This post is primarily aimed at those of us who do not have PD.

THIS IS A VERY WELL WRITTEN ARTICLE, THAT I READ ON ANOTHER WEBSITE. PETE GAVE ME HIS PERMISSION TO COPY IT SO THAT I MAY SHARE WITH YOU.

I may have a tremor or I may be slow or I may become immobile for a while as though glued to the floor.

But for a person suffering PD that's about all there is - isn't there?

Well, erm no. In fact the one thing that marks a person as suffering PD for most is the tremor or shaking and that is one symptom that I don’t have. There are many problems that remain invisible to those outside my orbit or even to those within it. If I count up the number of signs and symptoms that I have to work around then I get up to 40 and I am nowhere near the total possible

A collection of symptoms commonly experienced by those with PD affect the way we interact with the rest of the world. One of the first may be a "masked face", a deadpan expression that expresses nothing at all. We don't often smile or grin or make any type of meaningful expression without concerted effort. When normally a facial expression conveys so much more than we are aware of. And that deadpan expression may be construed as being rude or disinterested or perhaps lofty.

Most people are aware of body language at least to a small degree but it is not commonly known that the words used in conversation with someone only constitute about 7% of what passes between them. The other 93% is often hidden from direct or conscious awareness. This 93% is body language, tone and volume of voice and one more, odours too may play a part.

With these tools of communication many subtleties are permitted in normal conversation. But what of these tools for the victim of PD?

The first that springs to my mind is the softness, the quiet whispery voice that we develop and quite often we are oblivious to those listening but for them it is really trying. Fatigue and breathlessness can mean that sometimes I run out of breath and am unable to finish a sentence....

One of the first symptoms for many is the loss of a sense of smell - this, though not particularly significant does impoverish our lives and encourages the feeling of distance or remoteness with others as we fail to share the same awareness of our shared environment.

And there's more, we PD people sometimes drool or dribble if you prefer. This is because we do not automatically remove by swallowing an accumulation of saliva until an overload occurs. This is liable to be embarrassing and although not an invisible symptom is not obvious in the same way as a tremor and also helps to mark out a PD person as different.

Cognitive symptoms may arise, for example I sometimes struggle to find the right word and may well settle upon a word that does not convey the meaning quite as I intended. For some this problem gets worse and may be exacerbated by also developing hallucinations.

Some people suffer much worse cognitive difficulties with memory problems and maintaining an attention span long enough to sustain a conversation. Incidence of depression is higher than normal with 40% suffering from “the blues”.

So if I can't communicate effectively with people verbally how about if I write things down? - that's a good idea . . . . well isn't it? Erm no! my handwriting is all but illegible. "But couldn't you use a computer" - ah well yes but not at the counter of my local corner shop. Any other written / typed word has to be very carefully checked because my typing has so many errors included.

After minimal exertion I get so fatigued with a back aching so much in a way that is not so much painful as it is distressing that all I can think of is sitting down so that I can rid myself of this discomfort, this distress that accompanies my fatigue.

With all these problems I'm sure I'm quite hard work to talk to. Hard work to the extent that I wouldn't blame you if you diverted your attention away from me.

One last problem that has an effect on communication in only a minor way is my vision. Which tends to be a little blurry and most of the time I am unable to automatically keep both eyes converged upon any object that I am looking at. This means I have double vision and I walk around seeing two of everything. This effects communication because it is a distraction for me. It is something I have to work on rather than allowing my brain to automatically see and interpret the world before me. So I am not able to listen to you as well as you might hope.

In summary the list of symptoms that interfere with normal communication are:

1. Expressionless face

2. Whispery quiet voice with little cadence.

3. Loss of sense of smell

4. Drooling

5. Cognitive impediments

6. Illegible handwriting

7. Fatigue

8. Double and blurred vision. And one more

9. Is day time sleepiness and insomnia at night.

So when you are telling me a really exciting story well I'm sorry but I may just want to drift off to sleep now.

Add to these the ever present distraction of all activities made more difficult and a general feeling of malaise such that much of our energy is focused on doing things as normally as possible rather than giving you the attention you deserve.

