PARKINSON'S DISEASE NEWS
Parkinson's Disease News covers all significant new research, reports, books, and resources concerning Parkinson's Disease. Articles are chosen on the basis of their medical significance or potential interest. Our overwhelming priority is the facts, regardless of whether they contradict prevailing views or vested interests. Analysis and further information are provided either to explain the background or implications, or to balance misleading claims. If you notice errors or inadequacies, or dispute what is written, or want to propose articles, please e-mail firstname.lastname@example.org.
6th May 2016 - New research
BRADYPHRENIA IN PARKINSON'S DISEASE
Bradyphrenia is mental slowness. Bradyphrenia can consist of slowness of thought, impaired attention and motivation, lack of spontaneity, and inflexibility. Bradyphrenia was well known to occur in Parkinson's Disease. For the first time researchers have assessed how prevalent bradyphrenia is in Parkinson's Disease and what causes it.
Bradyphrenia was found to occur in as many as half of people with Parkinson's Disease. Between 11% and 51% of people with Parkinson's Disease were found to exhibit mental slowness by performing significantly worse on neuro- psychological tests including tests of attention and executive function. However, bradyphrenia was found to be uncommon in people with Parkinson's Disease who did not also have dementia or depression. The results suggest that the depression or dementia that often accompanies Parkinson's Disease is the cause of the bradyphrenia.
Bradyphrenia in Parkinson's disease may also reflect advancing age because the effects of age may be greater in some cases than the effects of basal ganglia disease once motor dysfunction has been allowed for. However, he dopamine system through the medial forebrain bundle projecting from the ventral tegmental area to the nucleus accumbens, ventral striatum (limbic striatum) and the cortex is associated with bradyphrenia.
Reference : Journal of Clinical and Experimental Neuropsychology  May 1 : 1-9 [Epub ahead of print] (T.T.Vlagsma, J.Koerts, O.Tucha, H.T.Dijkstra, A.A.Duits, T.van Laar, J.M.Spikman) Complete abstract In order to refer to this article on its own click here
29th April 2016 - New book
PARKINSON'S DISEASE : CURRENT AND FUTURE THERAPEUTICS AND CLINICAL TRIALS
Nestor Galvez-Jimenez, Hubert H.Fernandez, Alberto J.Espay, Susan H.Fox
Publisher's description : This book emphasizes treatment options for Parkinson's disease, critically assessing pharmacologic and surgical interventions for all aspects of the disease. Evidence from randomized controlled clinical trials is highlighted to develop practical recommendations for clinical practice. Lessons learnt from clinical trials are all addressed. Readers will find the necessary clinical and scientific foundations for the understanding of the disease, the underpinnings of the pathological processes, the identification of disease biomarkers, and the basis for solid therapeutics. The chapters are authored by an international team of specialists in each subject. Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books
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25th April 2016 - New research
"EARLY MORNING OFF" IN PARKINSON'S DISEASE
Early Morning Off (EMO) is a lengthy delay in the therapeutic effect of the initial dose of an oral medication in the morning. Early Morning Off (EMO) is a symptom experienced by people at every stage of Parkinson's Disease. However, few studies have assessed how common it is, leaving the extent of its impact almost completely unknown. For a graph showing the effects of EMO go to : Early Morning Off
EMO occurs as there is a delay in the effect of the initial dose of oral medication, possibly due to gastroparesis. Gastroparesis is a chronic condition in which the stomach cannot empty itself in the normal way. For more information go to : Gastroparesis
The analysis assessed the responses from 2205 completed surveys. People with Parkinson's Disease who felt they had EMO amounted to around 80%, with 37% of them stating that EMO was a daily occurrence. The prevalence of EMO increased as Parkinson's Disease worsened. However, even 52% of people with early Parkinson's Disease had EMO. The Quality of Life of those with EMO was also significantly reduced and the odds of caregivers feeling a sense of burden was higher. The prevalence of EMO in the survey results was high, and significantly lowered the persons Quality of Life. EMO was also observed in the early stages of Parkinson's Disease.
Reference : Reference : Journal of Neurological Science  364 : 1-5 (R.Onozawa, J.Tsugawa, Y.Tsuboi, J.Fukae, T.Mishima, S.Fujioka) Complete abstract In order to refer to this article on its own click here
21st April 2016 - New research
ALEXITHYMIA IN PARKINSON'S DISEASE
Alexithymia has been found to be highly prevalent in Parkinson's Disease to the extent that it is commonly part of it. Alexithymia is a personality trait characterised by difficulties identifying and describing feelings and a reduced tendency to think about emotions. For more information go to : Alexithymia
An extensive assessment of the medical databases was carried out. Ten studies reported that alexithymia prevalence was about double in Parkinson's Disease. In previous studies about 20% to 50% of people with Parkinson's Disease have alexithymia, which is about 2 to 4 times normal. Specific dimensions of alexithymia might be related to depression, anxiety, apathy and impulsivity. Two studies on neurological features reported a link between alexithymia and the stage of Parkinsons' Disease. The remaining studies found that alexithymia was independent from neurological symptoms and dopaminergic therapy. There is a strong association between alexithymia and the severity of depression, which appears to be the primary cause.
The results suggest that alexithymia is a primary characteristic of Parkinson's Disease that is often related to depression.
Reference : Parkinsonism and Related Disorders  Mar 30 [Epub ahead of print] (F.Assogna, L.Cravello, M.D.Orfei, N.Cellupica, C.Caltagirone, G.Spalletta) Complete abstract In order to refer to this article on its own click here
11th April 2016 - New research
ADAPTIVE DEEP BRAIN STIMULATION FOR PARKINSON'S DISEASE
Conventional Deep Brain Stimulation is set by a movement disorders specialist and left running continuously without change until the next clinic visit. However, this continuous high voltage stimulation may interfere with normal functioning. In contrast, Adaptive deep brain stimulation (aDBS) has the potential to greatly improve the treatment of Parkinson's disease by optimizing deep brain stimulation in real time according to fluctuating disease and medication state. For more information go to : Adaptive Deep Brain Stimulation
An external portable aDBS system prototype was developed that was designed for clinical testing in people with Parkinson's Disease who had externalised DBS electrodes. The aDBS system was validated by testing both its sensing and stimulation capabilities, and then by testing it in vivo, focusing on the sensing capabilities. By applying the aDBS system prototype in a patient with Parkinson's Disease, evidence was provided that it can track L-dopa and DBS-induced LFP spectral power changes among different patient's clinical states.
