Parkinson’s Changes the Rules: It’s OK to Ask for Help

DECEMBER 5, 2019 By  Lori DePorter

We all have a fundamental desire to help our loved ones, and this is particularly true of those of us with early-onset Parkinson’s disease. Life moves along, and we try to advance with it. We are used to taking care of our responsibilities. But when we have Parkinson’s, the rules change.

I was trying to accomplish many things and not doing any of them well. I felt defeated in my job, and as a mom, daughter, and wife. I didn’t know how to step back and recognize my limitations. I had been taking care of everything for over 25 years and I loved it.

Now I find myself in unfamiliar territory. It may be a natural part of getting older or my progression, but I am not the same person. I can’t do everything that I could in the past. And accepting my limitations is not easy.

When my doctor suggested that I see a psychologist, my immediate reaction was, “No, I don’t need to.” However, she was right. I did need therapy, at least in the short term. While it is not for everyone, therapy has been beneficial when I find myself struggling. My therapist can make me aware of things that my friends, family, and others who are part of my everyday routine can’t see in me.

Talking with a professional provides a different perspective. And sometimes, having a fresh look at your situation can help you to get to where you want to be. Unfortunately, therapy is not always available, and people often avoid seeking this kind of help because of the stigma attached.

New rules

While my approach is still a work in progress, I have developed some new rules. I am sure that I will add more and you may have some rules of your own. With the busy holiday season approaching, you may want to give these a try:

• You don’t need to take care of everything.
• Know when to seek support.
• It’s OK to ask for assistance.
• Allow others to help.

Parkinson’s makes us feel helpless at times. However, it’s not just about us. What about the people in our lives? Do they feel the same way? Maybe playing by the new rules and allowing them to help us will make them feel more useful. We can see our acceptance of their help as a gift to them rather than a burden — something as simple as opening a car door can make all the difference.

***

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/2019/12/05/changes-rules-accepting-help-counseling-psychotherapy/

Exposure to Second-Hand Smoke Linked to Lower Risk of Developing Parkinson’s, Study Suggests

DECEMBER 5, 2019 BY CATARINA SILVA, MSC

Second-hand smoke may have a neuroprotective effect, as exposure to this type of indoor pollutant seems to be associated with a decreased risk of developing Parkinson’s disease, according to a recent study.

Conversely, exposure to certain air pollutants — like nitrogen dioxide and ozone — might contribute to a higher risk of developing the disease.

The study, “The impact of long-term exposure to ambient air pollution and second-hand smoke on the onset of Parkinson disease: a review and meta-analysis,” was published in Public Health.

Air pollution is composed of a variety of particulate air pollutants, volatile organic compounds, gaseous air pollutants, and airborne metals. Exposure to polluted air has been consistently associated with adverse effects in respiratory and cardiovascular diseases, but little is known about the effects of such exposure in neurodegenerative disorders such as Parkinson’s.

Although the exact causes behind Parkinson’s disease are not fully understood, it is thought to be induced by “a complicated interplay of environmental and genetic factors,” according to these researchers.

As such, “further investigation of the modifiable risk factors of [Parkinson’s disease] is of imperative significance and expected to have broad implication for the primordial prevention of this disease,” they said.

Second-hand smoke is a type of indoor air pollution. Evidence indicates that active smokers have a 50% lower chance of developing Parkinson’s in comparison with non-smokers. “However, whether this negative correlation is causal and persists among persons regularly exposed to SS [second-hand smoke] remains undetermined,” the researchers said.

To learn more, the scientists searched five medicine-related databases for any observational or epidemiological evidence on the relationship between long-term exposure to air pollution and second-hand smoke and Parkinson’s susceptibility.

The studied air pollutants included: particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5), such as combustion particles, organic compounds, and metals; particulate matter with less 10 μm in diameter (PM10), including dust, pollen, and mold; nitrogen dioxides (NO2); ozone (O3); and carbon monoxide.

The researchers combined the results of 21 studies, involving a total 222,051 Parkinson’s patients, and performed a statistical review known as a meta-analysis.

A marginally significant higher risk of developing Parkinson’s disease was observed in those exposed to PM2.5, NO2, and O3. Although carbon monoxide was found to be positively associated with Parkinson’s susceptibility, statistical significance was not attained.