With these symptoms and more, getting more intense over time, the failure to communicate as normal leads eventually to social isolation. Talking to people is just too much effort and in any case we don’t want to burden other people with our communication difficulties, far better to stay at home out of the way --- out of sight out of mind!.

PD World Awareness Day - 11th April 2015

Last edited by Pete-1 - A special Thank you to Pete!!!

Parkinson's Disease Halted By Neurons Derived From Stem Cells Treated With A Stomach Cancer Drug

By News Staff | April 8th 2015 09:41 AM 

Researchers have taken a step toward using the implantation of stem cell-generated neurons as a treatment for Parkinson's disease.

 Parkinson's, which affect as many 10 million people in the world, is linked to a depletion of dopamine-producing neurons in the brain. Current treatments include medications and electrical implants in the brain which cause severe adverse effects over time and fail to prevent disease progression. 

Several studies have indicated that the transplantation of embryonic stem cells improves motor functions in animal models but the procedure has shown to be unsafe, because of the risk of tumors upon transplantation. 

Until now. Using an FDA approved drug for treating stomach cancer, mitomycin C, they were able to pre-treat undifferentiated mouse embryonic stem cells and grow dopamine-producing neurons that remained healthy and functional for as long as 15 months after implantation into mice, restoring motor function without forming tumors in mice modeled for Parkinson's.

The animals were separated in three groups. The first one, the control group, did not receive the stem cell implant. The second one, received the implant of stem cells which were not treated with mitomycin C and the third one received the mitomycin C treated cells.

After the injection of 50,000 untreated stem cells, the animals of the second group showed improvement in motor functions but all of them died between 3 and 7 weeks later. These animals also developed intracerebral tumors. In contrast, animals receiving the treated stem cells showed improvement of Parkinson's symptoms and survived until the end of the observation period of 12 weeks post-transplant with no tumors detected. Four of these mice were monitored for as long as 15 months with no signs of pathology.

They also found that treating the stem cells with mitomycin C induced a four-fold increase in the release of dopamine after in vitro differentiation. 

"This simple strategy of shortly exposing pluripotent stem cells to an anti-cancer drug turned the transplant safer, by eliminating the risk of tumor formation," says study leader Stevens Rehen, Professor at Federal University of Rio de Janeiro and researcher at D'OR Institute for Research and Education. 

The authors are working toward a clinical trial using pluripotent stem cells treated with mitomycin C prior to transplant to treat Parkinson's patients and also other neurodegenerative conditions. 

Citation: Details: M. Acquarone, T. Melo, F. G. Meireles Ferreira, J. Brito-Moreira, G. Oliveira, S. Ferreira, N. Castro, F. Tovar-Moll, J. C. Houzel, S. K. Rehen. Mitomycin-treated undifferentiated embryonic stem cells as a safe and effective therapeutic strategy in a mouse model of Parkinson's disease. Frontiers in Cellular Neuroscience.

http://health.einnews.com/article/259025871/EsMyjNNbEUzS-gxq

Parkinson's Disease and Pesticides: What's the Connection?

Scientists find a way chemicals may contribute to Parkinson’s

April 8, 2014 |By Bret Stetka

The pesticide Parkinson's connection

Thinkstock

What exactly causes Parkinson’s disease is far from figured out. But a clue has been lurking in cornfields for years.
 
The data confirm it: farmers are more prone to Parkinson’s than the general population. And pesticides could be to blame. Over a decade of evidence shows a clear association between pesticide exposure and a higher risk for the second most common neurodegenerative disease, after Alzheimer's. A new study published in Neurology proposes a potential mechanism by which at least some pesticides might contribute to Parkinson’s.
 
Regardless of inciting factors — and there appear to be many — Parkinson’s ultimately claims dopamine-releasing neurons in a small, central arc of brain called the “substantia nigra pars compacta.” The nigra normally supplies dopamine to the neighboring striatum to help coordinate movement. Through a series of complex connections, striatal signals then find their way to the motor cortex and voila, we move. But when nigral neurons die, motor function goes haywire and the classic symptoms set in, including namely tremors, slowed movements, and rigidity.
 
