changes in a walker's gait. Apple says 60,000 iPhone owners have already downloaded those apps and enrolled in medical studies.

Apple also announced that its annual developers conference will be held June 8 to 12 in San Francisco. That's when Apple typically previews the next versions of its Mac and iOS mobile systems.

http://www.messenger-inquirer.com/features/health/smartphones-tools-for-analyzing-medical-data/article_0f5d8741-d440-5f81-bd61-20b71f1b6210.html

Music as Medicine for the Mind

FoxFeed Blog

Posted by  Rachel Dolhun, MD, April 15, 2015

Music is powerful — it moves us physically and emotionally, often transporting us back to a previous place and time. A foot will start to tap along to a beat or tears begin to well up in response to a touching melody. Far from just stimulating memories surrounding a song, though, many believe music can actually help to preserve and even enhance cognitive function.

Rhythm of Music and Mind 

File this away for small talk or to use as a retort when someone declines your invitation to dance because they “have no rhythm.” Every person — or at least every brain — does have rhythm. This pattern changes depending on the state of activity: increasing when you’re alert and focused and slowing when you’re sleepy.

In certain diseases, like Parkinson’s, the brain rhythm in the circuit controlling movement gets off track. Specific treatments work to restore normal rhythm: deep brain stimulation delivers electrical stimulations and a new device breaks a freezing episode by playing a rhythmic clicking in the ear.

Knowing we all have this inherent rhythm and that we all respond to music somehow, researchers have investigated the brain changes that occur when listening to and playing music. The emotional experience of hearing music can increase the release of dopamine — the brain chemical lacking in Parkinson’s disease. People with musical training have better memory, executive function (planning, problem solving, organizing, etc) and visuospatial perception (ability to determine the relationship of objects in space). While playing music, multiple different areas of the brain are activated and in the long run, this leads to an increase in the volume and activity of the corpus callosum — the bridge that allows communication between the two sides of the brain.

Can Music Mend the Mind? 

What if you have no musical background or ability to carry a tune? What if dementia or Parkinson’s disease has already caused cognitive changes or movement difficulties? Can music help?

According to members of the 5^th Dementia — an unconventional group of musicians whose only requirements for participation include an interest in music and a diagnosis of Parkinson’s or dementia — that answer is a resounding yes. Their twice-weekly jam sessions have brought about a remarkable transformation in each individual involved. Through the universal language of music, those who have trouble recalling a daily schedule or holding a conversation are able to communicate in a different manner, express their emotions and connect with others on a deeper level.

Irwin Rosenstein, who plays keyboard for the group, describes the music as giving him a purpose so that Parkinson’s and dementia don’t define him. He and his wife Carol founded the 5^th Dementia and its parent organization, Music Mends Minds in 2014. Regarding the changes she’s seen in Irwin since then, Carol says “I think he’s much more alert. He’s much more interesting. His cognition has improved… We really were losing a connection, and he was really slipping away. And I can really say that he’s — he’s back again.”

Playing Music Is “a Full Body Workout for the Brain”

Playing music is a complicated undertaking that engages multiple areas of the brain simultaneously. In essence, it’s the definition of multitasking. Translating black and white symbols into pleasing sounds requires:

-          fine motor movements and an intact sensory system to manipulate an instrument,

-          immediate processing of visual and auditory elements of a melody, 

-          mathematical precision and internal rhythm to keep tempo, 

-          emotional interpretation of the sound, and

-          coordination with other performers.  

Playing music exercises the mind and body. It provides a route for social interaction. In drawing someone into its rhythm, it can calm a resting tremor, break a freezing spell and bring gait into a more normal pattern. Music can boost memory, lessen depression, and improve the volume and tone of speech. It’s no wonder some say music is magical.

Make Your Own Music 

You don’t have to have any musical training or talent to participate in music therapy. The leader of 5^thDementia says there are “no wrong notes” and their website states that the only possible side effect is “happy memories.” Although the 5^th Dementia is based in Los Angeles, music therapy is widely available. You can find a music therapist in your area through an online search or talk with your doctor or support group for other recommendations. If no opportunities for formal participation in a band are available, consider singing in the church choir, reaching out to a local music school or picking up your own instrument at home.