“Second-hand smoke conferred reduced risk of Parkinson disease, regardless of exposure occasions [at home/at work/in children] and timing,” the researchers said. This suggests that second-hand smoke might have a neuroprotective effect in those who are susceptible to developing Parkinson’s at some point in their lives.

Some possible explanations exist as to why cigarette smoke may be associated with a lower risk of Parkinson’s. One theory is that some tobacco smoke compounds contain properties that inhibit monoamine oxidase (MAO), an enzyme that plays a key role in the activation of MPTP, a well-known Parkinson’s-inducing neurotoxin, and that is involved in the degradation process of dopamine released by nerve cells.

“Other hypotheses include the direct neuroprotective effect of nicotine by stimulating dopamine release, upregulating nicotinic receptors, and inhibiting alpha-synuclein fibrillation, thereby suppressing and relieving parkinsonian symptoms,” the researchers said.

Given the many harmful effects of air pollutants, public and environmental health strategies that reduce outdoor air pollution levels could help lower the burden of Parkinson’s disease.

Despite the potential neuroprotective effect of second-hand smoke, caution is advised when interpreting these results, as more large-scale studies are necessary to fully understand such an association.

https://parkinsonsnewstoday.com/2019/12/05/second-hand-smoke-associated-with-lower-risk-developing-parkinsons/

Aphios Granted US Patent for Oral Administration of Bryostatin-1 Nanoparticles for Treatment of Neurodegenerative Diseases

December 05, 2019

WOBURN, Mass.--(BUSINESS WIRE)--Aphios Corporation today announced that it was granted United States Patent No. 10,485,766 for the oral administration of Bryostatin-1 nanoparticles for the treatment of neurodegenerative diseases such as Huntington’s Disease, Parkinson's disease, Multiple Sclerosis, Down syndrome and Alzheimer's disease.

Bryostatin-1 nanoparticles rapidly restore cognitive performance in Alzheimer's transgenic mice and improve inter-trial latency in transgenic mouse model of Down syndrome which shares many characteristics with Alzheimer’s

Neurodegenerative diseases, such as Down syndrome, Alzheimer’s disease, and other spongiform encephalopathies remain major health problems. Currently there are very limited means to treat these diseases. With respect to Alzheimer’s, Huntington’s and Parkinson’s diseases, these diseases tend to manifest themselves in older individuals and as the diseases progress; the afflicted individuals are less able to care for themselves. Dr. Trevor P. Castor, co-inventor of the patent states that, “It is therefore highly desirable to have simple therapies which can be administered (e.g. oral formulations) without the need for specially trained healthcare providers.”

Dr. Castor continues, “Our Mechanism-of-Action studies have shown that our lead Alzheimer's disease drug candidate, APH-1104, a potent analog of Bryostatin-1, is neuroprotective by α-secretase activation via novel PKC isoforms, down-regulation of pro-inflammatory and angiogenic processes and the substitution of β-amyloid for its soluble and harmless relative, sAPP-α at concentrations which are orders of magnitude lower than conventional APP modulators. Our in vivo studies show that we can rapidly restore cognitive performance in AD-transgenic mice by oral administration of Bryostatin-1 encapsulated in biodegradable polymer nanospheres. These nanoparticles protect Bryostatin-1 in its transit to the stomach, are resistant to stomach acids, and increase residence time and efficacy once transported to the circulation system in the duodenum.”

Dr. Jonathan Steven Alexander, a professor in LSU Health Shreveport’s Department of Molecular and Cellular Physiology and a co-inventor of the patent states, “We are another step closer to helping find a treatment for Alzheimer’s disease and other neurodegenerative diseases. In our hands, we discovered that Bryostatin-1 improves inter-trial latency in a transgenic mouse model of Down syndrome. Bryostatin-1 showed a significant improvement in inter-trial water maze performance, with a p<0.001 compared to vehicle treated transgenic Down mice. This shows a significant difference in task acquisition in the Down syndrome model which shares many characteristics with Alzheimer’s disease. Importantly, these data show for the first time a dose dependent improvement in task performance.” 

