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FEBRUARY 2008

 

29th February 2008 - New research

switching to Cabergoline

Clinical Neuropharmacology [2008] 31 (1) : 19-24 (Linazasoro G) Complete abstract

Cabergoline is a dopamine agonist that stimulates the D2 receptor activity and has a very long half-life. This pharmacological profile may result in clinically different effects. For more information go to
Cabergoline. The purpose of this study was to determine the safety and efficacy of switching overnight from dopamine agonists to cabergoline in people with Parkinson's Disease. People  with advanced Parkinson's Disease that is not fully controlled by L-dopa and either bromocriptine, pergolide, pramipexole, or ropinirole were converted to cabergoline overnight. Patients on bromocriptine were excluded from the analysis because of the small sample size.

Out of 128 patients, a few reported serious side effects. Twenty-eight patients reported 41 adverse events. Twelve patients were withdrawn due to adverse effects (either hallucinations, dyspnea, dizziness, or vascular problems). A significant improvement in symptoms was found after changing over to cabergoline. After 12 weeks, the mean dose of cabergoline was 3.2 mg. 25% of the patients were taking it twice a day. It is not known whether the improvement in symptoms was due to a placebo effect, the use of low doses of dopamine agonists, or to the effect of cabergoline.

 

28th February 2008 - New web site

FIGHTFORMORE.COM

Monica Ali is the wife of Muhammad Ali, the three-time world champion heavyweight, who was diagnosed with Parkinson's Disease 23 years ago.  She describes Parkinson's Disease as "the toughest opponent Muhammad has ever faced." At an American Parkinson's Disease Association meeting, she has helped to launch a new Web site for Parkinson's Disease called Fightformore.com. Go to FightForMore.Com for full details.

The site, sponsored by Valeant Pharmaceuticals, is intended to serve as an online national support group for Parkinson's Disease. The Fight For MORE national educational campaign aims to help Parkinson's disease patients and the millions of people caring for them to gain support, education and resources.

 

27th February 2008 - New research

THE WORLD'S HIGHEST INCIDENCE OF PARKINSON'S DISEASE

Acta Neurologica Scandinavica [2008] Feb 18; [Epub ahead of print] (Wermuth L, Bech S, Skaalum Petersen M, Joensen P, Weihe P, Grandjean P.) Complete abstract

New research has shown that the world's highest incidence of Parkinson's Disease is in The Faroe Islands, the Danish owned islands north of the British Isles. For more on the Faeroe Islands go to
Faeroe Islands.

The average annual incidence of Parkinson's Disease has been found to be 21.1 per 100,000 people. This means that people are being diagnosed with Parkinson's Disease at a faster rate in the Faeroe Islands than anywhere else in the world. The prevalence, which is the number of people that already have Parkinson's Disease is, at 206.7 per 100,000, also one of the highest in the world.  This is greater than it was in previous years. Fishing forms most of the Faeroes economy, and fish is very prominent in their diet. The cause of the high prevalence is unknown, but it has been suggested that neurotoxic contaminants in traditional food may play a role in the pathogenesis in this population, perhaps jointly with genetic predisposition.

 

26th February 2008 - New research

ROTIGOTINE PATCH - CLINICAL TRIAL RESULTS

Movement Disorders [2007] 22 (16) : 2398-2404 (Giladi N, Boroojerdi B, Korczyn AD, Burn DJ, Clarke CE, Schapira AH; SP513 investigators) Complete abstract

Rotigotine, which is marketed as Neupro, is a dopamine agonist formulated in a transdermal delivery system. For more information go to Neupro.

The present study was to investigate the efficacy and safety of the rotigotine transdermal patch in the treatment of early Parkinson's disease. Its effect was compared to the use of a placebo or ropinirole. Transdermal rotigotine at doses less or equal to 8 mg/day were not inferior to ropinirole at doses less or equal to 24 mg/day. Transdermal rotigotine at doses less or equal to 8 mg/day had a similar efficacy to ropinirole at doses less or equal to 12 mg/day. The rotigotine transdermal patch was well tolerated. The most common adverse events were reactions at the site of the application of the patch, nausea, and somnolence. Reactions at the application site were predominantly mild or moderate in intensity.