How deep-brain stimulation reshapes neural circuits in Parkinson's disease

In the new research, during surgery to implant a permanent DBS device (green with yellow tip) deep in the brains of Parkinson's disease patients, six recording electrodes (red) were temporarily placed on the surface of the brain. Credit: C. de Hemptinne UC San Francisco scientists have discovered a possible mechanism for how deep-brain stimulation (DBS), a widely used treatment for movement disorders, exerts its therapeutic effects. Few medical treatments show results as rapid and dramatic as those seen with DBS, in which surgically implanted devices deliver electrical pulses to inner brain structures involved in movement. In most Parkinson's disease (PD) patients who receive the treatment, symptoms of slow movement, tremor, and rigidity sharply diminish soon after the stimulation device is activated, and quickly return if the device is turned off. But surprisingly, there has been very little understanding of precisely why and how DBS works so well—a lack of knowledge that has held back efforts to further improve the therapy. Despite the great success of DBS, some significant problems remain. Customizing the stimulation delivered by DBS devices for each patient to maximally reduce symptoms is challenging and time-consuming. And a minority of patients never obtains the full benefit their physicians expect. With a better understanding of how DBS acts on brain circuits, researchers hope to address these shortcomings and make DBS an even more effective treatment. The new research, published online April 13, 2015 in Nature Neuroscience, reveals that DBS keeps PD symptoms in check by reducing excessive synchronization of brain activity in the motor cortex, a region on the outer surface of the brain that governs movements of the body. "This therapy is becoming widespread for many brain disorders aside from movement disorders, including psychiatric conditions such as depression, but no one knows how it works," said UCSF's Philip Starr, MD, PhD, the Dolores Cakebread Chair in Neurological Surgery and senior author of the new study. "This is a significant step in answering this question on the level of brain networks, not just addressing where you're actually applying the stimulation in the brain." Previous research led by Coralie de Hemptinne, PhD, a postdoctoral fellow in Starr's laboratory, laid the groundwork for the new study. In 2013, de Hemptinne, Starr, and colleagues reported in the Proceedings of the National Academy of Sciences that a measure of synchronized rhythmic activity in the brain, which normally varies with movement or other behaviors, is excessively high in in the cortex in PD. In that paper, the team hypothesized that this lockstep synchronization of brain circuits in PD thwarts the flexibility the brain requires to plan and execute movements, and that DBS might work by decoupling activity patterns in the motor cortex. In the new work, "since we had found this excessive synchrony in PD patients, we decided to see if there's a relationship between that synchrony and symptoms, and whether synchrony is lessened when symptoms are improved by DBS," said de Hemptinne, first author of the Nature Neuroscience paper. "We measured synchrony in the motor area of the brain before, during, and after DBS, and while the patient was resting or engaged in a movement task in which they had to reach and touch a computer screen." During surgery on 23 patients with Parkinson's disease in whom permanent DBS electrodes were being surgically implanted, the UCSF team slid a temporary strip of 6 recording electrodes under the skull and placed it over the motor cortex. As in the prior research, recordings of neural activity showed excessive synchronization of activity rhythms in the patients. As the name of the therapy implies, the end of the stimulating lead of DBS devices is placed in a structure deep in the brain known as the subthalamic nucleus (STN), which is part of a "loop" of neural circuitry that includes the motor cortex on the brain's surface. When the DBS device was activated and began stimulating the STN, the effect of the stimulation reached the motor cortex, where over-synchronization rapidly diminished. If the device was turned off, excessive synchrony re-emerged, more gradually in some patients than others. DBS surgery generally takes about six hours, and during the middle of the procedure patients are awakened for testing of the device and to ensure that the stimulating lead is properly placed in the STN. During this period the researchers asked 12 of the patients to perform a reaching task in which they had to touch a blue dot appearing on a computer screen. Importantly, said Starr, recordings revealed that DBS eliminated excessive synchrony of motor cortex activity and facilitated movement without altering normal changes in brain activity that accompany movements. "Our 2013 paper showed how Parkinson's disease affects the motor cortex, and this paper shows how DBS affects the motor cortex," said Starr. "With these two pieces of information in hand, we can begin to think of news ways for stimulators to be automatically controlled by brain activity, which is the next innovation in the treatment of movement disorders." Because in these experiments the recording strip had to be removed before the end of surgery, recording data was collected over a relatively short time. To broaden opportunities for research, Starr and his team have collaborated with medical device company Medtronic on a new generation of permanently implantable DBS devices that can record activity in the motor cortex while delivering stimulation to the STN. Five UCSF patients have received with these new devices, and all data they collect can be uploaded for research during follow-up visits, de Hemptinne said, which will bring an even deeper understanding of how DBS reshapes brain activity. "Now we can try to find even better correlations between DBS and symptoms, and we can even look at the effects of medications," said de Hemptinne. "This new ability to collect data over a longer time course will be very powerful in driving new research." More information: Nature Neuroscience, DOI: 10.1038/nn.3997 Journal reference: Nature Neuroscience Proceedings of the National Academy of Sciences Provided by University of California, San Francisco http://health.einnews.com/article/259844256/zhlH1IpWvlWEuAAu