Pesticides first came under suspicion as potentially lethal to the nigra in the early 1980s following a tragic designer drug debacle straight out of Breaking Bad. Patients started showing up at Northern California ERs nearly unresponsive, rigid, and tremoring — in other words, severely Parkinsonian. Savvy detective work by neurologist Dr. William Langston and his colleagues, along with the Santa Clara County police, traced the mysterious outbreak to a rogue chemist and a bad batch. He’d been trying to synthesize a “synthetic heroin” — not the snow cone flavorings he claimed — however a powder sample from his garage lab contained traces of an impurity called MPTP. MPTP, it turned out, ravages dopaminergic neurons in the nigra and causes what looks like advanced Parkinson’s. All of the newly Parkinsonian patients were heroin users who had injected the tainted product. And MPTP, it also turned out, is awfully similar in structure to the widely used herbicide paraquat, leading some neurologists to turn their attention to farms and fields.
 
In 2000, a meta-analysis linked confirmed and presumed pesticide exposure with increased risk of Parkinson’s. Subsequent work supported this connection, including a large 2006 study that followed patients for nine years. The patients exposed to pesticides had a 70% higher incidence of Parkinson’s when the study ended; the risk was the same for exposed farmers and exposed non-farmers, hence some other farm-related factor wasn’t to blame. The study didn’t report on specific toxins, but more recent work out of The Parkinson’s Institute in Sunnyvale, CA, founded by Langston after the MPTP discovery, did. The authors took detailed occupational and exposure histories from farmers and their families. Paraquat upped Parkinson’s risk 2.5-fold. Rotenone was also red-flagged.
 
Pesticides exert their neurotoxicity in a number of ways. Both paraquat and rotenone appear to wither dopaminergic neurons via free radical production. Free radicals are atoms or molecules with an unpaired electron looking for a partner; they do major cellular damage by pilfering electrons from other molecules, impairing their function. Rotenone may also interfere with the normal neuronal clearance of damaged or degraded proteins. Faulty proteins accumulate, derailing various cellular processes.
 
The new study, from a team at UCLA, proposes yet another mechanism by which some pesticides might contribute to Parkinson’s. It might also provide a major lead in understanding the disease. The team had previously found that the fungicide benomyl was associated with increased Parkinson’s risk and damaged the brain by inhibiting an enzyme called ALDH that normally helps metabolize fats, proteins and toxins like alcohol (certain ALDH mutation carriers have to take it easy at the bar). ALDH also detoxifies the dopamine metabolite DOPAL. When the enzyme isn’t working properly, DOPAL builds up in neurons and may explain the loss of dopaminergic neurons in Parkinson’s. This time around the authors tested 26 pesticides, first for their influence on ALDH activity in rat neurons and next for any epidemiologic association with Parkinson’s. Eleven pesticides inhibited ALDH at the concentration tested, eight of which could be included in the study based on available histories from 360 rural Californian patients. All eight were associated with an increased Parkinson’s risk and genetic variation in the ALDH2 subtype of the enzyme increased the risk further in those exposed. The findings not only point to new culprit compounds, but reflect the growing appreciation of Parkinson’s as a multifactorial disease, in many cases due to the collusion of both genetic and environmental factors.
 
At least 10% of Parkinson’cases are now thought to be due primarily to specific gene variants, and estimates suggest that genetics may contribute to upwards of 20% to 50%. Patients with a few specific mutations — common in people of Mediterranean descent — carry a nearly 100% chance of developing the disease. Though, as lead author Dr. Jeff M. Brontstein commented to Scientific American, while a minority of cases might be primarily due to a specific genetic or environmental risk factor, ultimately many if not most cases are likely due to gene-environment interactions. This may explain why there isn’t an epidemic of Parkinson’s in rural areas. Despite the large number of people regularly exposed to pesticides, not everyone has a genetic susceptibility.
 
This gets incredibly complicated when you consider the possibility of multiple genetic and environmental risk factors working together. It's clear that pesticides wreak havoc on the brain through a variety of mechanisms. Hence farmers and others regularly exposed are at risk for a multipronged, possibly cumulative attack. Certain industrial solvents also appear to bump up Parkinson’s vulnerability. Head trauma, in combination with a particular mutation, does too. And diets high in omega-3 fatty acids, found in fish, plant and seed oils, appear to protect against the disease. The laundry list of risk factors and contributors could explain the varied symptoms experienced by Parkinson’s patients. Some present early in life, some late. For many the classic motor symptoms predominate; others present with non-motor findings like sleep disturbances, constipation and depression. No two cases are identical.
 