About LSU Health Shreveport: LSU Health Sciences Center Shreveport is home to the School of Medicine, School of Graduate Studies and School of Allied Health Professions. The primary mission of the LSU’s Health Sciences Center at Shreveport is to teach, heal, and discover, in order to advance the well-being of the region and beyond. At the heart of LSUHSC-S is a strong faculty that includes over 600 nationally and internationally-acclaimed physicians and scientists. LSU Health Shreveport has strong community support, fostering a culture of diversity and inclusion that promotes mutual respect for all. For more information, visit www.lsuhscshreveport.edu.

About Aphios Corporation: Aphios Corporation (www.aphios.com) is an emerging growth biotechnology company developing green enabling technology platforms for improving drug discovery and manufacturing, nanotechnology drug delivery and pathogenic drug safety. Based on these enabling technology platforms, we are developing enhanced therapeutics for health maintenance and disease prevention, and the treatment of cancers such as prostate and pancreatic cancer, supportive care such as CINV, infectious diseases such as HIV, and nervous system disorders such as Alzheimer’s Disease, Multiple Sclerosis, Pain and Opioid Addiction.

Research leading to this discovery was in part funded by a SBIR Grant No. No. 5R44AG034760-03 from the National Institute on Aging (NIA), National Institutes of Health (NIH). The content of this press release is solely the responsibility of the authors and does not necessarily represent the official views of NIA and NIH.

https://www.businesswire.com/news/home/20191205005233/en/Aphios-Granted-Patent-Oral-Administration-Bryostatin-1-Nanoparticles

Though safe, nilotinib does not show promise for benefit for Parkinson's disease

DECEMBER 5, 2019   by Northwestern University

Immunohistochemistry for alpha-synuclein showing positive staining (brown) of an intraneural Lewy-body in the Substantia nigra in Parkinson's disease. Credit: Wikipedia

Northwestern University and the Parkinson Study Group announced that the Nilotinib in Parkinson's Disease (NILO-PD) study showed that nilotinib, an FDA-approved treatment for chronic myelogenous leukemia being tested for potential repurposing as a Parkinson's drug, was safe and tolerable in its trial population of 76 participants with moderate to advanced Parkinson's but does not exert a clinically meaningful benefit or biological effect to benefit those with Parkinson's disease.

The NILO-PD Steering Committee unanimously agreed to accelerate the announcement of these results, originally planned for 2020, in line with members' commitment to keep the Parkinson's community informed of new scientific findings as quickly as possible.

Gary Rafaloff of Marlboro, New Jersey, diagnosed with Parkinson's in 2012, served as a member of the NILO-PD steering committee. "No one wanted this trial to succeed more than I did," Rafaloff said. "If I had qualified, I would have participated as a volunteer. Instead I spent over two years working with the other committee members to ensure that the trial was designed and administered with the utmost rigor. Nevertheless, the results are what they are. The good news is that there are several other upcoming trials that we can focus on as we look forward to future success."

The randomized, placebo-controlled, double-blind study was led by principal investigator Tanya Simuni, MD, professor of neurology and head of the division of movement disorders at Northwestern University Feinberg School of Medicine. It was carried out at 25 sites through the Parkinson Study Group, the largest not-for-profit scientific network of Parkinson's disease centers in North America.

The trial was coordinated through the Clinical Trial Coordination Center at the University of Rochester, and statistical analysis was led by the University of Iowa. NILO-PD—which tested placebo, 150mg and 300mg doses of nilotinib daily over six months—was supported by an international consortium of research and patient advocacy groups: The Michael J. Fox Foundation for Parkinson's Research, The Cure Parkinson's Trust (London, United Kingdom), Van Andel Institute, The Parkinson Alliance and the Demoucelle Parkinson Charity (Brussels, Belgium). Novartis Pharmaceuticals Corporation provided the study drug and placebo for use in the trial.

"Science is a high-risk endeavor and too often strategies, even promising ones, do not prove replicable or scalable. Unfortunately, the results we observed—as measured by change in clinical symptoms and influence on biological measures—did not support testing nilotinib in a larger study," Simuni said. "This is not the outcome we hoped for, but we remain dedicated to pursuing better treatments by advancing other potential therapies in today's robust Parkinson's pipeline."

Simuni noted that it is critical that anyone considering adding nilotinib to their Parkinson's treatment regimen work closely with their health care provider before doing so. While nilotinib was seen to be safe and tolerable in the study population, the study was strict with health history, excluding those who may have heart issues or other health challenges. Therefore, its safety in a broader Parkinson's population remains unproven.

