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SEPTEMBER 2009

                                                                                                                                                      30th September 2009 - New book

DEEP BRAIN STIMULATION

Peter Bain, Tipu Aziz, Xuguang Liu, Dipankar Nandi

Publisher's description : Deep brain stimulation (DBS) is increasingly used for the treatment of patients with severe Parkinson's disease, but the technique and science behind it is still poorly understood by most clinicians. This book is intended to provide an overview of the use of DBS for movement disorders. The first part of the book covers the varying surgical techniques involved in implanting electrodes into various deep nuclei within the brain. The neuro-physiological techniques involved in this process and the complex issue of programming the implanted stimulator in order to optimize therapeutic efficacy and minimize stimulation induced adverse effects. The second part of the book describes how to select appropriate patients and describes the results of DBS treatment for Parkinson's disease, dystonia and tremors. Edited by three of the world's leading experts in the DBS field, this pocketbook provides neurologists, trainees, and specialist nurses with an overview of the therapeutics use of DBS. Click here for more details.  For more books concerning Parkinson's Disease go to Parkinson's Disease Books.

 

27th September 2009 - New research

OCCUPATIONS ASSOCIATED WITH PARKINSON'S DISEASE

Archives of Neurology [2009] 66 (9) : 1106-1113 (Tanner CM, Ross GW, Jewell SA, Hauser RA, Jankovic J, Factor SA, Bressman S, Deligtisch A, Marras C, Lyons KE, Bhudhikanok GS, Roucoux DF, Meng C, Abbott RD, Langston JW.) Complete abstract

Work in agriculture, education, health care, or welding was not associated with increased risk of Parkinsonism. Unexpected increased risks associated with legal, construction and extraction, or religious occupations were not maintained after adjustment for duration. However, having worked in business, finance, legal occupations, construction and extraction, or transportation and material moving was associated with postural instability and gait difficulty. None of the occupations, job tasks, or task-related exposures were associated with Parkinson's Disease being diagnosed at a younger age. Pesticide use made the likelihood of Parkinsonism almost twice (1.9 times) more likely.  Use of any of 8 pesticides more than doubled (2.2 times) the likelihood. This risk was even higher (2.59 times more likely) with the use of 2,4-dichlorophenoxyacetic acid. In order to refer to this article on its own click here.

 

26th September 2009 - New book

UNDERSTANDING PARKINSON'S DISEASE : A SELF-HELP GUIDE

David L. Cram, Xiao Gao, Steven Schechter

Publisher's description : A simple, sympathetic guide to coping with a progressive, disabling brain disorder. Physician Cram was diagnosed with Parkinson's disease ten years ago. Here he matches his personal experience with his experiences treating other patients with the disease. Cram is a firm believer in four elements to self-help : a positive attitude, information about the disease; partnership with a knowledgeable physician, and a willingness to take action, to do the things "that make you feel better, help slow the disability, and keep you as independent as possible for as long as possible.'' Cram goes on to explain the overall progression of the disease through five stages. The hope he offers is that early self-help and medication may delay or even prevent the later stages. He looks at at emotional considerations, diet, exercise, and other lifestyle needs, as well as present and possible medical treatments. Click here for more details.  For more books concerning Parkinson's Disease go to Parkinson's Disease Books.

 

22nd September 2009 - New research

THE PREVALENCE OF HALLUCINATIONS IN PARKINSON'S DISEASE

Journal of Neurological Science [2009] Sep 7 [Epub ahead of print] (Fénelon G, Alves G.) Complete abstract

Visual hallucinations have been found to be present in about one quarter to one third of people with Parkinson's Disease. Auditory hallucinations occur in up to 20%. Psychotic symptoms are frequent and disabling in people with Parkinson's Disease. Tactile (touch) and olfactory (smell) hallucinations are usually not systematically checked. Minor phenomena such as sense of presence and visual illusions affect anywhere between 17% to 72% of people
with Parkinson's Disease.

Delusions affect only about 5%. Hallucinations persist and worsen and their prevalence increases with time. The symptoms are usually due to Parkinson's Disease drugs. Dopaminergic agonists increase the likelihood of symptoms, but there is no simple dose-effect relationship between dopaminergic treatments and the presence or severity of hallucinations. Other factors associated with hallucinations include older age, duration of Parkinson's Disease, disease severity, altered dream phenomena, and daytime sleepiness. In order to refer to this article on its own click here.