The confusion isn’t just clinical. Recent evidence positions Parkinson’s as one of a number of related neurodegenerative disorders marked by the accumulation of abnormal proteins in the brain, including Alzheimer’s disease and ALS. They all appear partially genetic, partially environmental and probably in many cases both. Neuronal protein accumulations called Lewy bodies — a pathologic hallmark of Parkinson’s — are also found in the brains of Alzheimer’s patients; PD-afflicted brains often contain the amyloid protein aggregates common to Alzheimer’s. It’s a Venn diagram of neurodegeneration.
 
The new findings further confirm that those whose livelihood relies on repelling pests should pay mind to their increased risk for Parkinson’s, particularly if they have other known risk factors, and take precautions. They can limit exposure and avoid the riskier compounds. They can wear masks, clean up spills and wash up vigorously. Moreover, implicating ALDH in Parkinson’s pathology could represent an important step toward determining a final common pathway on which the various risk factors converge, a potential holy grail for drug development, and ultimately for patients. Rarely are neurologic diseases straight forward, and Parkinson’s has proved no different. But a terribly unfortunate outcome for many in search of heartier, healthier crops may have brought medicine one notch closer to deciphering a frustratingly complex disease.

Are you a scientist who specializes in neuroscience, cognitive science, or psychology? And have you read a recent peer-reviewed paper that you would like to write about? Please send suggestions to Mind Matters editor Gareth Cook, a Pulitzer prize-winning journalist and regular contributor to NewYorker.com. Gareth is also the series editor of Best American Infographics, and can be reached at garethideas AT gmail.com or Twitter @garethideas.

ABOUT THE AUTHOR(S)

Bret Stetka is an Editorial Director at Medscape

http://www.scientificamerican.com/article/parkinsons-disease-and-pesticides-whats-the-connection/

Shining a spotlight on Parkinson's

April 7,2015 Editorial: Shining a spotlight on Parkinson's

Did you know that April is Parkinson's Awareness Month? An entire month of recognition raises awareness so that a community can become better educated in a particular disease, situation or historic event. Hopefully that month will also see an influx in fundraising. Parkinson's is one of those vague diseases that we tend to associate with grandma or Uncle Bob. However, the most famous person coping with this disease isn't near grandma's age ... Michael J. Fox, of "Back to the Future" and "Family Ties" fame. When someone who is 21 to 40 years old receives a diagnosis of Parkinson's disease, it is often referred to as early onset Parkinson's. So, this isn't an age-related issue. Which is why taking some time from your day to educate yourself isn't a bad idea. Fox's website, www.michaeljfox.org offers a Podcast, a quiz and fundraising ideas and www.parkinson.org is the National Parkinson Foundation site, with quite a bit of downloadable information. The state site is www.parkinsonnetworkaz.org and is full of information and events coming up in our state. According to michaeljfox.org, "Parkinson's disease (PD) is a neurodegenerative brain disorder that progresses slowly in most people. Most people's symptoms take years to develop, and they live for years with the disease. In short, a person's brain slowly stops producing a neurotransmitter called dopamine. With less and less dopamine, a person has less and less ability to regulate their movements, body and emotions. Parkinson's disease itself is not fatal. However, complications from the disease are serious; the Center for Disease Control rated complications from PD as the 14th top cause of death in the United States." Some things to keep watch on, according to www.youngparkinsons.org, are these motor symptoms: Tremor (when limb is at rest) Bradykinesia (slowness) Rigidity (stiffness) Postural instability (balance problems) The website states, "It is important to know that not all of these symptoms must be present for a diagnosis of Parkinson's disease to be considered. In fact, younger people may only notice one or two of these motor symptoms, especially in the early stages of the disease. Finally, not everyone with PD has a tremor, nor is a tremor proof positive of Parkinson's. If you suspect PD, see a neurologist or movement disorders specialist." Get involved You have an opportunity to help Yavapai County families dealing with this disease. The Parkinson Network of Arizona is hosting the Paws for Parkinson's Walk and Expo on April 25 in Prescott Valley. "100 percent of funds raised will be dedicated to over 1,000 people in Yavapai County and their care partners who daily cope with the challenges and often difficult circumstances of living with Parkinson disease," according to the organization's press release. The Daily Courier will have a story later this week on the event and the group's website above has more information. Let's get out and do something to help one another! http://health.einnews.com/article/258806997/hatUHKO4n4vgyB5M - Robin Layton, editor