Nilotinib (marketed as Tasigna) inhibits the activity of c-Abl, a protein that has been linked to cellular pathways associated with Parkinson's disease including aggregation of alpha-synuclein protein and deactivation of parkin protein. In 2016, preliminary data from a small open-label Phase I clinical trial evaluating the safety and tolerability of nilotinib in people with advanced Parkinson's showed potential benefit in PD. The c-Abl pathway remains an important target of interest to Parkinson's researchers, with trials of other drugs in this class ongoing.

Study results were unblinded at a steering committee meeting on November 15. Study leadership and funding partners committed to broadly sharing top-line findings on an accelerated timeline—after reporting high-level results back to study participants and site investigators—in service to the Parkinson's community awaiting news from this trial and the donors who made the study possible.

NILO-PD leaders will share more detailed data with study volunteers on a call on December 12 and with the scientific community in February at the 3rd Pan American Parkinson's Disease and Movement Disorders Congress in Miami, Florida. The partners also plan to make data and biosamples available for further analysis to the wider Parkinson's research community.

"When the science doesn't pan out, it's easy to feel deflated. As a patient, I get it," said Michael J. Fox. "But even a study that doesn't show the results we hoped for ultimately gets us closer to the one that will."

Provided by Northwestern University

https://medicalxpress.com/news/2019-12-safe-nilotinib-benefit-parkinson-disease.html

Brain diseases with molecular diversity

4-DEC-2019    Marcus Neitzert
DZNE - GERMAN CENTER FOR NEURODEGENERATIVE DISEASES

New insights into abnormal proteins in Parkinson's disease and MSA

Parkinson's and multisystem atrophy (MSA) - both of them neurodegenerative diseases - are associated with the accumulation of alpha-synuclein proteins in the brain. Researchers at the German Center for Neurodegenerative Diseases (DZNE) and the Max Planck Institute for Biophysical Chemistry (MPI-BPC) have investigated the molecular makeup of these protein deposits finding structural diversity. Experts from South Korea, Australia, and Argentina were also involved in the study. The results, published in the scientific journal "Nature Communications", suggest that Parkinson's might be related to diverse types of protein aggregates.

Alpha-synuclein is a protein that occurs naturally in the body. It is assumed to be involved in signal transmission between neurons. The protein appears both at the cell membrane and solved - floating, so to speak - in the cell's interior. In addition to these "normal" variants, there are others that manifest in brain diseases. This applies e. g. to Parkinson's disease and MSA. Both can be associated with various neurological impairments, including movement disorders. In Parkinson's and MSA alpha-synuclein molecules stick together. As a result, elongated aggregates arise that are deposited inside neurons and other brain cells. "These deposits successively appear in various areas of the brain. They are a disease hallmark," explains Prof. Markus Zweckstetter, who heads a research group at the DZNE and the MPI-BPC. "There is evidence that these aggregates are harmful to neurons and promote disease progression."

A Matter of Folding

These deposits represent a potential starting point for medicines. The idea is that drugs might prevent alpha-synuclein molecules from sticking together or dissolve existing aggregates. To identify potential docking sites for agents, data on the aggregates' fine structure is required. Thus, the question is: What kind of shape (also known as "folding") do the molecules adopt within the aggregates? So far, information on this topic had been limited to data from laboratory experiments. "Previous studies investigated the molecular structure of aggregates that were synthesized in a test tube. We asked ourselves how well such artificially produced specimens reflect the patient's situation. That is why we studied aggregates generated from tissue samples from patients," said Zweckstetter. "We collaborated closely with international partners on this project. In fact, the tissue samples originated in Australia and the aggregates were synthesized in South Korea. We then did the structural studies in Göttingen."

Aggregates from brain samples taken from five deceased Parkinson's patients and five deceased MSA patients were examined. For comparison, the researchers artificially produced different variants of alpha-synuclein aggregates. For this, they used standard procedures. To compare the structure of the different aggregates, they applied nuclear magnetic resonance spectroscopy and other methods.

Structural Differences

"We found that aggregated proteins that came from the lab were structurally different to all aggregates generated from patient material," Dr. Timo Strohäker, first author of the study, commented on the findings. "In addition, proteins of MSA patients differed from those of Parkinson's patients. If one looks at the data more closely, you notice that the proteins of the MSA patients all had a largely similar shape. The proteins of the patients with Parkinson's were more heterogeneous. When comparing the proteins of individual Parkinson's patients, there is a certain structural diversity."