 

25th February 2008 - New book

Parkinson's Disease in focus

Charles Tugwell

Publisher's description : Parkinson's Disease in Focus is a resource for pharmacists and other healthcare practitioners who are involved with patients. It is aimed at being helpful to students of pharmacy and medicine, and to patients and those who care for them. The book provides a framework for medical practice, with a particular focus on drug therapy management. Developments in research of new treatments such as gene therapy are also discussed. Chapter contents include : The condition and its symptoms, Pharmacotherapy, Non-drug treatments, Complementary therapies, Surgical options, Symptom management not specific to Parkinson's disease, Development and future treatments, drug interactions and adverse effects. Click here for more details 

                                                                                                                                                

24th February 2008 - New research

DBS SURGERY TREATS DYSTONIA

Neuroscience. 2008 Jan 9; [Epub ahead of print] (Magarinos-Ascone CM, Regidor I, Gomez-Galan M, Cabanes-Martinez L, Figueiras-Mendez R.) Complete abstract

Dystonia is sustained muscle contractions that cause twisting and repetitive movements or abnormal postures. It often occurs alongside Parkinson's Disease. Deep brain stimulation (DBS) was applied in the internal segment of the globus pallidus (GPi) to treat dystonia.

DBS is a surgical method that uses electrodes implanted into the brain. For more information go to Deep Brain Stimulation. One year after surgery the dystonia movement scores were significantly lower than before surgery. Two years after surgery the dystonia movements had decreased by two thirds. The high activity of the muscle cells at rest was found to diminish to very low levels, allowing an ease of voluntary contractions.  The authors claim that the results suggest that DBS in the GPi is a reliable surgical technique for dystonia.

 

23rd February 2008 - New research

THE RISK OF FALLING IN PARKINSON'S DISEASE

The Journal of Neuroscience Nursing [2007] 39 (6) : 336-341 (Sadowski CA, Jones CA, Gordon B, Feeny DH.) Complete abstract

This study examined awareness of the risk factors for falling among patients with Parkinson disease using the Falls Risk Awareness Questionnaire (FRAQ). A survey of patients who attended a Movement Disorders Clinic for treatment of Parkinson's Disease was used.

FRAQ is a 28-item self-administered survey that assesses the knowledge and perception of risk factors for falling.  82% of the participants reported falls in the past.  30% of participants had fallen within the past month. 68% of the participants felt they were at risk for further falls. When asked to list potential risk factors for falling, only 14% could identify medication as a risk factor. People with Parkinson's Disease are at substantial risk of falling, yet many appear to be unaware of common risk factors, especially medication use.

 

22nd February 2008 - New research

ROPINIROLE V L-DOPA

Movement Disorders [2007] 22 (16) : 2409-2417 (Hauser RA, Rascol O, Korczyn AD, Jon Stoessl A, Watts RL, Poewe W, De Deyn PP, Lang AE.) Complete abstract

In a 5-year study, people with Parkinson's disease were divided between those given ropinirole, a dopamine agonist also known as Requip, and those given L-dopa. Those initially treated with ropinirole had a significantly lower incidence of dyskinesia compared with those who started with L-dopa. However, scores on the UPDRS (the main test for Parkinson's Disease), movement scores were significantly more improved in those given L-dopa. This was extended to a ten year study. 

The incidence of dyskinesia after ten years was still significantly lower in those taking ropinirole. The time taken to develop dyskinesia was longer in those taking ropinirole.  The incidence of at least moderate wearing off of effect was significantly lower in those taking ropinirole. Over ten years there were no significant differences in change in symptoms, scores concerning daily living or movement, or scores concerning quality of life, clinical impression, or sleepiness.

