Choosing a Rehab Facility

August 26, 2018   By FBN

By Richard Holt, D.O. 

You or one of your family members are in the hospital following an injury, illness or surgery and the physician or surgeon says it’s time to leave the hospital but rehabilitation or additional care is needed before going home. Some conditions that may require short- or long-term care at a rehabilitation facility include stroke; disabling diseases such as Parkinson’s disease or multiple sclerosis; brain and spinal cord injuries; orthopedic injuries or surgery; amputation; ventilator and breathing support; post-surgery recovery; acute illness and infection; and general wound care.  

Depending on resources, facility options, and the extent and length of rehabilitation and care needed, most people will either go to a skilled nursing facility that provides rehabilitation services or a long-term or short-term rehabilitation hospital.  

Staff at these specialized care centers may include nurses; physical, occupational and speech therapists; social workers; dietitians; a physician medical director; and other specialized medical staff as needed. 

Differences Between a Hospital, Skilled Nursing Facility or Acute Inpatient Rehabilitation Hospital 

What is the difference between a hospital, acute (short-term) rehabilitation hospital, long-term rehabilitation hospital and a skilled nursing facility? The differences have to do with the level of care provided, the length of care needed and the type of injury, illness or diagnosis of the patient. Here is some information on each type of care facility listed above: 

Acute-Care Hospitals provide constant, short-term treatment for a severe injury, an episode of illness or urgent medical condition. The patient is under the direct care of a physician. Most acute-care hospitals perform surgery and therefore provide short-term (days) post-surgery care. In medical terms, care for acute health conditions is the opposite of long-term care or care for chronic (ongoing) conditions. Length of stay is typically days, but may be longer depending on patient needs. 

Skilled Nursing Facilities (SNF) provide both short-term and long-term care for the elderly and/or those who have an illness or injury who require daily medical care, help with routine tasks, supervision and assistance. When around-the-clock care is required, a SNF may be the best option. Traditionally, the patient’s care is overseen by a physician, but a physician does not see the patient on a daily basis, as is the case in a hospital. SNFs provide physical, occupational and speech therapy, as well as nursing care. Medicare reports the average length of stay is 41 days.  

Short-Term Acute Inpatient Rehabilitation Hospitals can help speed the recovery process following surgery (most often an orthopedic surgery such as joint replacement or spine repair) or an extended hospital stay. Short-term rehabilitation focuses on rebuilding strength, retraining muscles, regaining speech and rewiring the brain. Treatment plans are individualized and most patients participate in two to three hours of physical and occupational therapy a day. Medicare reports the average length of stay is 12 days.  

Rehabilitation in Northern Arizona 

The highest quality rehabilitation care is available right here in Northern Arizona – no need to leave home. The newly opened Rehabilitation Hospital of Northern Arizona located on McMillian Mesa is the only rehabilitation hospital in the region, serving all of Northern Arizona. The 40-bed rehabilitation hospital provides intensive rehabilitation services to people recovering from disabling diseases or injuries, such as strokes, brain, spinal cord and orthopedic injuries. For more information, visit rhna.ernesthealth.com or call 928-774-7070. Follow on Facebook at Rehabilitation Hospital of Northern Arizona. 

By Richard Holt, D.O. 

Richard Holt, D.O., is the medical director at the Rehabilitation Hospital of Northern Arizona. Dr. Holt specializes in helping patients recover from injury or disease and live the highest quality of life possible. 

http://www.flagstaffbusinessnews.com/choosing-a-rehab-facility/

Brain-Wave Patterns Distinguish Parkinson’s Subtypes

August 27, 2018

Deep-brain stimulation can improve symptoms of Parkinson’s disease, but it does not work for all patients. Now, a paper in the August 21 Proceedings of the National Academy of Sciences suggests that characteristic brain waves set subtypes of PD apart, and might help clinicians improve DBS. Scientists led by Nuri Ince, University of Houston, found different oscillation patterns in the subthalamic nucleus (STN) in people with tremor-dominant PD, compared with patients with mostly postural instability and gait difficulty. “We think we can use these features to personalize DBS treatments,” said first author Ilknur Telkes. “In doing so we might increase the efficacy of DBS, especially in those who receive suboptimal benefit.”