Compared to conventional deep brain stimulation (DBS) for people with Parkinson's Disease (PD), the newer approach of adaptive DBS (aDBS), regulating stimulation on the basis of the patient's clinical state, promises to achieve better clinical outcomes, avoid adverse-effects and save time for tuning parameters.
6th April 2016 - New research
THE EMOTIONAL EFFECTS OF DBS ON PARKINSON'S DISEASE
Researchers assessed the effect of Deep Brain Stimulation (DBS) on anxiety, depression and psychosis. Deep Brain Stimulation involves the use of electrodes that are implanted into the brain and connected to a small electrical device that can be externally programmed. DBS can reduce the need for L-dopa and related drugs, which in turn decreases the dyskinesias that are a common side effect of L-dopa. DBS helps to alleviate fluctuations of symptoms and reduce tremors, slowness of movements, and gait problems. DBS requires careful programming of the stimulator device. For more information go to : Deep Brain Stimulation
Improvement of depression and anxiety was apparent after DBS, and was more pronounced in the short-term, an effect that seems to decline in later assessments. Concerning depression, DBS was more effective than medical treatment. However, with anxiety, medical treatments were found to be more effective than DBS. The pattern and course of depression and anxiety following DBS is not clear, although both seem to improve in the short-term. The risk of psychosis remains fairly constant throughout the first five years after DBS implantation. Results suggest that most psychoses occurring postoperatively are independent of DBS implantation and stimulation settings.
References : Acta Medica Portuguesa  27 (3) : 372-382 (M.I.Couto, A.Monteiro, A.Oliveira, N.Lunet, J.Massano) Complete abstract Neurosurgical Focus  38 (6) : E5 (A.A.Qureshi, J.J.Cheng, A.N.Sunshine, A.Wu, G.M.Pontone, N.Cascella, F.A.Lenz, S.E.Grill, W.S.Anderson) Complete abstract In order to refer to this article on its own click here
26th March 2016 - New research
ANTI-PSYCHOTICS DOUBLE MORTALITY RISK IN PARKINSON'S DISEASE
As many as 60% of people with Parkinson's Disease experience psychosis, and so the use of anti-psychotics in Parkinson's Disease is common. The use of anti-psychotics has been found to more than double the risk of mortality in Parkinson's Disease.
Anti-psychotic use in Parkinson's Disease was associated with more than twice (2.35 times) the risk of death compared with non use of anti-psychotics. The risk was significantly higher for people who used typical rather than atypical anti-psychotics. Among the atypical anti-psychotics used the risk relative to non use of anti-psychotics in descending order were 2.79 for olanzapine, 2.46 for risperidone, and 2.16 for quetiapine. The researchers concluded that the use of anti-psychotics is associated with a significantly increased mortality risk in people with Parkinson's Disease.
This finding highlights the need for cautious use of anti-psychotic use in people with Parkinson's Disease including examining the role of non-pharmacologic strategies in managing psychosis in Parkinson's Disease, and that anti-psychotics that do not increase mortality need to be developed.
Reference : JAMA Neurology  Mar 21 [Epub ahead of print] (D.Weintraub, C.Chiang, H.M.Kim, J.Wilkinson, C.Marras, B.Stanislawski, E.Mamikonyan, H.C.Kales) Complete abstract
The U.S. Food and Drug Administration has just announced that Nuplazid (pimavanserin), which is Acadia Pharmaceuticals drug to treat psychosis associated with Parkinson's disease, was effective enough to warrant approval. Nuplazid could be the first drug specifically approved in the United States for Parkinson's disease psychosis (PDP). However, pimavanserin was previously found to increase the mortality rate even more than those drugs in the present study. Complete abstract In order to refer to this article on its own click here
18th March 2016 - New research
MONITORING TECHNOLOGIES TO ASSESS PARKINSON'S DISEASE
Researchers carried out a systematic review in order to (1) list, (2) compare and (3) classify technological-based devices used to measure motor function in people with Parkinson's Disease into three groups : wearable, non-wearable and hybrid devices. A systematic search of the PubMed database resulted in the inclusion of 168 studies.
These studies were grouped based on the type of device used. For each device they reviewed the availability, use, reliability, validity, and sensitivity to change. 73 devices were identified. Of these, 22 were wearable, 38 were non- wearable, and 13 were hybrid devices. In accordance with their classification, 9 devices were recommended, 34 were suggested, and 30 devices were classified as listed. Within the wearable devices group, those classified as recommended were the :
Mobility Lab System (APDM) - A watch-sized device consisting of up to six sensors that enables the registration of different outcomes such as, postural sway, lower limb gait, postural transitions, upper limb gait, and trunk measures. Go to the web site
Physilog - An analysis method that uses body-attached gyroscopes to assess spatio-temporal parameters of gait, sway, physical activity, tremor and bradykinesia.Minimal attachment sites are used and no calibration is needed. Go to the web site
StepWatch 3 - The StepWatch 3 (SAM) is a step activity monitor used to capture differences in ambulatory activity according to age and functional limitation. The StepWatch (SAM) is the size of a pager and attaches to the ankle. Go to the web site
TriTrac RT3 Triaxial accelerometer - The TriTrac RT3 may be suitable for sustained tracking of free-living physical activity in the home environment. It is small, capable of collecting and storing data in one-minute epochs for 21 days. Go to the web site
McRoberts DynaPort - The DynaPort MiniMod Hybrid combines acceleration sensors and gyroscopes with six channels that assess the individual’s movement at 100Hz each. Go to the web site
Axivity (AX3) - The Axivity (AX3) is a three-axis accelerometer that has a non-volatile flash memory chip linked by a USB-enabled microcontroller. Inside the sealed polycarbonate puck is a temperature sensor, ambient light sensor, and real time clock and lithium polymer battery. Go to the web site
Within the non-wearable devices group, those classified as recommended :
Nintendo Wii Balance Board - Nintendo Wii Balance Board is a commonly used accessory for video game consoles. It is considered a cheap, widespread, clinimetric robust device that can be used to measure postural instability in PD patients. Go to the web site
GAITRite gait analysis system - The GAITRite system is an electronic pathway that contains pressure sensitive sensors arranged in a grid-like pattern. The carpet is portable and can be rolled up for transportation. It is used for laboratory evaluation and provides information regarding several gait parameters, such as walking speed, cadence and step length. Go to the web site
Within the hybrid devices group the only one classified as recommended was the :
Kinesia system - Kinesia integrates accelerometers and gyroscopes in a compact patient-worn unit to capture kinematic movement disorder features. The sensor component of the device is mounted on a ring, which fits on a finger. Go to the web site
Reference : Journal of Neuroengineering and Rehabilitation  13 (1) : 24 (C.Godinho, J.Domingos, G.Cunha, A.T.Santos, R.M.Fernandes, D.Abreu, N.Gonçalves, H.Matthews, T.Isaacs, J.Duffen, A.Al-Jawad, F.Larsen, A.Serrano, P.Weber, A.Thoms, S.Sollinger, H. Graessner, W.Maetzler, J.J.Ferreira) Go to the Complete study In order to refer to this article on its own click here
16th March 2016 - New research
SMARTPHONES FOR ASSESSING PARKINSON'S DISEASE TREMOR
The assessment of Parkinson's Disease and the treatments that sohould be used for it are dependent on the quantification of symptoms such as tremor. A new system has been proposed for mobile phone applications, in which the mobile phone assesses the level and frequency of a person's tremor. . The system is based on measuring the acceleration from the hand of the person with Parkinson's Disease using a mobile cell phone accelerometer. For more information concerning use of mobile phone accelerometers for tremor go to : Mobile phone accelerometers
Recordings were made from an equal number of people with and without Parkinson's Disease. The recordings were analysed using a two level wavelet packet analysis. Features were extracted forming a feature vector of 12 different elements. The features extracted from the subjects were classified using a neural networks classifier. The results obtained showed an accuracy of 95%. These results indicate that a cell phone accelerometer can accurately detect and record rest tremor in people with Parkinson's Disease.