The alpha-synuclein proteins of all aggregates contain "beta sheets", which is in line with previous investigations. Accordingly, the molecular backbone is twisted in a way that the proteins are largely two-dimensional. Within the aggregates, the proteins stick together in layers. However, folding does not encompass the whole protein. Each protein also contains areas that are unstructured. Besides, orientation of the beta sheets bears significance. "It is a question of how much of a protein is folded and also how it is folded," Zweckstetter stated.

Various Types of Aggregates in Parkinson's

In the structure of the alpha-synuclein associated with Parkinson's, there were some significant differences between patients. This might be due to the fact that the course of Parkinson's can vary quite considerably between individuals. "The variability of Parkinson's disease could be related to differences in the folding of aggregated alpha-synuclein. This would be in contrast to the 'one disease-one strain' hypothesis, that is to say that Parkinson's disease is associated with one, clearly defined aggregate form. However, in view of our relatively small sample of five patients, this is just a guess," said Zweckstetter. "Yet, our results certainly prove that studies with tissue samples from patients are necessary to complement lab experiments in a sensible way."

###

Original Publication

Structural heterogeneity of α-synuclein fibrils amplified from patient brain extracts 
Timo Strohäker et al., Nature Communications (2019), 
DOI: 10.1038/s41467-019-13564-w

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/2019-12/d-gc-bdw120419.php

Managing the Cost of Chronic Illness

DECEMBER 4, 2019 BY MARY BETH SKYLIS

Chronic illness is expensive. It costs money, time, and peace of mind. Whether you’re sifting through your worries or counting the pennies in your pocket, illnesses affect all avenues of life. 

Before the symptoms of a disease appear, one may go about daily life unencumbered by thoughts of self-preservation. But disease changes everything. 

According to the U.S. Centers for Disease Control and Prevention, 90 percent of the country’s annual healthcare spending — some $3.5 trillion — is related to chronic illnesses such as diabetes, Alzheimer’s disease, and others. 

With Parkinson’s disease, the same costs apply. While the return is generally worth the investment, Parkinson’s treatments are expensive. And people most often are hit with shocking bills at the same time they’re losing physical independence. 

So how do you foot the bill? Where is the balance between finding the appropriate care and saving your pennies? What do you do when financial limitations find you?

Switching from full-time to part-time work

For many PD patients, one big question is: “Will I be able to keep my job as the disease progresses?” Everyone’s situation is different, and there’s no universal answer to this question. It depends on the job and how PD affects you. 

My dad worked as a Realtor for most of his adult life, and he remains invested in that world. He grew up in the same area where he worked, and many of his clients were friends first. So I doubt he’ll ever entirely give up his profession. But he has certainly chosen to change his relationship with work. 

One thing he noticed early on is that stress seems to drastically affect his PD symptoms. So adapting to the disease was never a debate. He just needed to determine how to move forward. His solution was to slow down and reduce the number of homes he sells. This means that his income has changed as well. 

Luckily, my mom is a worker bee. Even when she has a day off, she fills her time with projects and goals. She continues to work full-time and hold down the fort. But the financial side of PD has been fluid and will continue to change. Will my parents have to downsize houses again one day? Sell some assets? What happens when my mom realizes she’s in her 60s and can’t work as much anymore? 

Medical care and travel expenses

Medical care is a complicated subject. If you’re lucky enough to live in or near a city, the options allow you the privilege of choice. But what if you have to commute an hour each way and you’re not comfortable with your driving abilities anymore? What if you live in a remote area of the country and medical care is limited? The greatest cost in this situation seems to be time — your time and the time of a loved one.

Since undergoing deep brain stimulation, an expensive surgery, Dad continues to see his neurologist to tune the hardware. He always has a companion for these visits, which increase his quality of life. But he gives up time to travel and money for gas, and he probably pays something for each doctor visit. Sometimes he’ll also see an herbalist (the “witch doctor,” as he says) and a chiropractor. And even with insurance, he spends a lot of money on medication. 

My mom’s thoughts on the cost of Parkinson’s

My mom was kind enough to share some thoughts about the cost of Parkinson’s disease. She said that while they’re doing fine, it seems that “fun money” inevitably turns into bill money. Yet she remains positive. She, like my dad, continuously adapts to the changes that come with chronic illness. 