Warren Grill, Duke University, Durham, North Carolina, agreed. “It was not known before that oscillatory patterns differ across symptom profiles or types of PD,” he told Alzforum. “I was really excited by the finding because I think it has important implications for future developments in DBS.” Grill was not involved in the study.  

Telkes and colleagues analyzed recordings taken from microelectrodes used to guide DBS surgery. During the procedure, surgeons record activity at different depths of the brain to find an optimal place to implant electrodes. Telkes analyzed recordings taken from 24 patients, trying to find tell-tale differences.

Patients fell into two main groups based on their oscillation patterns. One group of 13 was made up of tremor-dominant (TD) patients, while the other 11 patients had primarily postural instability and gait difficulty (PIGD). In the TD patients, microelectrodes picked up a high-frequency oscillation of 200 to 260 Hz in the top 2 mm of the STN. The amplitude of that oscillation coupled strongly with the phase of the beta oscillation, which is typically in the 13–30 Hz range. Both TD and PIGD groups had faster high-frequency oscillations of 260–400 Hz at greater depths, between 2 mm and 5 mm, but these oscillations were more strongly coupled to the beta oscillations in the PIGD group 

Strong Coupling, Different Areas. 

In the upper substantia nigra (top panels), high-frequency oscillations coupled with beta oscillations (color bar shows strength) in TD patients (left) but not in PIGD patients (right). The opposite pattern emerged in the lower STN.  [Courtesy of Telkes et al., 2018.]

Studies of other populations will be needed to confirm these findings, Telkes said. It’s not clear yet whether these data will be helpful for DBS, but they suggest that taking a patient’s symptom profile into account could help surgeons place DBS electrodes and optimally stimulate the brain, said Grill. Perhaps placing electrodes higher up in the STN in TD-PD might disrupt high frequency/beta coupling there, while placing electrodes deeper in PIGD patients would be better. Previous studies found that when levodopa and DBS disrupted coupling in the subthalamic nucleus, PD symptoms improved (López-Azcárate et al., 2010). 

However, Maya Katz, University of California, San Francisco, cautioned that people with PD can fluctuate from year to year between TD and PIGD subtypes (Simuni et al., 2016). “It would be very difficult to target DBS on a biomarker that is changing as the disease progresses,” she told Alzforum. Finding the abnormal oscillations to target in DBS is important, she said, but she believes researchers should aim for something more stable.—Gwyneth Dickey Zakaib

References

Paper Citations

1. López-Azcárate J, Tainta M, Rodríguez-Oroz MC, Valencia M, González R, Guridi J, Iriarte J, Obeso JA, Artieda J, Alegre M. Coupling between beta and high-frequency activity in the human subthalamic nucleus may be a pathophysiological mechanism in Parkinson's disease. J Neurosci. 2010 May 12;30(19):6667-77. PubMed.
2. Simuni T, Caspell-Garcia C, Coffey C, Lasch S, Tanner C, Marek K, PPMI Investigators. How stable are Parkinson's disease subtypes in de novo patients: Analysis of the PPMI cohort?. Parkinsonism Relat Disord. 2016 Jul;28:62-7. Epub 2016 Apr 23 PubMed.

https://www.alzforum.org/news/research-news/brain-wave-patterns-distinguish-parkinsons-subtypes

New Purification Method May Improve Stem Cell Replacement Therapy for Parkinson’s

 AUGUST 28, 2018 BY ALICE MELÃO 

A new process to select and purify stem cells that hold therapeutic potential to replace dopamine-producing neurons may hasten clinical development of this promising avenue to treat Parkinson’s disease.

Upon being transplanted, these cells promoted dopamine production and reduced the severity of disease-related motor symptoms in an animal model of Parkinson’s disease.

The pre-clinical study with that finding, “Discovery of Novel Cell Surface Markers for Purification of Embryonic Dopamine progenitors for Transplantation in Parkinson’s Disease Animal Models,” was published in Molecular & Cellular Proteomics.

Current standard therapies for Parkinson’s disease focus mainly on restoring dopamine signaling in the brain to reduce the severity of symptoms and improve patients’ quality of life. However, this strategy does not resolve the main mechanism that leads to dopamine reduction — the loss of a specific population of brain cells called dopaminergic neurons.