Reference : Journal of Medical Engineering Technology  Mar 15 : 1-8 [Epub ahead of print] (L.Fraiwan, R.Khnouf, A.R.Mashagbeh) Complete abstract In order to refer to this article on its own click here
18th February 2016 - New research
IRON ACCUMULATION IN PARKINSON'S DISEASE
Previous studies have claimed that there is an accumulation of iron in the brains of people with Parkinson's Disease This study was designed to explore the progressive pattern of iron accumulation at different stages of Parkinson's Disease. They were able to confirm a regionally progressive pattern of iron accumulation in the different stages of Parkinson's Disease.
The substantia nigra pars compacta, which is the primary area of the brain affected by Parkinson's Disease, showed significantly increased iron levels in people with early Parkinson's Disease.
In people with advanced Parkinson's Disease, the regions of the brain with higher concentrations of iron spread to other areas of the brain (substantia nigra pars reticulata, red nucleus, globus pallidus).
Iron accumulation occurs in Hereditary Hemochromatosis. If iron accumulation caused Parkinson's Disease people with Hereditary Hemochromatosis should also have Parkinson's Disease. However, very few people with Hereditary Hemochromatosis have it. Instead of causing Parkinson's Disease, higher intake of iron is associated with a reduced risk of Parkinson's Disease. Iron is essential for the formation of dopamine, which is deficient in Parkinson's Disease. It is a common compensatory mechanism for a cofactor such as iron to accumulate when the substance it facilitates the formation of is deficient. So instead of iron accumulation causing Parkinson's Disease, Parkinson's Disease causes iron accumulation.
Reference : NMR in Biomedicine  Feb 8 [Epub ahead of print] (X.Guan, M.Xuan, Q.Gu, P.Huang, C.Liu, N.Wang, X.Xu, W.Luo, M.Zhang) Complete abstract In order to refer to this article on its own click here
11th February 2016 - New research
EXCESSIVE DAYTIME SLEEPINESS IN PARKINSON'S DISEASE
Excessive daytime sleepiness (EDS) is a common feature of Parkinson's disease (PD) that contributes to the disease burden and increases the risk of harm. For more information go to : Excessive daytime sleepiness The aim of this study was to examine persistency and risk factors for EDS in people with Parkinson's Disease.
Excessive daytime sleepiness proved to be a non-persistent symptom in Parkinson's Disease, although persistency and the proportion of patients with EDS increased when followed up. At the outset, 43% of people with Parkinson's Disease had EDS. This increased to 46% when checked later on. Those factors that were more associated with Excessive daytime sleepiness in Parkinson's Disease were : male gender, poorer night time sleep, cognitive dysfunction, autonomic dysfunction, hallucinations, less severe dyskinesias, dosage of dopamine agonists, and use of anti-hypertensives.
With longer disease duration of Parkinson's Disease a large proportion of patients develop Excessive daytime sleepiness (EDS). However, some of the risk factors are modifiable, and so can be altered in order to lessen the degree of Excessive daytime sleepiness.
18th January 2016 - New research
20 PER CENT WITH PARKINSON'S DISEASE ARE MISDIAGNOSED
An extensive study, carried out over the last 25 years, has shown that around 20% of people diagnosed with Parkinson's Disease have been misdiagnosed. The expertise of the person making the diagnosis did not make a considerable difference.
Twenty studies were assessed for the accuracy of diagnosing Parkinson's Disease. The average accuracy of diagnosing Parkinson's Disease for these studies was only 80%. For clinical diagnosis performed by non-experts the accuracy of diagnosis was even less at 73% accuracy. Accuracy of clinical diagnosis performed by movement disorders experts rose from 79% at the initial assessment to 84% after a follow-up assessment. The average accuracy of diagnosis by movement disorders experts overall was 82%.
The accuracy of diagnosing Parkinson's Disease was found to have not significantly improved in the last 25 years. The overall validity of clinical diagnosis of Parkinson's Disease is far from satisfying. This is particularly true in the early stages of Parkinson's Disease, when the response to dopaminergic treatment is less defined and hallmarks of alternative diagnoses such as atypical Parkinsonism may not have emerged. For more concerning the methods of diagnosing Parkinson's Disease go to : Diagnosis of Parkinson's Disease
7th January 2016 - New research
OPICAPONE - NEW COMT INHIBITOR FOR PARKINSON'S DISEASE
Opicapone is a COMT inhibitor presently being assessed as a possible replacement for the COMT inhibitor Entacapone in its use in Parkinsons' Disease. COMT inhibitors are added to the use of L-dopa to enhance its effect because COMT inhibitors help to prevent the breakdown of L-dopa. Entacapone is presently the most widely used COMT inhibitor for use in Parkinson's Disease. For more information go to : Entacapone
A comparison was made between the use of a placebo, oral treatment with opicapone (5 mg, 25 mg, or 50 mg once daily), or entacapone (200 mg with every L-dopa intake). The reduction in off times were 56 minutes for a placebo, 96 minutes for entacapone, 91 minutes for 5mg opicapone, 86 minutes for 25mg opicapone, and, best of all, 116 minutes for 50mg opicapone. Adverse effects were reported in 50% of people taking a placebo, 57% taking entacapone, 52% taking 5mg opicapone, 55% taking 25mg opicapone, and 54% taking 50mg opicapone.