New Blood Signature Analysis May Help Diagnose Parkinson's Disease Earlier

By Staff Editor Apr 6, 2015 - 3:14:13 PM

(HealthNewsDigest.com) - A new blood test may more accurately identify blood signatures, or biomarkers, for Parkinson's disease (PD), according to a new study published in the journal Movement Disorders. The study, conducted by researchers at Mount Sinai and funded by the Michael J. Fox Foundation for Parkinson's Research, applies a new approach to looking for blood biomarkers for both patients with and without a known genetic risk factor for PD. This paper is the fourth in a series that report new computational techniques to improve the identification of reliable blood biomarkers.
While biomarkers--such as bad cholesterol level in the case of heart disease--hasten diagnoses by offering accurate measures of disease progression, there are currently no fully validated biomarkers for PD.
The Mount Sinai study analyzed the blood of four groups of mice with genetic material (e.g. ribonucleic acids or RNA) predicted by researchers to form part of a PD signature. Researchers also examined the blood of a group of Ashkenazi Jewish patients living with PD, as well as a separate group of healthy controls. About half of the human subjects--both symptomatic PD patients and healthy controls--have small changes in their DNA code called mutations, in a gene known to increase the likelihood of developing Parkinson's: leucine-rich repeat kinase 2, or LRRK2. Just one to two percent of Parkinson's patients carry this gene mutation, and many LRRK2 mutation carriers are from the Ashkenazi Jewish population. The other samples studied came from individuals without the mutation, half of whom had clinical PD.
After comparing the mouse and human blood samples, researchers identified RNA signatures that can be measured in blood samples that correlate with the disease-causing mutations in the LRRK2 gene in PD patients.
While LRRK2 mutations contribute to PD risk in a small percentage of patients, researchers believe related pathways also play a role in much more common, non-inherited cases of PD. Studying it may speed progress toward treatments that would benefit everyone with the disease, not just those with genetic mutations.
"This is the first time we've studied animal models and clinical samples, and used them to look at RNA expression patterns of biomarkers in PD," said Stuart Sealfon, MD, Chairman and Glickenhaus Professor, Department of Neurology, Mount Sinai Health System and lead author of the study. "Our other goal is to use this approach to identify subtypes of the disease so that treatment can be targeted more accurately and in addition, incorporated with clinical trials that facilitate the ability to identify new therapeutic and disease modifying agents."
Parkinson's disease (PD) is a chronic and progressive movement disorder affecting nearly one million people in the U.S. PD involves the malfunction and death of vital nerve cells in the brain, called neurons. Some of these dying neurons produce dopamine, a chemical that sends messages to the part of the brain that controls movement and coordination. As PD progresses, the amount of dopamine produced in the brain decreases, leaving a person unable to control movement normally. The cause of PD is unknown and there is presently no cure.
"The goal of this research is to improve early disease detection, especially in people who are carrying a predisposing genetic mutation," said Dr. Sealfon. "If you can improve your ability to diagnose the disease more specifically and identify new subtypes, this can help overcome the hurdle in developing new treatments for Parkinson's and other brain diseases. The next step is to replicate this approach in a larger sample, where we track patients longitudinally and see how profiles are changing over time."

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About the Mount Sinai Health System
The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services--from community?based facilities to tertiary and quaternary care.
The System includes approximately 6,600 primary and specialty care physicians, 12?minority?owned free?standing ambulatory surgery centers, over 45 ambulatory practices throughout the five boroughs of New York City, Westchester, and Long Island, as well as 31 affiliated community health centers. Physicians are affiliated with the Icahn School of Medicine at Mount Sinai, which is ranked among the top 20 medical schools both in National Institutes of Health funding and by U.S. News & World Report.
For more information, visit mountsinai.org, or find Mount Sinai on Facebook, Twitter, YouTube and Instagram.