 

21st February 2008 - New research

THE PREVALENCE AND TREATMENT OF DYSKINESIA

Journal of Neural Transmission [2007] 114 (8) : 1023-1026 (Muller T, Woitalla D, Russ H, Hock K, Haeger DA.) Complete abstract

Dyskinesia is involuntary physical movement, that is often caused by the excessive effects of dopaminergic drugs such as L-dopa. A study into the prevalence and treatment of dyskinesia in Parkinson's Disease patients was performed with 380 Parkinson's Disease specialists interviews relating to Parkinson's Disease, and 1,900 retrospectively completed patient record forms for patients with dyskinesia.

Physicians reported that 34% of their Parkinson's Disease patients experience dyskinesia, and that 20% of patients with Parkinson's Disease were affected by moderately-to-completely disabling dyskinesia. Treatment of dyskinesia was looked upon by the physicians as unsatisfactory. Different methods of treating dyskinesia are being examined. However, dividing up the L-dopa dosage is presently the first choice means of treating dyskinesia.

 

20th February 2008 - News report

MAO-B LEVELS INCLINE PEOPLE TO PARKINSON'S DISEASE

A new study showed that high levels of MAO-B cause Parkinson's Disease symptoms.  MAO-B is a naturally occurring chemical in the body that is responsible for breaking down several substances such as dopamine, whose deficiency causes Parkinson's Disease. For more information go to MAO-B. Scientists at the Buck Institute for Age Research, raise the possibility that humans could be tested for high MAO-B levels to see if they have this risk factor for Parkinson's Disease.

The study appears in the February 20 issue of the open-access, online journal, PLoS ONE. Levels of MAO-B vary 50-fold in humans and tend to increase with age. Several studies have suggested that increases in MAO-B contribute to the development of Parkinson's Disease, but direct proof of a contributory role for MAO-B has been lacking. Tests to measure levels of MAO-B are not currently available to the general public. Researchers suggest that MAO-B testing could be akin to current practices involving cholesterol, but add that "the fact that someone has high levels of MAO-B does not necessarily mean they are fated to develop Parkinson's Disease." For more information go to the Complete article.

 

19th February 2008 - New clinical trial

CONTROLLING EXCESSIVE SALIVA IN PARKINSON'S DISEASE

NeuroHealing Pharmaceuticals have initiated Phase II Clinical Trials of NH004 for Sialorrhea in Parkinson's Disease. Sialorrhea (drooling or uncontrolled salivation from the salivary glands) is often described as the single most disabling social problem for many people with Parkinson's Disease, and affects up to 75% of patients with advanced Parkinson's Disease. Depending on its degree, drooling can result in social and medical disability, impaired speech, or serious feeding difficulties.

Unable to manage oral secretions, affected persons are at an increased risk of aspiration pneumonia, skin maceration, and infection. NH004 is an intra-oral, slow-dissolving film containing a fast acting anticholinergic agent to control the symptoms of sialorrhea. The drug is embedded in a muco-adhesive film that is placed in the mouth and provides a slow, localized delivery of the medication while minimizing systemic exposure to the drug. The film design makes it suitable for unobtrusive use in a social environment. For more information go to the Complete article.

 

18th February 2008 - New research

MENTAL HEALTH PROBLEMS INCREASE BEFORE AND AFTER DIAGNOSIS

Neuroepidemiology [2008] 30 (2) : 71-75 (Leentjens AF, Driessen G, Weber W, Drukker M, van Os J.) Complete abstract

Parkinson's disease is often, but not always, accompanied by a deterioration in mental health. It has been found that mental health problems start increasing up to three years prior to diagnosis, before Parkinson's Disease is even evident. Researchers suggest that this deterioration could be an early indicator of forthcoming Parkinson's Disease.

This coincidence of medical disorders may be due to reduced dopamine being common to both Parkinson's Disease and depression. However, about two years after diagnosis, mental health problems actually tend to decline. This is odd given that dopamine levels tend to decrease even further after diagnosis. It might possibly be explained by the fact that most people start taking dopamine increasing drugs. This increase in mental health problems prior to and after diagnosis is greater for women than for men, and also for younger rather than older individuals.