The most common adverse effects were dyskinesia, insomnia and
constipation. There was little difference in this respect between entacapone
and certain dosages of opicapone.
Reference : Lancet Neurol  Dec 22 [Epub ahead of print] (J.J.Ferreira, A. Lees, J.F.Rocha, W.Poewe, O.Rascol, P.Soares-da-Silva) Complete abstract In order to refer to this article on its own click here
31st December 2015 - New research
PRE-MOTOR SYMPTOMS OF PARKINSON'S DISEASE
Parkinson's disease is characterised by motor and non-motor clinical
features. The latter may present as pre-motor symptoms several years before
the onset of motor symptoms. Pre-motor symptoms have been found to be
associated to a later motor onset of Parkinson's Disease.
Pre-motor symptoms load is associated to a later motor onset of PD. Pre-motor symptoms are more frequent in subjects with late onset Parkinson's disease. Female subjects report a higher number of pre-motor symptoms, depression and anxiety being the most common.
Reference : Journal of Parkinson's Disease  Dec 10 [Epub ahead of print] (M.Rodríguez-Violante, A.J.de Saráchaga, A.Cervantes-Arriaga, R.Millán-Cepeda, R.Leal-Ortega, I.Estrada-Bellmann, C.Zuñiga-Ramírez) Complete abstract In order to refer to this article on its own click here
30th December 2015 - New book
GOODBYE PARKINSONS, HELLO LIFE !
Alex Kerten, David Brinn
Publishers description : In Goodbye Parkinson’s, Hello Life! Alex Kerten presents his holistic technique that combines dance therapy, behavior modification, and martial arts, to prove that there is life beyond the diagnosis of PD. Goodbye Parkinson’s, Hello life! received "Recommended Reading" status by the Michael J. Fox Foundation. Those who follow Kerten's techniques and are committed to becoming “Parkinson’s warriors” can succeed in eliminating many of their symptoms and return to a productive and fulfilling life. Instead of viewing themselves as Parkinson's victims, the methods in Goodbye Parkinson’s, Hello life! will lead them to become healthy people with Parkinson's. Includes 20 easy-to-follow exercises. Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books
28th December 2015 - New research
ULTRA EARLY DIAGNOSIS OF PARKINSON'S DISEASE
Researchers determined the value of enhanced substantia nigra echo in the diagnosis of Parkinson's Disease by analyzing the intensity and area of substantia nigra echo using transcranial Doppler sonography (TCS). Transcranial Doppler sonography is a technique that uses a handheld, microprocessor-controlled, low-frequency, pulsed Doppler transducer to measure the velocity and pulsatility of blood flow within certain areas of the brain. For more information go to : : Transcranial Doppler Sonography
People without Parkinson's Disease were compared to people with ultra early stage Parkinson's Disease using results of substantia nigra echo, which are graded I (the least) to V (the greatest). The sensitivity of substantia nigra echo in diagnosing Parkinson's Disease was 89% and the specificity was 93%. The levels were much higher in early Parkinson's Disease. The figures for those people with Parkinson's Disease compared to those who did not have it were Grade V (19% v none), Grade IV (33% v none), Grade III (36% v 6%), Grade II (11% v 40%), Grade I (none v 53%). High grades were only present in Parkinson's Disease. Low grades were only present when there was no Parkinson's Disease.
Analysis of substantia nigra echo is therefore of practical use for the diagnosis of the ultra early stage Parkinson's Disease. It is cheaper and easier than the primary scanning methods and so can potentially improve the accuracy of clinical diagnosis to significantly enhance the early clinical prevention of disability.
Reference : European Review of Medical and Pharmacologial Sciences  19 (23) : 4621-4626 (J.J.Zhuang, Y.H.Zheng, X.W.Xu, L.Zhou) Complete abstract In order to refer to this article on its own click here
26th December 2015 - New book
MY DEGENERATION : A JOURNEY THROUGH PARKINSON'S
Publishers description : How does one deal with a diagnosis of Parkinson’s disease at the age of forty-three? My Degeneration, by former Anchorage Daily News staff cartoonist Peter Dunlap-Shohl, answers the question with humor and passion, recounting the author’s attempt to come to grips with the “malicious whimsy” of this chronic, progressive, and disabling disease. This graphic novel tracks Dunlap-Shohl’s journey through depression, the worsening symptoms of the disease, the juggling of medications and their side effects, the impact on relations with family and community, and the raft of mental and physical changes wrought by the malady. Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books
23rd December 2015 - New research
PARKINSON'S DISEASE GENE SUPPRESSES CANCER
Melanoma incidence is higher in people affected by Parkinson's Disease but the genetic link shared by both diseases was unknown. The Parkin gene (PARK2) is often mutated in Parkinson's Disease and is consequently sometimes a genetic cause of Parkinson's Disease. However, PARK2 is also a tumor suppressor gene both of melanoma predisposition and progression. Melanoma is a form of skin cancer more common in Parkinson's Disease. For more information go to : Melanoma
The An in-depth analysis of the PARK2 (Parkin) gene showed that mutations were present far more often in Parkinson's Disease, making Parkinson's Disease nearly four times more likely. The formation of the Parkin gene occurs in melanocytes but not in most cells in which there is melanoma. The formation of the Parkin gene in melanoma cell lines resulted in a drastic reduction of cell proliferation. Inhibition of the Parkin gene in melanocytes stimulated their proliferation.
The results show an important role for the Parkin gene (PARK2), not only in Parkinson's Disease, but also as a tumor suppressor both in melanoma predisposition and progression, which could explain the association between Parkinson's Disease and melanoma.
Reference : Journal of the National Cancer Institute  108 (3) pii : djv340 (H.H.Hu, C.Kannengiesser, S.Lesage, J.André, S.Mourah, L.Michel, V.Descamps, N.Basset-Seguin, M.Bagot, A.Bensussan, C.Lebbé, L.Deschamps, P.Saiag, M.T.Leccia, B.Bressac-de- Paillerets, A.Tsalamlal, R.Kumar, S.Klebe, B.Grandchamp, N.Andrieu-Abadie, L.Thomas, A.Brice, N.Dumaz, N.Soufir) Complete abstract In order to refer to this article on its own click here
1st December 2015 - News release
NUMIENT AUTHORISED FOR USE IN PARKINSON'S DISEASE
Impax Laboratories have received authorisation in the EU for the use of NUMIENT™ (Levodopa and Carbidopa) Modified-Release Capsules for the treatment of Parkinson's Disease.