Acting Out Your Dreams Might Be An Early Sign Of Parkinson's Disease

By: Tanya Lewis
Published: April 13, 2015 03:05pm ET

A rare sleep disorder that makes people act out their dreams may be an early warning of a deadly neurological illness, a new review of previous research suggests.

About half of people who have a condition known as rapid eye movement sleep behavior disorder will develop Parkinson's disease or a related disorder within a decade of being diagnosed with RBD.

Eventually, nearly everyone with RBD will ultimately develop a neurological disorder, the study found. [Top 10 Spooky Sleep Disorders]

"If you get this disorder and live long enough, you will almost certainly get Parkinson's disease or a condition similar to it — it's an early warning sign," said Dr. Michael Howell, a professor of neurology at the University of Minnesota in Minneapolis and co-author of the study, published today (April 13) in the journal JAMA Neurology.

The main symptom of RBD is moving around during the rapid eye movement (REM) period of sleep, when most dreaming occurs and the muscles are usually paralyzed by the brain stem. People with RBD are thought to have a brain-stem malfunction that allows them to move during REM sleep, and thus act out their dreams, according to the study.

People with RBD describe having vivid dreams, and their enactments range from small hand movements to violent actions such as punching, kicking or leaping out of bed. The disorder poses a risk of injury to the patient or their bed partner, Howell said. Scientists first described the disorder in the 1980s. It is distinct from sleepwalking, and affects about 0.5 percent of the population, or 35 million people worldwide, he said.

To find out whether RBD was, in fact, an early sign of Parkinson's disease and similar brain disorders, Howell and his colleagues sifted through more than 500 studies on the subject published between 1986 and 2014.

Strikingly, they found that between 81 and 90 percent of patients with RBD developed a degenerative brain disorder during their lifetimes, the studies showed.

Parkinson's disease is caused by the breakdown of certain proteins, called alpha-synuclein proteins, in neurons in the brain that produce dopamine, a chemical that produces pleasurable feelings in response to rewarding activities. It could be that RBD results from the early stages of alpha-synuclein breakdown in the brain, so it could be a useful warning sign of Parkinson's, Howell said. Not everyone who develops Parkinson's disease will have RBD first, however.

The findings could help doctors find a way to treat Parkinson's while it's still in its early stages, Howell said.

RBD is not curable, but it can be treated with high doses of the sleep aid melatonin or low doses of the anti-anxiety drug clonazepam. Patients with RBD should also take steps to prevent possible sources of injury.

"It's very important to make the bedroom environment [as] safe as possible" by removing objects that can be picked up or used as a weapon, such as guns, Howell said.

Parkinson's disease is not curable, either, but it can be managed with drugs. In addition, an experimental therapy known as deep-brain stimulation has shown promise in some patients.

Follow Tanya Lewis on Twitter. Follow us @livescience, Facebook & Google+. Original article on Live Science.

Copyright 2015 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. 

10 exercise tips for people with Parkinson's

Friday April 10, 2015

My name is Karl Robb and I am delighted to be guest blogging for NWPF for Parkinson’s Awareness Month! I hope that you enjoy it!

One point that I like to emphasize in my lectures is that Parkinson’s disease is an unconventional illness that probably requires an unconventional solution. Keep in mind that you most likely didn’t get this illness overnight, so getting better may take time as well. 

If you enjoy exercise, I congratulate you on achieving this point. I am very happy for you. If you have Parkinson’s and enjoy exercising, I am jealous. As a former avid skier and tennis player, the will remains but the execution has dwindled. Exercise works best for those who are disciplined enough to make exercise a daily ritual. Keeping motivated and inspired is sure to help physical and mental fitness on many levels. Here are 10 suggestions to consider for starting or maintaining a fitness plan in your life: Keep in mind that this is strictly my opinion and I am not a medical expert.

10. Set reasonable and attainable goals that you can work up to and achieve. Set new goals once you have met the previous mark.