In recent years the transplant of stem cells (a type of cell that can give rise to almost any cell type in the body) that can replace dopamine-producing neurons has become an attractive therapeutic pathway. But its translation into the clinics has been delayed, in part, due to the difficulty to select and purify stem cells that hold therapeutic potential without contamination of unwanted progenitor cells that could lead to tumors  and other complications.

“Although robust methods have been introduced that produce enough modified cells, uncertainty remains for selecting the right cell types from human pluripotent cells for transplantation,” researchers wrote.

Researchers now have developed a new standardized method that can ease the selection and purification of stem cells that specifically differentiate into dopamine-producing nerve cells, which are those affected in Parkinson’s disease.

The team engineered human stem cells to produce a green florescent protein that could be detected easily, as well as the LMX1A protein, which is an important marker of dopaminergic progenitors during brain cell differentiation.

These stem cells were cultured for 12 days in the laboratory and transformed into the desired mature dopamine-producing neurons. In undifferentiated cells, the fluorescent reporter was not produced.

The team further isolated their cells of interest based on the presence of a surface protein, called contactin 2 (CNTN2), which also is a characteristic marker of dopaminergic brain cell progenitors.

To test their activity, researchers transplanted these purified cells into the brains of rats with Parkinson’s disease, and compared the animals’ outcomes with those transplanted with unpurified stem cell-derived cells, or those left untreated.

Both groups of treated rats showed significant symptom improvement after 10 weeks of receiving the cells. Still, the rats that received CNTN2-enriched cells — produced and isolated using the new method — had a faster motor recovery and better dopamine production.

Researchers believe these results demonstrate that “purity of transplanted cells might be a more critical parameter to achieve recovery of motor abilities compared to the number of transplanted cells.”

Given that, the newly established purification method can be an efficient approach to produce large numbers of human stem cell-derived “dopaminergic progenitors for therapeutic applications,” they added.

https://parkinsonsnewstoday.com/2018/08/28/purification-method-may-boost-stem-cell-replacement-therapy-parkinsons/

Xeomin Eases Tremor Severity, Improves Hand Function in People with Essential Tremor, Phase 2 Trial Shows

AUGUST 28, 2018    BY JOSE MARQUES LOPES, PHD 

Intramuscular treatment with Xeomin (incobotulinumtoxinA) decreases tremor severity and improves hand function in patients with essential tremor of the upper limbs, according to Phase 2 trial results.

Results of the trial, titled “Efficacy and safety of incobotulinumtoxinA for upper-limb essential tremor in a randomised, double-blind, placebo-controlled trial using kinematics-guided clinical decision support,” was presented at the recent 2018 World Congress on Parkinson’s Disease and Related Disorders in Lyon, France.

Essential tremor — often misdiagnosed as Parkinson’s disease — is a progressive movement disorder, found in more people ages 40 and older. It mainly affects the hands and arms, but head, voice, and leg tremors may also occur.

Unlike Parkinson’s, which is associated with motor symptoms such as slow movement and muscle stiffness, essential tremor does not cause other health problems, although unsteady gait may be observed. Also, while patients with Parkinson’s typically experience tremors when their hands are at rest, those with essential tremor have them when using their hands.

Researchers conducted a randomized, double-blind Phase 2 clinical trial (NCT02207946) — sponsored by Merz Pharma, Xeomin’s developer — to evaluate the effectiveness and safety of a single, kinematics (motion)-guided intramuscular injection of Xeomin in adults with moderate to marked essential tremor in their upper limbs. The trial was conducted in the U.S. and Canada.

A total of 30 patients were included — 19 of whom were randomized to receive Xeomin, at a total dose of up to 195 Units, and 11 received a placebo. The participants all got an injection in the wrist, with optional injections into the shoulder and/or elbow. Muscle selection was based on each patient’s patterns of tremor, while doses per muscle were based on a kinematics-guided TremorTek analysis, which uses a combination of wearable movement sensors and computer software.

Differences between Xeomin and placebo were assessed at weeks four and eight for maximum wrist-tremor amplitude and motor performance, measured by the Fahn-Tolosa-Marin (FTM) Part B score. Analyses of tremor severity, with the FTM tremor scale, and grip strength were conducted over 24 weeks.