Numient is the same as Rytary, which is already available in the U.S.. Rytary and Numient are novel and distinct by including immediate release AND extended release versions of L-dopa. The different versions of Sinemet and Madopar include only immediate release OR extended release versions of L-dopa. For more information go to : Medscape
The authorisation is based on the results of Phase 3 clinical trials, which assessed the safety and efficacy in early and advanced Parkinson's Disease. In the primary clinical trial, advanced Parkinson's Disease treatment with IPX066 (NUMIENT) reduced the "off" time, from 36% to 23% compared to 36% to 29% for immediate-release levodopa-carbidopa. IPX066 (NUMIENT) also increased the "on" time without dyskinesias during waking hours by 1.9 hours compared with an increase of 0.8 hours following treatment with immediate-release levodopa-carbidopa.
The most frequently reported adverse reactions were nausea, occurring in approximately 12% of all patients; then dizziness, headache, and dyskinesia, each occurring in approximately 8% of all patients; and insomnia, occurring in approximately 6% of all patients. Serious adverse events from gastrointestinal haemorrhage and allergic oedema were uncommon. For more information go to : Impax In order to refer to this article on its own click here
27th November 2015 - New research
LOWER PARKINSON'S DISEASE PREVALENCE AMONGST SMOKERS
Epidemiological studies previously reported a 60-70% reduced risk of Parkinson's Disease in smokers as compared to non-smokers. However, relationships between former smoking and Parkinson's Disease have been poorly investigated.
When assessed, current smokers were found to be far less likely to have Parkinson's Disease. Former smokers were found to be far more likely to develop Parkinson's Disease than people who had never smoked. Around 44% of people with Parkinson's Disease reported quitting smoking before they were diagnosed with Parkinson's Disease. The average time for cessation was 9 years, with a range of 2 to 16 years. The most important reasons given by people with Parkinson's Disease for quitting smoking were an illness different from Parkinson's Disease (51%), and knowledge of the harmful effects of smoking (47%).
The reduced prevalence of current smokers among people with Parkinson's Disease is consistent with previous findings, suggesting a protective effect of smoking. However, it could be due, at least in part, to the increased prevalence of former smokers among people with Parkinson's Disease patients, that were more prone to quit smoking.
Reference : Parkinsonism Related Disorders  21 (3) : 216-220 (M.Moccia, R.Erro, M. Picillo, E.Vassallo, C.Vitale, K.Longo, M.Amboni, G.Santangelo, R.Palladino, A.Nardone, M.Triassi, P.Barone, M.T.Pellecchia) Complete abstract In order to refer to this article on its own click here
23rd November 2015 - New research
RESTLESS LEGS SYNDROME OCCURING IN PARKINSON'S DISEASE
Restless legs syndrome (RLS) has been reported to have a prevalence of 0% to 52% in Parkinson Disease. However, it is still debated whether RLS in Parkinson's Disease is a pre-motor feature, a motor complication, or merely an association by chance. This study evaluated RLS prevalence in Parkinson's Disease. RLS is a condition of the nervous system that causes an overwhelming and irresistible urge to move the legs. For more information go to : Restless Legs Syndrome
The prevalence of RLS in Parkinson's Disease becomes progressively more likely in Parkinson's Disease and is therefore part of it. RLS went from 4% of those with Parkinson's Disease at the outset, to 6% after 2 years, to 16% after 4 years. Insomnia was 15 times more likely to occur with RLS. Daytime sleepiness was 9 times more likely to occur with RLS. Older age was only slightly more likely to occur with RLS. More preserved dopaminergic pathways and cardiovascular disturbances were also more likely. In another clinical study RLS occurred in 15% of people with Parkinson's Disease after 3 years.
Reference : Reference : Sleep  Nov 6 [Epub ahead of print] (M.Moccia, R.Erro, M.Picillo, G.Santangelo, E.Spina, R.Allocca, K.Longo, M.Amboni, R. Palladino, R.Assante, S.Pappatà, M. T.Pellecchia, P.Barone, C.Vitale) Complete abstract Reference : Journal of Neurology  Nov 14 [Epub ahead of print] (M.Elena, N.Anna, A.Monica, G.Matteo, A.Giorgia, C.Stefano) Complete abstract In order to refer to this article on its own click here
18th November 2015 - New research
THE IMPACT OF DATSCAN ON PARKINSON'S DISEASE DIAGNOSIS
The aim of this study was to evaluate the impact of DaTscan in people with and without Parkinson's Disease in order to assess the degree of confidence in the diagnosis of Parkinson's Disease. DaTscan is the name of a clear colourless solution used for injection in SPECT scans. A SPECT scan uses a radioactive substance and a special camera to create three dimensional images that show how the organs work. The patient is positioned on a table in the room where they undergo the SPECT scan. For more information go to : Spect Scan
L-dopa is When a DaTscan was carried out on people with definite Parkinson's Disease, the DaTscan was markedly abnormal in 92% of people with Parkinson's Disease and normal in the remaining 8%. Each of the sensitivity and positive predictive values of DaTscan in patients who had a clinical diagnosis of Parkinson's Disease is therefore 92%.
In people with an uncertain diagnosis of Parkinson's Disease, 48% had remarkably abnormal scans, 16% had mild abnormalities, and 36% had normal scans.
A markedly abnormal DaTscan is confirmed as the diagnostic pattern for Parkinson's Disease but not in all people with Parkinson's Disease. Remarkably abnormal scans can also occur in people who did not have a certain diagnosis of Parkinson's Disease. Therefore, even though the DaTscan is one of the most accurate methods of diagnosing Parkinson's Disease no method of diagnosis provides complete certainty.