 

17th February 2008 - News report

LIBRA DBS SYSTEM - A NEW DEVICE FOR PARKINSON'S DISEASE

The University of Rochester Medical Center (URMC) is one of the sites testing a new device for patients with Parkinson’s disease and Essential Tremor. The study will help determine whether the Libra DBS system - a new and improved form of Deep Brain Stimulation (DBS) technology - is effective in providing relief for patients who are unable to adequately control their symptoms. The manufacturers already produce other neuromodulation products. For more information go to Advanced Modulation Systems.

The DBS system is a surgically implanted medical device that delivers an electrical stimulation to areas of the brain that control movement. The system consists of a neurostimulator – a pocket-watch-sized device that is implanted under the collarbone – and wires, or leads, which run from the neurostimulator under the skin and into the brain through an opening in the skull. The leads are surgically guided to one of two areas in the brain depending upon the patient and the condition being treated. For more information go to the Complete article.

 

14th February 2008 - New research

LEWY BODIES PRECEDE PARKINSON'S DISEASE

Acta Neuropathologica [2008] Feb 9; [Epub ahead of print] (Dickson DW, Fujishiro H, Delledonne A, Menke J, Ahmed Z, Klos KJ, Josephs KA, Frigerio R, Burnett M, Parisi JE, Ahlskog JE.) Complete abstract
                                                                                                                                                                               Lewy bodies are often a cellular symptom of Parkinson's Disease and some other neurological disorders.
For more information go to Lewy body. Lewy bodies are basically rubbish bins that get rid of  damaged elements from brain cells. However, Lewy bodies are also detected in the brains of about 10% of people over the age of 60 that do not have Parkinson's Disease or any other neurological disorder. When Lewy bodies are found in normal individuals, the process is sometimes referred to as incidental Lewy body disease (iLBD). The distribution of Lewy bodies in healthy individuals is similar to that found in people with Parkinson's Disease.

It remained unknown as to whether Lewy bodies under these circumstances were merely part of ageing, or indicated that somebody was going to develop Parkinson's Disease. Researchers findings suggest that Lewy bodies in healthy individuals (iLBD) is preclinical Parkinson's Disease and that the lack of symptoms in these people is solely due to the threshold for symptoms not quite being reached. Along with other studies, this means that virtually all symptoms, cellular and physical, are occurring and developing well before it is realised that somebody has Parkinson's Disease, and that cell damage is already taking place before diagnosis.

 

13th February 2008 - News report

STEM CELL SURGERY NOW USED INTERNATIONALLY

There are now clinics with stem cell therapy facilities in the Dominican Republic, Cuba, China, Russia, Singapore, Thailand, India and Germany. Many of them use foetus stem cells, umbilical cord cells and adult stem cells. According to Dr Abraham, Director of Nichi-in Center for Regenerative Medicine, stem cell therapy does cure liver cirrhosis and spinal cord injury provided the patient is young and the level of injury is low. He suggests that stem cell therapy was a real boon to patients with spinal cord injury, liver cirrhosis, peripheral vascular diseases and ischaemic heart diseases.

“Multi-centric study of stem cell application in these disorders have proven the safety in all and efficacy in a select group of patients, who otherwise have no other option for treatment”. However, nobody undergoing stem cell surgery for Parkinson's Disease has ever been cured of it. All patients undergoing stem cell surgery have returned home with Parkinson's Disease and still have to be treated for Parkinson's Disease. What benefits some medical disorders is frequently not of any use in others. For more information go to the Complete article.

 

12th February 2008 - News report

ELECTRIC ACUPUNCTURE FOR PARKINSON'S DISEASE

Two American physicians have unveiled a machine that they claim could dramatically improve the life of people with Parkinson’s disease. It's a device that sends small electrical currents into the hands and feet of patients - a bit like acupuncture or acupressure.

They began testing it a month ago. They say so far it's showing very positive results. Once a day, patients use his machine to send electrical currents into their bodies. "It's done through electrodes on the hands and feet, and it stimulates acupuncture points and reflexology points, as well as free nerve endings," said Dr. Rhodes. Dr. Rob Izor, who is the neurologist who oversees the tests claims that all five of their patients have shown progress. Doctors Izor and Rhodes say more research is needed before their machine will be available to the public. For more information go to the Complete article and VIDEO.