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http://health.einnews.com/article/258680533/Q0s_od6RBoEY_cfC

Clinical trial offers hope to those with Parkinson's

 

Grady Harris, 67, participated in a clinical trial in which focused ultrasound was used to stop his tremors from Parkinson's disease. He was photographed Thursday, March 12, 2015.  (Bill Tiernan | The Virginian-Pilot)

 

Ann Perkins, who was diagnosed with Parkinson's disease in 2000, works out at the Great Neck Recreation Center in Virginia Beach on Thursday, March 19,2015. (Bill Tiernan | The Virginian-Pilot)

By Elizabeth Simpson

The Virginian-Pilot

© April 1, 2015

The first symptom, a shaky hand, surfaced a decade ago when Grady Harris was sanding his boat.

Harris, who was 57 at the time, thought it was the strain of the sanding, but his brother noticed the tremors, too.

It turned out to be the beginnings of Parkinson's disease, a progressive nerve disorder that affects a million Americans.

Hundreds of symptoms have been chronicled over the years, including a vanishing sense of smell and severe muscle loss.

A signature indicator is tremors - involuntary, rhythmic movement of a hand, arm, leg or other body part.

Medications kept those at bay for Harris, a Virginia Beach resident, for many years, but as the disease progressed, the shaking in his right hand picked up.

Some treatments for Parkinson's struck Harris as too invasive, such as deep brain stimulation, in which wires implanted in the brain send electrical impulses to stem the tremors.

But several years ago, a University of Virginia doctor who was treating Harris said he'd be a good candidate for something new that would not involve scalpels or opening his skull: focused ultrasound.

The idea is to zap tremor-causing nerve cells in the brain by focusing intersecting sound waves on them without damaging surrounding tissue - sort of like holding a magnifying glass above a leaf so that intensified light can burn a tiny spot.

Harris said yes to a clinical trial that would be conducted by doctors at two U.S. hospitals, the University of Virginia Health System in Charlottesville and Swedish Medical Center in Seattle.

His experience offers a window into the world of Parkinson's disease and scientific efforts to find new hope for patients.

Ultrasound mainly has been used for diagnostic purposes, such as capturing images of a fetus during pregnancy.

These days, the technology is used routinely to check for internal conditions such as kidney stones, heart defects or dangerous fluids.

Focused ultrasound, however, goes beyond diagnosis to treatment. An MRI guides highly focused, intersecting ultrasound beams to zap cells deep within the body. While this use is still mostly under clinical study, it has the advantage of being noninvasive, so recovery is quicker, and the process is less expensive.

The U.S. Food and Drug Administration has approved focused ultrasound to treat uterine fibroids and pain from bone cancer.

Clinical trials are under way at U.Va., exploring the approach for people with Parkinson's and a neurologic disorder called essential tremors that causes involuntary, rhythmic shaking.

In a pilot study in 2011, 15 essential-tremors patients who received focused ultrasound treatments saw improvement, and the results were published in the New England Journal of Medicine. Lead researcher Dr. Jeff Elias said in a recent phone interview that two of the subjects have since had some recurrence of the tremors, but most haven't.

Results from a second, larger study at eight research centers are looking positive, according to Elias, but full findings won't be available until later this year.

Two other clinical trials have been launched to treat symptoms of Parkinson's disease. One group includes people with dyskinesia, which is slow, uncoordinated, abnormal movements. The other focuses on Parkinson's patients whose main symptom is tremors that are resistant to treatment.

That study is the one that Harris, who is now 67, enrolled in as a subject.

Going into the study, Harris was told he'd receive either the treatment or a sham, in which he'd go through the MRI machine and all the steps of the treatment, except with no ultrasound beams.

He hoped he'd get the real thing, but he was committed to doing whatever he could to further research into his condition. Also, those who received the sham treatment would eventually be offered the real one.

In addition to worsening tremors, he was experiencing stiffness, imbalance, fatigue and muscle soreness.

Before the procedure, he had an all-day assessment of his cognitive abilities, balance and agility, along with blood and psychological evaluations.