 

18th September 2009 - New research

SUICIDE IS FIVE TIMES MORE LIKELY IN PARKINSON'S DISEASE

Journal of Neurological Science [2009] Sep 7 [Epub ahead of print] (Kostic VS, Pekmezovic T, Tomic A, Jecmenica-Lukic M, Stojkovic T, Spica V, Svetel M, Stefanova E, Petrovic I, Džoljic E.) Complete abstract

People with Parkinson's Disease have been found to be five times more likely to commit suicide. In some people with Parkinson's Disease, this tendency increases far beyond that. Current thoughts of death or suicide were found in nearly a quarter of people with Parkinson's Disease. This tendency was related to mood, especially depression, rather than the severity of  Parkinson's Disease symptoms.

The primary cause of Parkinson's Disease is insufficient dopamine. Although insufficient dopamine causes the excessive muscle contraction that is characteristic of Parkinson's Disease, insufficient dopamine also affects the emotions, tending to make people more prone to depression. This is why depression is common in many, but certainly not all people with Parkinson's Disease. So the increased likelihood of suicide and suicidal thoughts in Parkinson's Disease is largely caused due to a biochemical deficiency of dopamine rather than by the practical problems and circumstances that Parkinson's Disease can lead to. In order to refer to this article on its own click here.

 

14th September 2009 - New book

BENEFICIAL EFFECTS OF PHYSIOTHERAPY ON FUNCTION IN PARKINSON'S DISEASE

Muhammed Al - Jarrah

Publisher's description : Drugs used to treat PD halt the symptoms of the disease for a few years, but later can result in serious complications. Surgery as another option available to treat PD has been shown to carry significant risk factors and treat only certain symptoms of PD. Several studies demonstrated that exercise provides protection against PD and lowers the risk of getting PD, but most of these studies did not examine the physiological mechanisms of how exercise helps patients with PD. In this book, we conducted experiments to begin to narrow down the possible changes occurring with exercise in chronic/progressive animal model of PD that would explain the beneficial outcomes. These mechanisms include the beneficial effect of exercise on Respiratory parameters such as O2 consumption, CO2 production, and heat production in cardiac and skeletal muscles. Click here for more details.  For more books concerning Parkinson's Disease go to Parkinson's Disease Books.

 

11th September 2009 - News release

THE WORLD'S SMALLEST DEEP BRAIN STIMULATOR FOR PARKINSON'S DISEASE

Approval has been given for the world's smallest, longest-lasting rechargeable Deep Brain Stimulator (DBS) for Parkinson's Disease. Deep Brain Stimulation (DBS) involves the use in Parkinson's Disease of electrodes that are implanted into the brain and connected to a small electrical device that can be externally programmed. For more information go to Deep brain stimulation. The new small device is called the Brio neurostimulator. It is very thin and light, and only slightly bigger than a man's wrist watch. Additionally, the device has the greatest recommended implant depth of any rechargeable DBS device.

The thin profile and greater implant depth potentially makes the neurostimulator less noticeable and more comfortable for patients. The Brio DBS system delivers mild electrical pulses to specific targets in the brain, stimulating the structures that are involved in muscular movement. The system consists of a neurostimulator – a surgically implanted battery-operated device that generates the electrical pulses – and leads which carry the pulses to the brain to influence the irregular nerve signals responsible for the symptoms of Parkinson’s Disease. For more details read the News release. In order to refer to this article on its own click here.

 

9th September 2009 - New research

THE EFFECT OF ROPINIROLE (REQUIP) ON PARKINSON'S DISEASE

Clinical neurology and neurosurgery [2009] Sep 2 [Epub ahead of print] (Valldeoriola F, Cobaleda S, Lahuerta J.) Complete abstract

Ropinirole is a dopamine agonist that is commonly used in the treatment of Parkinson's Disease. It is often sold as
Requip, Ropark, or Adartrel. For more information go to Ropinirole. Ropinirole was found to be mostly used as an add on treatment (in 76% of cases), and as the only treatment in around a quarter (24%) of those people using it. The average maintenance dose was found to be 9mg per day, and normally be within the range 4mg to 15mg.