9. If you don’t like exercise, you may not stick with it—but exercise can be fun. Find one or more exercises that you will try to do on a routine basis.

8. Vacuuming, playing video games, dancing, walking, playing ping pong and jumping rope are not always labeled as exercise but they can all be great ways to have fun, will keep your interest, and get your blood pumping all in one.

7. Depending upon your needs, there is help available through books, videos, and classes. David Zid’s Delay The Disease book and video as well as John Argue’s The Art of Moving (book and video) may be just what you are looking for as a home routine.

6. Exercise works best when the mind, body, and spirit are all working in unison. Be sure to keep an open mind to yoga, Qi Gong, and Tai Chi.

5. Don’t put your health at risk to get exercise. Talk to your doctor about your exercise regimen. Be careful to not sustain an injury, as that will be a setback to your progress.

4. Sleep, diet, and stress reduction are every bit as important to exercise to your health. Finding ways to relax through music, massage, reiki, yoga, and meditation can be very helpful.

3. Knowing your body and your limits will dictate where you start and how fast to move forward.

2. Remember to exercise the whole body and not just the physical part. Working the mind everyday with puzzles, brain games, brain teasers, and crosswords might just be a helpful addition to your workout.

1. Don’t forget to breathe, laugh, and smile. Learn relaxation techniques and reduce the role of stress in your life with small changes.

Karl Robb has had Parkinson’s for over 30 years and is the author of the Amazon bestselling book, A Soft Voice in a Noisy World: A Guide to Dealing and Healing with Parkinson’s Disease. Karl’s blog is at www.ASoftVoice.com and his Twitter is @asoftvoicepd.

Karl Robb
NWPF Guest Blogger

Ageing Singapore sees more cases of Parkinson's disease

Salma KhalikThe Straits TimesMonday, Apr 13, 2015

Mr Lawrence Yong, 53, was buying lunch when he had difficulty taking money out of his wallet.

The muscles in his right arm had stiffened suddenly and he could not move it.

The hawker shot him a dirty look.

"It was like he thought I had ordered the food but didn't want to pay," Mr Yong recalled.

This sudden freezing of muscles is a symptom of Parkinson's disease, which he has had for about 12 years.

He also gets the more common symptom of tremors in his right hand and arm, which get worse when he is under stress, causing him to quit his engineering job two years ago.

He is on four types of medication, which he has to take three times a day. A two-hour delay would bring on intense tremors.

The disease is caused by degeneration in the brain that interferes with motor transmission signals.

Over time, it results in trembling in the hands, arms, legs and face, stiffness of the limbs and body, slow movement and poor balance and coordination.

Patients in severe cases have difficulty swallowing, chewing and speaking, and may also have urinary problems, constipation and disrupted sleep.

Dementia is also more prevalent among such patients.

At the cremation service of former Prime Minister Lee Kuan Yew on March 29, his daughter Dr Lee Wei Ling revealed that he had Parkinson's disease during the last three years.

Mr Lee died on March 23 at the age of 91, after being ill with severe pneumonia. He had been warded at the Singapore General Hospital (SGH) since Feb 5.

The Republic's ageing population has seen a rise in the number of people with Parkinson's disease, and this group is likely to grow as it is the most common neurodegenerative disease among the elderly.

The Parkinson Society Singapore says there are 6,000 to 8,000 people with the disease here.

Associate Professor Louis Tan of the National Neuroscience Institute (NNI) said it usually takes more than 12 years for a patient to progress to the severe stage of the illness. Most patients are over 60 years old, though it can affect those as young as 40.

"Unfortunately, to date, there are no proven therapies that can help prevent the disease from happening or progressing," he said.

But there are medications that can counter the effects of the disease.

Dr K. Puvanendran, a neurologist who practised for more than 40 years at SGH before moving to private practice, said the effectiveness of the medications could wane after four to five years, and the disease could then progress very rapidly.

Despite taking medication, Mr Leong Piew Seng, 65, went from not being able to write properly to using a wheelchair in just five years. Now, he also has incontinence and difficulty swallowing.

Dr John Thomas, a neurosurgeon at Mount Elizabeth Novena Hospital and a visiting consultant at SGH, said surgery could bring about immediate improvement that could last for several years.

In Europe, many opt for this in the earlier stages of the disease, when greater physical changes occur, such as a shuffling gait and lack of balance, and the risk of falls increases, he said.