In December 2012, he went to a focused ultrasound clinic at U.Va. They shaved his head, then placed it in a halo-like device with four prongs to hold it perfectly still. He lay motionless in the MRI machine as his brain was scanned, and ultrasound rays beamed into a middle region of the brain called the thalamus, where faulty circuitry causes tremors.

Harris remained conscious and able to answer questions throughout the 4-1/2- hour process.

At first, he didn't feel anything when told the first of a series of procedures was beginning. As they continued, though, he felt a little dizzy. Then, very dizzy. Finally, he felt a wave of head pain come over him, and a sense of pressure.

There was a button he could press if he wanted to stop, but he endured.

The sensations, though intense, also gratified him because they led him to believe he was indeed getting the real treatment.

He was growing tired when Elias asked whether he could do one last procedure.

Harris said yes. "I was relieved to know there was only one more."

After that, he was taken to a hospital room where his wife awaited him.

He was so tired, he didn't notice the one thing that had brought him there in the first place.

His wife pointed it out:

His hand had stopped shaking.

"My hand was as steady as this table," he said. "That's when I realized, 'Hey, this is cool. This is good.' "

The next day, he drove home to Virginia Beach.

Harris' experience is the kind that grabs the attention of people like Ann Perkins.

A 64-year-old who lives in Virginia Beach, Perkins was diagnosed with Parkinson's when she was 48.

She worked as a pharmaceutical representative at the time and happened across a pamphlet in a doctor's office that said, "Has your handwriting become smaller?"

Hers had, so she read on and found out it was a symptom of Parkinson's disease. She had another symptom on the list, too: losing her sense of smell.

Diagnosed soon after that, she kept her job for 10 years but quit after she fell down at work. She's now an advocate for Parkinson's education and services, and she runs a local support group through the American Parkinson Disease Association.

Medication helps her symptoms, but they have gradually worsened. "I am feeling fine now, but it takes a lot of work. From the time I wake up till the time I go to bed, I'm thinking about what I can do to manage my symptoms." She does drills to keep her voice strong, stretches to keep muscles from tightening, exercises to keep limber.

She doesn't like the idea of having holes bored into her head to insert electrodes for deep brain stimulation, nor of having to replace their batteries periodically.

Not long ago, she saw a news show about focused ultrasound for Parkinson's patients in Israel and Switzerland. It mentioned work being done at U.Va. She called and had her name put on the list. "Grady Harris beat me to it," she said with a laugh.

She said the studies give the Parkinson's community hope.

That's something Dr. Neal Kassell hears from people with various diseases he says could be helped by focused ultrasound. He was co-chairman of the Department of Neurology at U.Va. and is founder and chairman of the Focused Ultrasound Foundation in Charlottesville.

Kassell said research is under way across the globe in areas of epilepsy, brain tumors, prostate cancer, Alzheimer's disease and many other illnesses.

"The level of interest is exploding," he said.

Harris eventually learned he did get the real treatment.

Deep in his heart, he knew it. For weeks, he showed friends how his hand had stopped shaking and described the clinical trial.

"People said, 'You let them to do that?' There's a lot of people who wouldn't do it. I'm glad I was considered for it."

He was examined the next day, and again at one week, one month, three months, six months and a year.

Two months after the procedure, Harris' tremors began coming back.

He said Elias told him he could try again once the study is finished, if the FDA approves focused ultrasound for use.

Elias can't talk about the complete results of studies that are ongoing.

Harris continues his work at a Charles Barker auto dealership in Virginia Beach, where he oversees used-car acquisition. He still plays golf, "but not very good," he says.

The losses of Parkinson's continue apace. "My memory is nowhere near what it was. You lose your train of thought."

He's starting to have tremors in his right leg and the right side of his face, as well.

Still, he appreciated being able to participate in the study.

"To have the opportunity to improve my quality of life in any way, to not take advantage of that would be a waste. I think if I hadn't had it done, the progression would be worse."

He wants to wait and see the final results of the study - expected later this year - before deciding whether to try it again.

Elizabeth Simpson, 757-222-5003, elizabeth.simpson@pilotonline.com

http://hamptonroads.com/2015/03/clinical-trial-offers-hope-those-parkinsons