Reference : Clinical Nuclear Medicine  40 (5) : 390-393 (I.Gayed, U.Joseph, M. Fanous, D.Wan, M.Schiess, W.Ondo, K.S.Won) Complete abstract In order to refer to this article on its own click here
16th November 2015 - New book
EVERYTHING YOU NEED TO KNOW ABOUT PARKINSON'S DISEASE
Publishers description : Inspired by her mom who has lived with and battled the disease for 25 years, author Lianna Marie wrote her first book Everything You Need To know About Parkinson’s - All in One Place ! An easy-to-read guide that answers the most important questions about Parkinson's Disease, featuring chapters on : Types of Parkinson's, Surgical and Alternative Treatment Options, How to Deal with Freezing and Other Mobility Issues, How to Manage Medication Side Effects, What Foods to Eat and Avoid, How to Cope with Anxiety and Depression, How to Manage Weight Loss, Helpful Exercises, Handy Parkinson's Gadgets, Caregiving, And More ! Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books
11th November 2015 - New research
L-DOPA REDUCES THE RISK OF LOSS OF EYESIGHT
L-dopa, which is commonly used for the treatment of Parkinson's Disease, has been found to reduce the risk of Age-related Macular Degeneration (AMD), which is a leading cause of visual loss in the elderly. Age-related macular degeneration (AMD) is a condition that causes the loss of central vision, usually in both eyes. In AMD, this vision becomes increasingly blurred, which means : reading becomes difficult, colours appear less vibrant, people's faces are difficult to recognise. For more information go to : Age-related Macular Degeneration
L-dopa is crucially involved in the biochemistry of eyesight. A key cell type involved in Age-related Macular Degeneration (AMD), the retinal pigment epithelium, expresses a g-protein coupled receptor that, in response to L-dopa, upregulates pigment epithelia derived factor, while downregulating vascular endothelial growth factor. So researchers investigated the relationship between L-dopa and Age-related Macular Degeneration (AMD). In those people taking L-dopa, AMD occurred significantly later than in those people who did not take L-dopa. The likelihood of developing AMD at all was also found to be reduced in those people taking L-dopa, which is what many people with Parkinson's Disease take.
Reference : The American Journal of Medicine  Oct 30 [Epub ahead of print] (M.H.Brilliant, K.Vaziri, T.B.Connor Jr, S.G.Schwartz, J.J.Carroll , C.A.McCarty, S.J.Schrodi, S.J.Hebbring, K.S.Kishor, H.W.Flynn Jr, A.A.Moshfeghi, D.M.Moshfeghi, M.E.Fini, B.S.McKay) Complete abstract In order to refer to this article on its own click here
10th November 2015 - New book
BOTH SIDES NOW : A JOURNEY FROM RESEARCHER TO PATIENT
Dr Alice Lazzarini
Publishers description : In Both Sides Now, Alice Lazzarini, an internationally recognized researcher in neurogenetic disorders shares her personal and professional journey. Having been a member of the team that discovered the first Parkinsons disease-causing gene mutation in the synuclein protein, she realizes she is developing symptoms of the very disease she had researched. Only after facing a disease that can cause complete dependency is she able to forge her independence. It is the story, too, of the new perspective her lifelong fear of birds takes on when she learns that the gene she helped discover is responsible for song learning in the male zebra finch. Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books For more information concerning Alice Lazzarini go to Alice Lazzarini
9th November 2015 - 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 da Vinci had Parkinson's Disease 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.
20th October 2015 - New book
BRAIN STORMS : THE RACE TO UNLOCK THE MYSTERIES OF PARKINSON'S DISEASE
Publishers description : Seven million people worldwide suffer from Parkinson's, and doctors, researchers, and patients continue to hunt for a cure. In Brain Storms, the award-winning journalist Jon Palfreman tells their story, a story that became his own when he was diagnosed with the debilitating illness. He takes us back to the late 1950s and the discovery of L-dopa. Palfreman chronicles how scientists have worked to crack the mystery of what was once called the shaking palsy, from the earliest clinical descriptions of tremors, gait freezing, and micrographia to the cutting edge of neuroscience, and charts the victories and setbacks of a massive international effort to best the disease. Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books In order to refer to this article on its own click here
14th October 2015 - New research
NEUROPATHY IS 20 TIMES MORE LIKELY IN PARKINSON'S DISEASE
Polyeuropathy has been found to be 20 times more likely in people with Parkinson's Disease. Polyneuropathy is the simultaneous malfunction of many peripheral nerves throughout the body. Acute polyneuropathy begins suddenly in both legs and progresses rapidly upward to the arms. Symptoms include weakness and a pins-and-needles sensation or loss of sensation. In the most common chronic form only sensation is affected. For more information go to : Polyneuropathy
Polyneuropathy was found to be twenty times more likely to occur in people with Parkinson's Disease. As many as 45% of people with Parkinson's Disease were found to be affected by Polyneuropathy.
Researchers did not establish a relationship between Polyneuropathy occuring and either : the long term use of L-dopa, the duration of Parkinson's Disease, or the age of the people affected.
In previous studies neuropathy was also found to be far more common in Parkinson's Disease. In those studies around 37% of people with Parkinson's Disease were affected. Neuropathy was related to vitamin B12 deficiency, age, serum folate levels, and even more so to L-dopa use. Neuropathy was more than twice as likely in people with Parkinson's Disease who have been taking L-dopa for a long time.
Reference : Neuro Endocrinology Letters  36 (4) : 363-367 [Epub ahead of print] (Z.Grambalova, M. Kaiserova, M.Vastik, K.Mensíkova, P.Otruba, J.Zapletalova, J. Dufek, P.Kanovsky) Complete abstract In order to refer to this article on its own click here
29th September 2015 - New book
10 BREAKTHROUGH THERAPIES FOR PARKINSON'S DISEASE
Publishers description : In his latest book, Dr Okun he reveals the breakthroughs in Parkinson’s disease that will pave the road to meaningful progress. In this book he reviews all of the recent breakthrough ideas and therapies in Parkinson’s disease, and he reviews the knowledge gained which is extending far beyond a single drug or stem cell. He paints the broader and more exciting picture and reviews the portfolio of breakthroughs spanning drug, cell, vaccine, device, genetics, care, and behavior. He believes that patients and families with personal investments in Parkinson’s disease should be informed and updated about all of these potential breakthrough therapies. Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books In order to refer to this article on its own click here
24th September 2015 - New research
AUTOANTIBODIES FOR THE DIAGNOSIS OF PARKINSON'S DISEASE
For the first time a selection of blood-borne autoantibody biomarkers with a higher prevalence in early Parkinson's Disease were used to facilitate the diagnosis of early Parkinson's Disease. Antibodies are proteins produced by a person's immune system that allows their body to distinguish between "self" and "non-self" proteins. For more information go to : Autoantibodies
The sera of people with early stage Parkinson's Disease were screened with human protein microarrays containing 9486 potential antigen targets in order to identify autoantibodies that are potentially useful as biomarkers for Parkinson's Disease.
Selected, blood-borne autoantibody biomarkers with a higher prevalence in early Parkinson's Disease could distinguish early Parkinson's Disease with an overall accuracy of 88%, a sensitivity of 94% and a specificity of 85%.
These biomarkers were also capable of differentiating people with early Parkinson's Disease from those with mild to moderate Parkinson's Disease with an overall accuracy of 97%. The biomarkers could also distinguish people with early Parkinson's Disease from those with other neurological disorders.
The results demonstrate, for the first time, that selected autoantibodies
may prove to be useful as effective blood-based biomarkers for the diagnosis
of early Parkinson's Disease.