She ended a recent email on a positive note: “NONETHELESS, we are doing alright!”

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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/2019/12/04/chronic-illness-costs-sacrifices-decisions/

I’ve Made BIG Improvements with Parkinson’s Therapy Program

DECEMBER 4, 2019 BY "SHERRI WOODBRIDGE" 

I have been seeing a physical therapist four times a week for the last month. I hadn’t injured myself, though I experience aches and pains with Parkinson’s disease. 

My neurologist referred me to a physical therapist who teaches the BIG program. The LSVT BIG program is designed for people with Parkinson’s to bring their movements to a more “normal” state, as they tend to become slower and smaller over time.

My first session

My first appointment consisted of small “tests,” like those performed during a Parkinson’s diagnostic exam but less extensive. The therapist examines and times your walking and tests your balance, among other abilities.

BIG is customized for people with Parkinson’s. Perhaps you struggle with getting out of bed. Though this specific activity isn’t included in the standard routine of the BIG program, it can be worked into your tailored activities. The therapy can help you no matter what stage of the disease you are at and it’s recommended that you start treatment as early as possible.

What improved?

The BIG treatment improved my walking in general, and I gained confidence with “stair-stepping.” I no longer take each stair sideways, with extreme caution, and slower than molasses. The program helped me to be more intentional in my activities and how I carry them out.

At my therapy sessions, we started with the exercises that are specific to the BIG program. I completed two exercises while sitting in a chair, stretching down, up, and back, and ending with a “BIG” finish. The rest of the exercises — except for the last — are performed while standing and are aimed at balance and coordination, and also end with a “BIG” finish. The program strives to teach the person with Parkinson’s to emulate the bigger movements of those around them who walk and interact “normally.”

After the “regular” exercises, we practiced tasks tailored to my needs. These included cutting up food, buttoning/unbuttoning and zipping/unzipping my coat or sweater, and other tasks. After those exercises, we walked around the neighborhood for a half-hour, practicing arm swings and balance.

Was it worth it?

My sessions are over, and as my movements have improved, my outlook has, too. While the exercises are not difficult to do, they must be practiced daily for continuous improvement. I noticed that if I skipped even one day, it made a difference to my ease of movement. I realize that if I want to live BIG, I need to exercise BIG, and that means I must think BIG.

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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/2019/12/04/think-big-live-big-movements-big-program-physical-therapy/

From depression to Parkinson’s disease: The healing power of dance

December 4, 2019        Adrianna Mendrek

Historically, the body and movement have been widely disregarded within psychotherapy. But times are changing, as a growing movement of somatic and dance therapies are gaining scientific credibility. (Shutterstock)

“When a body moves, it’s the most revealing thing. Dance for me a minute, and I’ll tell you who you are.” Mikhail Baryshnikov

Why do we stop dancing when we grow up? Why do we disconnect and alienate ourselves from the body? It is surprising to me that dance/movement therapy (DMT) is not more popular within the fields of psychology and psychotherapy globally.

For a couple of decades, I devoted my attention as a researcher in behavioural neurobiology and psychiatry almost exclusively to the brain and mental health, neglecting the rest of the body. 

I was trained in the late 1990s, the decade of the brain. I have been mesmerized by the complexity of the brain, completely forgetting that it is part of the entire organism, intimately connected and reciprocally interacting with the entire body. 

Interestingly, in my personal life my body has played a central role. My way to deal with any mental health problems has been through long walks, dancing and yoga.

https://youtu.be/mhoEjbvIEw8 

An introduction to dance/movement therapy from the American Dance Therapy Association.

This is partly why in the past few years, as a professor in psychology at Bishop’s University, I have started incorporating bodywork in my teaching and research, and why I entered a dance/movement therapy training program in Canada this summer.

Understanding the body in motion

Dance/movement therapy goes beyond simply dancing. DMT uses dance and movement to promote insight, integration and well-being, as well as to diminish undesirable symptoms in various clinical populations. 

Unlike mainstream talk therapies, DMT uses the entire body to approach the client primarily on a non-verbal and creative level. The body in motion is both the medium and the message. DMT recognizes the moving body as the centre of the human experience, and that body and mind are in constant reciprocal interaction.