 

9th February 2008 - New research

THE MYSTERY OF RESTLESS LEGS SYNDROME

Neurology [2008] 70 (1) : 35-42 (Winkelman JW, Shahar E, Sharief I, Gottlieb DJ.)  Complete abstract

Restless Legs Syndrome is characterized by an urge to move the legs. This urge can often be accompanied by pain or other unpleasant sensations, and it either occurs or worsens with rest. It becomes more likely at night, which is why  sleep disturbances are the most frequent reason for patients seeking medical help for it. It becomes progressively more common with age. Just like Parkinson's Disease, dopaminergic drugs are the primary method of treating it.

However, it is not purely a Parkinson's Disease symptom, as it often occurs in people that don't have Parkinson's Disease. The precise cause has never been known. Researchers evaluated the association between Restless Legs Syndrome and both cardiovascular disease and coronary heart disease. In a large study, they found that Restless Legs Syndrome was far more common in those people with either cardiovascular disease or coronary heart disease. This association was stronger in those with severe Restless legs Syndrome. Given that anemia is also common in RLS, it appears that besides dopamine deficiency, that reduced blood flow to the legs worsens Restless Legs Syndrome. The precise reason why is still not known.


                                                                                                                                                                                    8th February 2008 - News report

Blood Pressure drugs Cut Risk Of Parkinson's Disease

Long term use of calcium channel blockers, one of several types of blood pressure lowering tablets in widespread use, cuts the likelihood of developing Parkinson's Disease by 23%. There was no reduced risk when using several other high blood pressure drugs : ACE inhibitors, AT II antagonists and beta blockers. Researchers have suggested more research is needed to determine why calcium channel blockers such as verapamil and diltiazem help Parkinson's disease, whether this is a causal association, and why other high blood pressure medications do not offer a reduced risk.

The Parkinson's Disease Society, said : "It is too early to state with confidence whether calcium channel blockers can protect against Parkinson's disease. Although people using calcium channel blockers in this study had a lower incidence of Parkinson's we cannot determine whether these drugs can prevent the condition." For more information go to the Complete article.
 

                                                                                                                                                    7th February 2008 - New research

HARMANE - A COMMON CAUSE OF TREMOR

Neurotoxicology [2007] Dec 27; [Epub ahead of print] (Louis ED, Jiang W, Pellegrino KM, Rios E, Factor-Litvak P, Henchcliffe C, Zheng W.) Complete abstract

Harmane is a potent tremor-producing neurotoxin. In 2002, researchers demonstrated elevated blood harmane concentrations in an initial sample of 100 cases of Essential Tremor. Between 2002 and 2007, the same researchers assembled a new and larger sample of Essential Tremor cases in order to prove their previous findings.  Levels of harmane in the blood were confirmed to be much higher in those people with tremor. Harmane was highly related to cases of Essential Tremor. This was even more so in cases that were genetic, suggesting an inherited inclination to
high harmane levels. Harmane derives from Harmal.

In the U.S.A., Harmal was originally grown as an exotic plant. However, strong winds inadvertently mixed Harmal in with other crops. Harmane and similar substances are consequently also found in wheat, rice, corn, barley, soybeans, rye, grapes, mushrooms, vinegar, and plant-derived beverages (wine, beer, whisky, brandy, and sake). According to previous research, harmane is also commonly contained in tobacco smoke, which suggests that smoking could also cause tremor by increasing harmane levels. For more information go to the Complete article.

 

5th February 2008 - News report

SEROTONIN RELIEVES L-DOPA SIDE EFFECTS

As Parkinson's Disease progresses, L-DOPA can cause prominent side effects, such as dyskinesia, that counteract L-dopa's effectiveness. Researchers have provided evidence that serotonin, a substance that the brain produces primarily to cause sleep, as well as regulate mood, appetite, and sexuality and sleep, can also play a role in Parkinson's disease. Researchers have shown using a model, that L-dopa side effects can be blocked by stimulating a serotonin receptor. 