19th September 2015 - New research
LONG TERM EFFECTS OF DBS ON PARKINSON'S DISEASE
Researchers assessed the long term effect of Subthalamic nucleus Deep Brain Stimulation (DBS) on Parkinson's Disease. People with Parkinson's Disease were assessed before DBS and 1, 3, 5 years after DBS had begun. DBS involves the use of electrodes that are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. DBS can reduce the need for L-dopa and related drugs, and reduce dyskinesia. For more information go to : Deep Brain Stimulation
As a result of DBS the quality of life improved by 58% after 3 years but gradually declined afterwards. Sleep, cognition, and emotion were mostly unchanged. After 5 years, when assessed without medication DBS improved Parkinson's Disease motor symptoms by 35%. However, after 5 years, when assessed with the simultaneous use of medication, motor symptoms were similar to those at the outset. L-dopa intake was reduced from 660mg to 310mg after 5 years. STN DBS can therefore improve Parkinson's Disease and reduce the need for L-dopa but there is a gradual decline and diminished efficacy after five years of use.
Reference : Chinese Medical Journal  128 (18) : 2433-2438 (L.L.Jiang, J.L.Liu, X.L. Fu, W.B.Xian, J.Gu, Y.M.Liu, J.Ye, J.Chen, H.Qian, S.H.Xu, Z.Pei, L.Chen) Complete abstract In order to refer to this article on its own click here
10th September 2015 - New research
DROXIDOPA - PARKINSON'S DISEASE CLINICAL TRIAL RESULTS
Although it normally has completely different uses, including orthostatic hypotension, the prodrug droxidopa has been found to reduce the symptoms of Parkinson's Disease. Droxidopa is a synthetic amino acid precursor. It can pass the blood brain barrier and form noradrenaline and adrenaline, which are derivatives of L-dopa and dopamine. Droxidopa is marketed as Northera. For more information go to : Droxidopa
The use of droxidopa in Parkinson's Disease was compared to the use of a placebo. The two groups were comparable in all respects. After two weeks and also nearly two months Parkinson's Disease symptoms scores were significantly different from the outset. Individual motor symptoms such as stiffness, resting tremor, and alternate hand motion were also significantly improved with the use of droxidopa, suggesting that droxidopa is effective in improving rigidity, tremor and alternate motion of hand.
Droxidopa was effective as symptomatic adjunct therapy, and significantly improved motor function and activities of daily living. On the way to forming noradrenaline and adrenaline, it must therefore have dopaminergic activity.
Reference : Parkinsonism and Related Disorders  Aug 21 [Epub ahead of print] (S. Zhao, R.Cheng, J.Zheng, Q.Li, J.Wang, W.Fan, L.Zhang, Y.Zhang, H.Li, S.Liu) Complete abstract In order to refer to this article on its own click here
31st August 2015 - New research
ASTHMA TREBLES THE RISK OF PARKINSON'S DISEASE
Asthma has been found to treble the likelihood of developing Parkinson's Disease. This risk is multiplied in more severe asthma. Asthma is a common long-term condition that can cause coughing, wheezing, chest tightness and breathlessness. Occasionally, asthma symptoms can get gradually or suddenly worse, causing an "asthma attack". For more information go to : Asthma
From those people that were diagnosed with asthma, those who subsequently developed Parkinson's Disease were identified. Also examined were their asthma severity, as indicated by the frequency of hospital admissions for asthma. People with asthma were found to have an increased risk of developing Parkinson's Disease that was three times normal.
People with more severe asthma who had frequent hospital admissions exhibited a far greater risk of subsequent Parkinson's disease that was as much as 16 times greater than would be expected. Fewer hospital admissions made the likelihood less than this.
The link between asthma and Parkinson's Disease is the level of activity of the cholinergic neurons. Cholinergic activity stimulates muscle contraction, which can provoke the muscular symptoms of Parkinson's Disease. Cholinergic activity also affects the bronchial glands. That is why anti-cholinergic drugs are used for both asthma and Parkinson's Disease.
Reference : Allergy  Aug 27 [Epub ahead of print] (C.M.Cheng, Y.H.Wu, S.J.Tsai, Y.M.Bai, J.W.Hsu, K.L.Huang, T.P.Su, C.T.Li, C.F.Tsai, A.C.Yang, W.C.Lin, T.L.Pan, W.H.Chang, T.J.Chen, M.H.Chen) Complete abstract In order to refer to this article on its own click here
30th August 2015 - New book
THE NEW PARKINSON'S DISEASE TREATMENT BOOK : PARTNERING WITH YOUR DOCTOR TO GET THE MOST FROM YOUR MEDICATIONS
J. Eric Ahlskog
Publishers description : Dr. Ahlskog draws on thirty years of clinical experience to present the definitive guide to dealing with all aspects of Parkinson's Disease, from treatment options and side effects to the impact of the disease on caregivers and family. Dr. Ahlskog's goal is to educate patients so that they can better team up with their doctors to do battle with the disease. This book also examines additional aspects of treatment, such as the role of nutrition, exercise, and physical therapy. Patients are able to make more informed choices, and doctors are able to provide more tailored care. This book delivers extensive information to all parties concerned : patients, caregivers, and doctors. Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books In order to refer to this article on its own click here
12th August 2015 - New research
TRANSDERMAL ROTIGOTINE - CLINICAL TRIAL RESULTS
Transdermal rotigotine, which is marketed as Neupro, is a dopamine receptor agonist that is used in the treatment of Parkinson's Disease. It offers the potential for continuous dopaminergic stimulation that could avoid the fluctuations observed with traditional forms of dopamine agonists. Neupro provides continuous delivery for 24 hours following application of the patch to intact skin. For more information go to : Neupro and Transdermal rotigotine system
Rotigotine made hardly any difference to the Non-motor symptom score in Parkinson's Disease. However, improvements were detected in mood and apathy. General symptom improvements and the PDQ-39 scores also favoured rotigotine. Transdermal rotigotine also improved swallowing. There was a significantly greater reduction in the off-time when using rotigotine.
Adverse events reported more frequently with rotigotine were nausea, application site reactions, somnolence and headache. Serious adverse events were only uncommonly reported.