Just like with more traditional psychotherapies, DMT can be applied in a wide range of ways. It may involve talking, different types of music or no music at all. It can be done in groups, with individuals or with couples. Therapists sometimes dance with their clients and at other times observe. 

A group therapy session may involve a warm-up and check-in as to where we are at emotionally, mentally and physically. It may be followed by the development of a theme, which emerges spontaneously or has been prepared by a therapist (for example, working with difficult emotions). It ends with grounding (reconnecting with our bodies and our selves in the present moment) and closure (for example, a gesture, a sound, a word). 

All of this is done with our bodies in motion or stillness, but some verbal sharing, journaling, drawing and other elements may be added.

Exploring new movements can help people see a wider range of possibilities in a given situation. (Shutterstock)

Dance/movement therapy has been around for several decades but it has never become widely popular, possibly due to a lack of well-designed research studies. This has changed and I would like to highlight here a few recent studies supporting the benefits of dance and DMT on emotional regulation, cognitive function and neural plasticity.

A positive effect on depression

One of the main reasons people dance is to modify their emotional state; typically, they strive to feel more joy and happiness and to reduce stress and anxiety. Since its inception dance therapy, similar to somatic psychotherapies, has emphasized the reciprocal interaction between body and mind, and the ability to regulate emotions via changes in body postures and movements. 

The exploration of new movements can evoke novel perceptions and feelings. It may also facilitate seeing a wider range of possibilities in a given situation. Some new or old movement patterns may evoke repressed material and enhance better understanding of oneself and one’s environment and history.

One of the most compelling studies supporting this idea examined complex improvised movements, and identified unique sets of movement components that can elicit the feelings of happiness, sadness, fear or anger. The associations between emotions and specific motor components have been used in the past for diagnosis or emotion recognition. This study goes further and proposes specific techniques for modifying emotions.

https://youtu.be/rUQlFZJySYA 

A new report from WHO/Europe provides evidence of the benefits of the arts for mental and physical health.

A recent systematic review of research on dance/movement therapy specifically found it to be effective in the treatment of adults with depression.

Improvements in Parkinson’s disease

Dance typically involves learning sequences of steps and movements in space, in coordination with music. In other words, it requires substantial physical and cognitive engagement and, as such, it should improve not only muscle tone, strength, balance and coordination, but also memory, attention and visuospatial processing.

When comparing relatively long-term dance interventions (of six and 18 months) to conventional fitness training, several studies have found improvements in attention and verbal memory and neuroplasticity in healthy older adults. Researchers also found improvements in memory and cognitive function for older adults with mild cognitive impairment after a 40-week dance program. 

In addition, a recent meta-analysis of seven randomized controlled trials comparing the effects of dance therapy to non-dance interventions in Parkinson’s disease found that dance was especially beneficial for executive function, the processes that help us plan, organize and regulate our actions.

Changes in brain structure

Dancing engages extensive areas of the cerebral cortex as well as several deep brain structures.

A recent descriptive systematic review included eight well-controlled studies, all of which demonstrated changes in brain structure following dance intervention. These changes included: increased hippocampal and parahippocampal volume (involved in memory), increased gray matter volume in the precentral gyrus(involved in motor control) and white matter integrity in the corpus callosum(involved in communication between the two hemispheres).

New ways of moving can produce new ways of feeling and perceiving the world. (Shutterstock)

Overall, these studies are compatible with the idea of using dance and DMT in various neurological and psychiatric disorders — such as Parkinson’s disease, Alzheimer’s disease and mood disorders — as well as in the general population.

New possibilities for feeling and perceiving

It is clear that dance has a powerful effect on the human body and psyche. 

DMT from its inception emphasized that the body is inseparable from, and in constant reciprocal interaction with, the mind. As such, sensations, perceptions, emotions and thinking affect our body and the way we move. By observing the body we can deduce mental states. 

Conversely, our posture and our movements have the power to transform our mental states, to evoke repressed memories, to release spontaneity and creativity, to reorganize our brains. New ways of moving and dancing may produce new ways of feeling and perceiving the world. 

This is one of the most exciting and profound aspects of DMT and it is shocking that the body, movement and dance have been almost entirely ignored by mainstream psychotherapy. It is time to change that!

https://theconversation.com/from-depression-to-parkinsons-disease-the-healing-power-of-dance-123748