They used a molecule they are calling CP94253, which mimics the action of serotonin. Involuntary movements, as are seen in advanced Parkinson's Disease, decreased when using it. The researchers believe that CP94253, and similar serotonin 1B receptor agonists (synthetic substances that act like serotonin), may counteract L-DOPA-induced behaviours by reducing the release of GABA, a substance the brain produces to inhibit the transmission of nerve impulses. The researchers suggest that this provides a rationale for developing drugs that act like serotonin in order to treat the side effects experienced in advanced Parkinson's Disease.  For more information go to the Complete article.

 

4th February 2008 - News report

SUPERCOMPUTERS USED TO DEVELOP PARKINSON'S DISEASE DRUGS

Proteins are long chains of amino acids, just like pearl necklaces are long chains of pearls. Proteins regulate most of the functions in the body. Just as pearl necklaces can change shape and position, so can proteins. It is only when a protein is in a certain position that it has any effect on the cells of the body.  Supercomputers may now help obtain precise geometric details of proteins, something that may be important for determining exactly the shape and position of proteins when they interact with the various cells in the body. 

This has become possible due to the development of MAPAS (Membrane-Associated Protein Assessments). Previously, choosing the structure of a specific drug that would have effect on any biological function out of the many possibilities was largely a matter of trial and error, because the precise structure of the drugs that were needed was not even known. Researchers at the San Diego Supercomputer Center (SDSC) and UC San Diego say that this approach may now lead to the development of new drugs for medical disorders such as Parkinson's Disease. According to the researchers, this tool has already provided them with important information regarding Parkinson's Disease. For more information go to the Complete article.
 

                                                                                                                                                       2nd February 2008 - New research

DYSTONIC TREMOR : DYSTONIA AND TREMOR WITHOUT A LACK OF DOPAMINE

Movement Disorders [2007] 22 (15) : 2210-2215 (Schneider SA, Edwards MJ, Mir P, Cordivari C, Hooker J, Dickson J, Quinn N, Bhatia KP.) Complete abstract

A number of patients had tremor in their arms, and reduced arm swing on the affected side, so Parkinson's Disease was suspected. All of the patients also had dystonia, or at least components of arm tremor that were compatible with dystonic tremor. Despite it being considered that they had Parkinson's Disease, none of them had developed akinesia (a loss of movement) after nearly six years. In contradiction of the suggestion that they might have Parkinson's Disease, none of them had a lack of dopamine, which would be expected in Parkinson's Disease.

Given that Parkinson's Disease is so frequently misdiagnosed, the researchers suggest that clinicians should be aware that dystonia can begin with arm tremor, impaired arm swing and sometimes jaw tremor, but without akinesia. These are not necessarily Parkinson's Disease symptoms even though these symptoms are often experienced by people with Parkinson's Disease. Parkinson's Disease is largely due to a lack of dopamine. However, dystonia is largely due to a lack of GABA, an entirely different substance produced in the brain.

 

1st February 2008 - News report

Michael J. Fox Foundation FUNDS FOUR DIFFERENT APPROACHES

The Michael J. Fox Foundation has awarded funding for research projects using four very different approaches to dealing with Parkinson's Disease. One of them will work to develop a disease-modifying drug that could block the toxicity associated with clumping of the protein alpha-synuclein, a substance that often appears in the cells of people with Parkinson's Disease.

Another project will test compounds that specifically target inflammation in Parkinson's Disease to determine whether blocking inflammation using certain drugs reverses loss of activity of dopamine-producing cells. The third project concerns a substance that crosses the blood-brain barrier, and then increases levels of trophic factors, which are specialized substances that potently promote survival of nerve cells. The fourth project concerns the mitochondria which is the energy producing part of cells.  It is widely believed that the function of the mitochondria is reduced in Parkinson's Disease. Newly developed substances that improve mitochondrial function will be assessed to se whether these substances help to prevent cell damage. For more information go to the Complete article.

 

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