Treatment with Xeomin induced a trend toward decreased wrist-tremor amplitude, compared with placebo, at week four, and showed a significant improvement at week eight. Persistent anti-tremor effects were seen by motion measurements up to 24 weeks after a single injection of Xeomin.

The data further demonstrated that Xeomin significantly improved motor performance at both the fourth and eighth weeks. Maximum grip strength in the treated arm decreased by 20%, with no notable change in those on placebo. Although two patients receiving Xeomin reported localized finger-muscle weakness, none of the participants discontinued treatment due to muscle weakness.

“Kinematics-guided incobotulinumtoxinA (Xeomin) administration significantly decreased tremor severity and improved hand motor function versus placebo in patients with ET of the upper limb,” the researchers wrote.

Xeomin was recently approved by the U.S. Food and Drug Administration to treat adults with chronic sialorrhea, or excessive drooling, a common condition in Parkinson’s patients. It has also been approved for the treatment of adults with abnormal head position and neck pain due to involuntary contraction of neck muscles, abnormal spasm of the eyelids (blepharospasm) in patients previously treated with Botox (onabotulinumtoxinA), and to reduce muscle stiffness of the upper limbs.

https://parkinsonsnewstoday.com/2018/08/28/xeomin-effective-essential-tremor-patients-phase-2-trial/

Flee or Fight: Which Do You Choose?

AUGUST 27, 2018        BY "SHERRI WOODBRIDGE"

As a young parent, it is often hard to realize how fast time slips away. You’re too busy changing diapers, refilling milk bottles, wiping dirty faces, and running bath water. You’re doing tubs of laundry daily and wiping up spills hourly. You’re consumed with the next activity, whether it be a school baseball game or homework assistance.

Through all of the busyness, you lose sight of the reality this could be one of the “lasts.” The last rocking chair moment. The last bottle feeding while you hold your not-so-little-one-anymore. The last Boy Scout camp out.

As my grandkids grow, there have been times I’ve wondered if it was the last day for opportunities to rock them because they won’t fit on my lap any longer. Will today be the last day for my granddaughter to be excited to see me as she runs into my arms when I pick her up from her preschool? Will today be the last day my grandson will be enamored with a hummingbird and wave “bye-bye” as it flies away? Will this be the last day my youngest grandson tries to roll over because tomorrow he won’t need to try anymore, having another life moment for which he can claim victory?

Sometimes “growing up” in life can bring us down. The important thing for me to remember is it’s dangerous to stay down. When dealing with a chronic disease on a daily basis (constant pain, loss of mobility, confusion, whatever comes with whatever you have), we can easily find ourselves dying in our spirit. We lose the desire to be a part of the fleeting days. We want to “fleet” right along with them. Life is sometimes unbearable.

The fleeting days, the hard days, are partly why I watch my grandkids. Life is so very precious, and tomorrow isn’t promised. We aren’t promised endless opportunities to spend time with those who mean the most to us. We might choke on an olive at supper, and that will be it. We may get another tomorrow, but we don’t know we’ll have energy or strength or a clear mind.

Knowing PD’s path and the road it could choose for me, I may avoid the olive choking incident but still be left with the inability to do much of anything in the years to come with my husband, my kids, and my grandkids.

And so, I must make a choice. In lieu of the pain, loss of movement, lack of energy, strength, and everything else that can come into play with a chronic disease: Do I say forget it and give in to that dying spirit? Or do I endure through the pain, the frustration of losing control of my body and mind, and keep fighting this thing?

I choose to fight.

There may be some reading this today who are not so sure. Some who have been fighting much longer, much harder, than I have. That is what prompted this post. Someone may feel like giving up, like giving in. 

Please don’t. 

If you don’t have the strength to fight emotionally, write me, leave a comment, or message me on Facebook. Something. You are not in this alone. I will fight with you. I will fight for you. I’ve been there in the dark places, and fighting is so much better because even in pain, in the unknown, life is precious. And if we fight together, we may just beat this thing.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

https://parkinsonsnewstoday.com/2018/08/27/parkinsons-disease-forces-choice-between-fleeing-fighting/

Pain May Be Early Detector of Parkinson’s, Study Suggests

AUGUST 27, 2018 BY JOSE MARQUES LOPES, PHD

Patients likely to have prodromal, or early, Parkinson’s disease tend to have a higher prevalence of pain, according to a new study.