Said Prof Tan: "Surgery is a proven effective means of improving the symptoms and movement of patients with Parkinson's disease. However, we recommend surgery only when medical therapies are not able to sufficiently control the patient's condition."

NNI's medical director Associate Professor Ng Wai Hoe noted that only patients who remain responsive to the medication L-Dopa will benefit, with more than nine in 10 showing improvement following surgery.

The improvement can be quite dramatic - from a patient having difficulty walking and poor balance, to walking like a normal person.

Prof Ng added that surgery is safe and the benefits long-lasting, but its effectiveness will decline as the disease progresses.

Deep brain stimulation (DBS) surgery involves putting two electrodes into the brain to help regulate the signals. The electrodes are attached by wire to a battery set in the patient's chest.

It is expensive and can cost $90,000 or more in private practice. A basic battery lasts about five years and replacing it costs $25,000. The implant alone costs $36,000.

Prof Ng said the NNI does about one such operation a month, adding: "All patients who have been referred to us for DBS and are suitable for surgery have never been denied subsidy."

salma@sph.com.sg

This article was first published on April 12, 2015.
Get a copy of The Straits Times or go to straitstimes.com for more stories.

- See more at: http://news.asiaone.com/news/singapore/ageing-singapore-sees-more-cases-parkinsons-

disease#sthash.fQvTvree.dpuf

THIS VIDEO COULD SAVE YOUR LIFE!! w/ Jeff Rehman Fire fighter/Paramedic

PLEASE WATCH, WITH PARKINSON'S DISEASE WE CHOKE EASILY

THIS CAN POSSIBLY SAVE YOUR LIFE. 

TURN VOLUME ON.

Can REM disorder increase chances of Parkinson's?

DR. ROBERT ROSENBERG DR. ROBERT ROSENBERG Courier Columnist Dear Dr. Rosenberg, I am a 50-year-old man diagnosed with REM Behavior Disorder. I have been told by my doctors that people with my disorder can develop diseases like Parkinson's. How frequent is this? A: REM Behavior Disorder is a disease where those afflicted paradoxically move while dreaming. The dreams are frequently violent and can result in self-injury or injury to one's bed partner. It is estimated that 65 percent of those with the disorder will go on to develop a neurodegenerative disorder, most often of the Parkinson's type. These include Parkinson's, Dementia with Lewy bodies, and Multisystem Atrophy. The lag time from diagnosis of REM Behavior Disorder until the development of one of these disorders averages ten to twenty years. Dear Dr. Rosenberg, I am 70 years old and while a great student when I was younger, I am now having trouble learning new things. I have been taking some online finance classes and find it much harder to retain things. I do not sleep well. Could this have anything to do with it? A: Great question. There has been some recent work done by researchers at the National Institutes of Health that point to this problem as we age. It would appear that delta (deep) sleep is very important for memory. As we get older, we progressively have less delta sleep and more of the lighter stages of sleep. This may be one reason that it becomes more difficult to retain new information with advancing years. Researchers are working on ways to increase deep sleep with aging. In the future, this may no longer be a problem. Dear Dr. Rosenberg, I am on Medicare and was diagnosed with sleep apnea. I want to try one of those oral appliances. I understand that they are now approved by Medicare. Can I just go to a dentist and get one made? A: Not exactly. First, you have to find out how severe your sleep apnea is. If it is mild to moderate, you can proceed to the dentist but you will need a referral from a physician. If your sleep apnea is severe, then you must first demonstrate intolerance to CPAP (Continuous Positive Airway Pressure) before you can qualify for an oral appliance. I hope this helps. Dear Dr. Rosenberg, Is it true that sleep apnea can cause damage to the heart? My husband snores like a freight train and recently his doctor told him his heart was thickened and enlarged. He does not have high blood pressure. A: The stress put on the heart by sleep apnea can negatively affect the heart muscle. During the apneas, the heart has to work much harder than normal to keep blood pumping. As a result, the muscle can become thickened and stiffer than normal. If untreated, this can result in heart failure. I would urge you and your husband to discuss his snoring with your cardiologist or primary care giver. Dr. Robert Rosenberg, board-certified sleep medicine specialist, will answer readers' questions by incorporating them in future columns. Contact him through the form at www.answersforsleep.com or via mail at the Sleep Disorders Center of Prescott Valley, 3259 N. Windsong Drive, Prescott Valley, AZ 86314.http://health.einnews.com/article/259680739/iUumr0z8h7O1JmY_