Over a quarter (28%) of people taking Ropinirole reported adverse reactions. The most frequent adverse reactions were somnolence and sedation (9%), gastrointestinal symptoms (7%), increase in dyskinesia (6%), and orthostatic symptoms (4%). Treatment using Ropinirole was withdrawn in 14% of patients, largely because of either adverse reactions, lack of efficacy, or change in treatment. Over 80% of people taking Ropinirole were considered by their neurologists to have improved after taking it. In order to refer to this article on its own click here.

 

5th September 2009 - New research

RETINAL STEM CELLS DISAPPEAR AFTER SURGERY FOR PARKINSON'S DISEASE

Neurology [2009] Sep 2. [Epub ahead of print] (Farag ES, Vinters HV, Bronstein J.) Complete abstract

Retinal pigment epithelial cells have been found to disappear after being used in a form of surgery intended for use in Parkinson's Disease. For years, the use of implanted stem cells have been claimed to have the potential  to rid Parkinson's Disease. One of these means is the use of RPE
(retinal pigment epithelium) cells. These cells are found in the eyes and can also produce dopamine, the substance whose deficiency causes Parkinson's Disease.

A 68-year-old man underwent surgical implantation of 325,000 RPE cells in Spheramine (gelatin microcarriers) for the treatment of Parkinson's Disease. He happened to die six months after the surgery took place. This enabled the researchers to see what happened to retinal stem cells after surgical implantation. Over 99.9% of the cells had disappeared after only six months. Implanted cells simply failed to survive. A previous study using the same methods demonstrated only a moderate benefit for six months. For more details see the Complete abstract. Despite different forms of stem cell surgery now being carried out in countries around the world, there is not even one study in the entire medical literature showing that anybody has ever been rid of Parkinson's Disease by this means.  In order to refer to this article on its own click here.

 

2nd September 2009 - News report

PIMAVANSERIN FAILS CLINICAL TRIAL FOR PARKINSON'S DISEASE

Pimavanserin, a drug in development for psychosis related to Parkinson's Disease failed to have any beneficial effect in clinical trials. Psychotic episodes, such as hallucinations and delusions, sometimes occur in Parkinson's Disease. The drug was being developed by Arcadia and Biovail. For more information go to Biovail.

Parkinson's Disease is largely due to insufficient dopamine. Psychosis appears to be due to almost the opposite - an excess or an accumulation of dopamine. This is why anti-psychotic drugs can cause Parkinson's Disease symptoms, and why Parkinson's Disease drugs can sometimes cause symptoms of psychosis. Pimavanserin is a "5-HT 2A receptor inverse agonist". Biochemically that could have no effect on the excessive dopamine found in psychosis.  So the failure of Pimavanserin in clinical trials is almost predictable. The psychosis sometimes experienced in Parkinson's Disease is normally due to the excessive use of dopaminergic drugs. So a reduction in the use of those drugs is a more rational approach than using an additional drug to combat the effects of dopaminergic drugs. In order to refer to this article on its own click here.

 

1st September 2009 - History

LEONARDO DA VINCI'S DESCRIPTIONS OF PARKINSON'S DISEASE

The Italian artist, engineer and scientist Leonardo da Vinci (1452-1519) also studied anatomy, physiology and medicine. Leonardo da Vinci kept secret notebooks in which he wrote and sketched his ideas and observations, in handwriting that only he could read. So keen was he to study the human body that he went out at night to dissect human corpses. For more information go to Leonardo da Vinci.

Over 300 years before James Parkinson formally described Parkinson's Disease, Leonardo da Vinci saw people whose symptoms coincided with those seen in Parkinson's Disease. Leonardo wrote in his notebooks that "you will see.....those who.....move their trembling parts, such as their heads or hands without permission of the soul; (the) soul with all its forces cannot prevent these parts from trembling." In a translation of Da Vinci's notebooks "The movements of paralytics of those benumbed by cold, whose head and members move without control of the soul, who cannot stop the movements." The combination of difficulty with voluntary movement ("paraletici") and tremor ("tremanti') leave little doubt of the diagnosis of Parkinson's Disease. At the end of his life Leonardo was unable to paint due to the loss of control of movement in his hands. It has been suggested that, by then, Leonardo had the disorder himself. Due to most of his notebooks remaining secret for centuries, Leonardo did not receive any credit for contributing to the recognition of Parkinson's Disease. In order to refer to this article on its own click here.

 

 

 

 

 

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