The findings indicate that pain may be a relevant disease marker before the appearance of motor disturbances.

The study, “Pain: A marker of prodromal Parkinsons disease?” was presented at the recent 2018 World Congress on Parkinson’s Disease and Related Disorders (IAPRD), held in Lyon, France.

Disease-related changes in patients with Parkinson’s can start decades before the onset of motor symptoms and may include pain, among other non-motor changes.

Researchers at the Bangur Institute of Neurosciences in India conducted a combined hospital and community-based study to evaluate whether pain could be an early clinical marker of future development of Parkinson’s in people with no motor impairment.

The study included a total of 500 individuals (314 men, 186 women) older than 50 from an urban community, who were examined for the prevalence of different types of pain by interviewing patients and relatives, and analyzing medical records.

The likelihood ratio (LR) of prodromal Parkinson’s — according to the research criteria of the Movement Disorder Society — were estimated in these patients divided into two groups: a control group (LR under 80%) and a prodromal, or early, Parkinson’s group (LR above 80%).

Presence of pain was assessed in 95 patients with less than two years of disease duration and who were attending a neurology outpatient department (clinical group). Different pain syndromes were classified according to the U.S. ICD-9-CM system of diagnostic codes (the official system of assigning codes to diagnoses and procedures associated with hospital utilization in the U.S.).

Thirty-two of the 500 individuals (6.4%) had a LR consistent with early Parkinson’s. These patients showed a significantly higher prevalence of pain than the controls — 23 (71.8%) vs. 144 (30.76%), respectively.

Pain prevalence in the clinical group was 63.15%, which was comparable to the prodromal group, researchers observed.

The data also revealed that both the clinical and the prodromal groups had a higher prevalence of cervicalgia (neck pain), shoulder pain, pelvic pain, pain in the thigh joint, backache, and low back pain compared to controls.

Individuals in the clinical and prodromal groups also had more frequent frozen shoulder — characterized by stiffness and pain in the shoulder joint — restless legs syndrome(discomfort in the legs and an irresistible urge to move them), and nocturnal leg cramps.

“This is an indirect evidence that pain can be an important early clinical marker of [Parkinson’s],” the authors wrote.

However, they noted that longitudinal studies are needed to better assess the predictive value of pain in Parkinson’s disease.

https://parkinsonsnewstoday.com/2018/08/27/pain-may-be-early-marker-parkinsons-disease-study-suggests/

At 40, He Found Out He Had Parkinson's Disease and Was Fired. Now He Runs a $3.2 Million Company

August 27, 2018   By Leigh Buchanan

Bill Evans lost his job at a staffing business after a faulty diagnosis. So he started his own company--and landed Comcast as a client.

Early onset Parkinson's disease cost Bill Evans his job in a placement agency and complicated efforts to grow Current Staffing, his basement-based startup. Then a cold call to Comcast landed the first of several blue-chip clients eager to work with a company whose founder is disabled. Here Evans talks about his lucky break, strategies for working around his Parkinson's, and plans to help others with disabilities find employment. --As told to Leigh Buchanan

In 2006, I was working for a staffing business in Connecticut when my hands started to shake. The doctors told me I had familial tremors--a common, benign movement disorder--and put me on medication. The medication caused depression. It slowed me down and interfered with my work.

Two years later, I learned I had been misdiagnosed. It turned out I have Parkinson's disease, which is very unusual in someone as young as 40. I stopped the wrong treatment and started the right one. The depression and slowness went away. But by that time, the damage to my career was done. The economy had crashed. For years, I'd been underperforming at my job. I found myself unemployed.

At my old job, I'd done work for the Pentagon. One of my contacts there had moved to a company in New York. One day, he called me and asked for help with some tough-to-fill tech positions. I found three great people in four weeks. When it came time to pay me, he asked, "What is your corporate tax ID number?" I said, "My what?" That is how my business started.

Current Staffing Solutions founder Bill Evans.CREDIT: Courtesy Bill Evans

At first, I worked out of my basement, targeting companies that publicly state they make accommodations for people with disabilities. I landed a few clients but was barely making ends meet. If my son, who was a fussy eater, didn't want to eat what we'd bought with the week's budget, he didn't eat. No one should have to see that.

In early 2014, I cold-called Comcast and got L. Jay Burks, their manager of supplier diversity. The timing was perfect: Jay was scheduled to become the chairperson of the supply chain track for a nonprofit dedicated to disability inclusion. He wanted to prove that a company headed by someone with a disability could compete. Jay said, "Bill, you have been doing this for 20 years. You have convinced me you know what you're doing. I'm going to change your life. I am going to make you a tier one vendor for Comcast."

If you're a supplier for Comcast, other companies want to work with you. On the strength of that account, I've signed up The Hartford, Exxon Mobil, Center Point Energy, and Bed Bath & Beyond. Last year, I moved out of the basement and into an office.

People with disabilities represent a huge, underutilized pool of talent. So in addition to our specialty in IT staffing, we also help place members of that population. Sometimes I'll assist people even if they're not going to work for one of our clients. For example, I recently persuaded Amazon to remove the timing element from an online test to accommodate a job candidate who has PTSD and finds countdowns stressful.

I'm working on a spinoff business called Operation Able Inclusion that will put people with disabilities and their caretakers to work in call centers. Research shows companies can reduce the normal call center attrition rate by hiring such candidates and letting them work remotely with appropriate accommodation. The business plan won Microsoft's inaugural Infinite Perspective pitch competition. I am also talking to several Fortune 500 companies about building the first help desk where people with disabilities can call and get someone with the same disability to answer disability-related questions.

About half of Current Staffing's own employees have disabilities of some kind. I personally manage my Parkinson's by scheduling meetings for when I take my medication, which minimizes the shaking. I have an assistant, and there are several inexpensive tools that help me work. The speech-recognition software Dragon Naturally Speaking is phenomenal.

I'm a fifth-degree black belt and teach karate here in Southbury, Connecticut. Those lessons helped us survive financially when we were struggling. Now, there's new research showing that exercise can slow the effects of Parkinson's. So the fact I was forced to keep teaching is actually what made it possible for me to work. It's been a blessing in disguise.

When I call people, I have a standard line. I say, "I have Parkinson's disease. That makes it difficult for me to type and tie my shoes. On a positive note it is not painful, and it does not kill you early. Also, the shaking helps me keep my weight under control." That gets a laugh. I have just become a human being to the person I'm speaking to. I am no longer just a salesperson. And that is a big leap forward in the sales world.

https://www.inc.com/magazine/201809/leigh-buchanan/2018-inc5000-current-staffing-solutions.html

Effects of deep brain stimulation in patients with Parkinson's disease

28-Aug-2018

Improved effects on motor function and fewer side effects possible 

 Charité - Universitätsmedizin Berlin

The implantation of DBS electrodes enables researchers to gain insights into the functional roles of both the basal ganglia and their associated nerve tracts (structures and nerve tracts inside the orange circle). Basal ganglia are areas of the brain that are involved in movement and motor control.

Researchers from Charité - Universitätsmedizin Berlin have studied motor and cognitive effects of deep brain stimulation in patients with Parkinson's disease. Their results show that the adverse cognitive effects of deep brain stimulation are linked to a different neural pathway than that responsible for the treatment's desired motor effects. This finding will help optimize treatments for patients with Parkinson's disease. Results from this research have been published in Brain*. 

Deep brain stimulation (DBS) is an effective treatment alternative for Parkinson's disease patients with an inadequate response to drug treatments. DBS targets the subthalamic nucleus, which forms part of the diencephalon, a division of the forebrain. The subthalamic nucleus integrates information from different neurons and is primarily responsible for motor processes, but also plays an important role in cognitive processes, such as decision-making and response modulation.

Researchers from Charité's Department of Neurology on Campus Charité Mitte have studied the effect of DBS on both cognitive and motor pathways. By combining behavioral experiments with brain mapping and computational modeling, the researchers were able to show that effects on motor function - such as improvements in motor control - are mediated by different neural pathways to those responsible for unwanted cognitive effects, such as premature actions in situations involving a decision-making process. 

These findings enhance our understanding of the neuronal networks affected by Parkinson's disease, deliver insights into the pathophysiology of Parkinson's disease, and enable us to draw conclusions regarding the mechanism of action of DBS. "Only an improved understanding of the treatment's mechanism of action will allow us to make deep brain stimulation more effective, thus enabling us to improve the quality of life of patients with Parkinson's disease through a reduction in the side effects of treatment," explains the study's first author, Dr. Wolf-Julian Neumann, a researcher at the Department of Neurology.

As a next step, the researchers from the Movement Disorders Working Group are hoping to use measurements of neural activity to differentiate between disease-specific patterns of neural activity and patterns found in healthy individuals. "This will allow us to adapt brain stimulation treatments according to the needs of the individual patient and in real time. "It is an important step on the way to developing an intelligent, personalized and demand-adapted treatment," says Working Group Leader Prof. Dr. Andrea A. Kühn of the Department of Neurology.

###

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.

https://www.eurekalert.org/pub_releases/2018-08/c-ub-eod082818.php

Sensor array may detect de novo Parkinson's disease in breath

 August 27, 2018

(HealthDay)—A sensor array has the potential to identify de novo Parkinson's disease (PD) patients with high sensitivity, specificity, and accuracy values, according to a research letter published online July 10 in ACS Chemical Neuroscience.

John P.M. Finberg, Ph.D., from the Israel Institute of Technology in Haifa, and colleagues describe a clinical trial that attempted to distinguish between de novo PD and control subjects using an electronic system for detection of volatile molecules in exhaled breath. The association with other common tests for PD diagnostics, including smell, ultrasound, and nonmotor symptoms, was also examined. Data were included for 29 PD patients after initial diagnosis and 19 control subjects.

The researchers found that for the sensor array, the sensitivity, specificity, and accuracy values were 79, 84, and 81 percent, respectively, for detection of PD from controls. This was compared with 93, 90, and 92 percent for midbrain ultrasound, and 62, 89, and 73 percent for smell detection.

"The results confirm previous data showing the potential of sensor arrays to detect PD," the authors write.

More information: Abstract/Full Text (subscription or payment may be required) 

Journal reference: ACS Chemical Neuroscience

https://medicalxpress.com/news/2018-08-sensor-array-de-novo-parkinson.html

Study raises the standard for measuring nerve cell death

August 27, 2018, University of British Columbia

Healthy neurons visualized using fluorescent microscopy. Credit: UBC Okanagan

Researchers at UBC's Okanagan campus have developed a new and improved method to judge the effectiveness of experimental therapies for neurodegeneration—the progressive loss of neurons.

"Neurons—or nerve cells—are hugely important to our daily lives," says post doctoral fellow Aaron Johnstone and study lead author. "These specialized cells collect and process the large amounts of information that enter our bodies via our senses, control our muscles and organs, and form our thoughts and memories. When these cells become unhealthy, it leads to diseases like Alzheimer's and Parkinson's, ALS, glaucoma and chronic pain."

Johnstone says his study uses the first automated test specifically designed for measuring degeneration of sensory neurons grown in a lab.

"The variability in nerve cell lengths, densities and shapes have traditionally made it difficult to reliably analyze their health," says Johnstone. "This, in turn, has generated confusion about the effectiveness of potential pharmacological or genetic treatments."

Using the new approach, which is software-assisted, the research team were able to measure nerve cell densities more accurately.

Post doctoral fellow Aaron Johnstone. Credit: UBC Okanagan

To do this the team grew nerve cells in a lab environment, and after establishing healthy neurons researchers mimicked the conditions that cause neurodegeneration. Neuron loss was then captured using fluorescent microcopy—a process that makes the tiny cells easier to see—and analyzed using a computer algorithm.

Johnstone suggests that objective measurement is essential to the process of developing new medicines.

"This procedure makes evaluating new treatment options, like drugs or gene therapies, far more accurate and trustworthy," Johnstone adds.

The study, published in PLOS ONE was supported by funds from the Canadian Institutes of Health Research and the Health Research Fund of Quebec.

Journal reference: PLoS ONE

Provided by: University of British Columbia 

https://medicalxpress.com/news/2018-08-standard-nerve-cell-death.html