References : European Journal of Neurology  Jun 22 [Epub ahead of print] (A.Antonini, L.Bauer, E.Dohin, W.H.Oertel, O.Rascol, H.Reichmann, M.Schmid, P.Singh, E.Tolosa, K.R.Chaudhuri) Complete abstract
Dysphagia  May 13 [Epub ahead of print] (M.Hirano, C.Isono, H.Sakamoto, S.Ueno, S.Kusunoki, Y.Nakamura) Complete abstract
Journal of Neurology  261 (10) : 1887-1893 (M.Nomoto, Y.Mizuno, T.Kondo, K.Hasegawa, M. Murata, M. Takeuchi, J.Ikeda, T.Tomida, N.Hattori) Complete abstract In order to refer to this article on its own click here
5th August 2015 - New research
FROZEN SHOULDER SYNDROME IN PARKINSON'S DISEASE
Frozen Shoulder Syndrome, which is a common musculoskeletal disease in Parkinson's Disease, has been found to occur at times in nearly half of people with Parkinson's Disease. The shoulder becomes stiff and so greatly restricts movement of the shoulder. It can cause chronic pain and physical disability. For more information go to : Frozen Shoulder Syndrome
Frozen Shoulder Syndrome can more commonly affect people with Parkinson's Disease, with from 12% to 46% of people with Parkinson's Disease being affected. Shoulder problems generally occur far more commonly in Parkinson's Disease. Those prone to Frozen Shoulder Syndrome had initial symptoms of akinesia twice as frequently as tremor. In at least 8% of people with Parkinson's Disease who have Frozen Shoulder Syndrome, frozen shoulder syndrome was even the first symptom, occurring up to 2 years before other common symptoms of Parkinson's Disease. However, the "frozen shoulders" and pain can respond to L-dopa.
Reference : Parkinson's Disease  Jun 9 [Epub 2015] (Y.T.Chang, W.N.Chang, N.W.Tsai, K.Y.Cheng, C.C.Huang, C.T.Kung, Y.J.Su, W.C.Lin, B.C.Cheng, C.M.Su, Y.F.Chiang, C.H.Lu) Complete abstract In order to refer to this article on its own click here
2nd August 2015 - New book
DISORDERS OF SLEEP AND CIRCADIAN RHYTHMS IN PARKINSON'S DISEASE
Aleksandar Videnovic, Birgit Högl
Publishers description : This book is the first to take into account the rapidly growing body of knowledge on the relation between sleep and PD. It provides a unique source of in-depth information on sleep and circadian dysregulation in Parkinson's disease. The book is divided into two parts: the first comprises chapters on normal sleep-wake homeostasis, followed by changes that occur in PD and discussions of available tools for the assessment of sleep-wake cycles in PD. In the second part, sleep and circadian disorders associated with PD are described in individual chapters, including sections on epidemiology, etiology, pathogenesis, differential diagnosis, and treatment. Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books In order to refer to this article on its own click here
25th July 2015 - New research
DIABETIC DRUG REDUCES THE RISK OF PARKINSON'S DISEASE
Glitazones, which are diabetic drugs, have been found to be associated with a 28% reduction in the risk of developing Parkinson's Disease. Glitazones are peroxisome proliferation activated receptor gamma agonists. For more information go to : Glitazones
Diabetics, who did not have Parkinson's Disease, who were prescribed Glitazones, were compared with people taking other diabetic drugs. Their progress was recorded until they received a diagnosis of Parkinson's Disease. The incidence of Parkinson's Disease was 6.4 per 100,000 in those taking Glitazones and 8.8 in those taking other diabetic drugs. This is the equivalent of a 28% reduction in the risk of developing Parkinson's Disease when taking Glitazones. However, the authors point out that glitazones have been associated with some serious side effects.
Another diabetic drug, Exenatide was previously found to improve Parkinson's Disease. As with Glitazones, the authors did not suggest how this diabetes drug can have effect in Parkinson's Disease. For more information go to : Exenatide
18th July 2015 - New research
DRY POWDER INHALER FOR PARKINSON'S DISEASE
A dry powder inhaler has been found to be a viable means of administering L-dopa. Because of its rapid onset of action, pulmonary administration of L-dopa is a possible alternative to the oral administration of L-dopa in Parkinson's Disease patients in an off period. Its means of administration could enable a very quick therapeutic effect. Researchers studied the ability of people with Parkinson's Disease to operate a dry powder inhaler (DPI) correctly during an off period.
They used an instrumented test inhaler with three different resistances to air flow. The volumes inhaled varied from 1.2 litres to 3.5 litres. Total inhalation time and the time to peak inspiratory flow rate both decreased with decreasing inhaler resistance. Nearly all of the patients could hold their breath for at least five seconds after inhalation and most of them could extend this time to ten seconds. The data from this study indicate that patients with Parkinson's disease will be able to use a dry powder inhaler during an off period and they provide an adequate starting point for the development of an L-dopa powder inhaler.
An L-dopa inhaler using L-dopa in liquid form instead of a dry form, that takes only 10 minutes to start having effect, is already undergoing clinical trials in Parkinson's Disease. For more information go to : L-dopa inhaler
Reference : PLoS One  10 (7) : e0132714 (M.Luinstra, A.W.Rutgers, H.Dijkstra, F. Grasmeijer, P.Hagedoorn, J.M.Vogelzang, H.W.Frijlink, A.H.de Boer) Complete abstract In order to refer to this article on its own click here
14th July 2015 - New research
YERBA MATE REDUCES THE LIKELIHOOD OF PARKINSON'S DISEASE
Yerba Mate has been found to reduce the likelihood of Parkinson's Disease by more than a third. Yerba Mate is a very common beverage in some countries of South America. It is a herb, that is dried and chopped, before pouring hot water over it to make a drink. For more information go to : Yerba Mate
A study of hospital records was conducted in order to investigate the association between Parkinson's Disease and yerba mate intake. Coffee and tea intake were also assessed. The likelihood of Parkinson's Disease was reduced to 63% for those drinking yerba mate, which was down to 60% for those drinking tea, and was only 51% for those drinking coffeee. Yerba mate contains three xanthines : caffeine, theobromine and theophylline, the main one being caffeine, which is primarily how it has its stimulatory effect. Tea contains more caffeine than yerba mate. Coffee contains more caffeine than tea. Caffeine occurs to a lesser extent in cola drinks, cocoa, and chocolate.
Although the researchers detail the reduced likelihood of Parkinson's Disease because of drinking yerba mate, the reduced likelihood of Parkinson's Disease is even greater when drinking tea, and even more so when drinking coffee. The effect appears to be directly related to the caffeine intake. Caffeine is a naturally occurring adenosine antagonist. The Adenosine antagonist drugs Tozadenant, Preladenant, and Istradefylline are presently being assessed for their use in the treatment of Parkinson's Disease.
Reference : Journal of Neurological Science  Jun 24 [Epub ahead of print] (E.M.Gatto, C.Melcon, V.L.Parisi, L.Bartoloni, C.D.Gonzalez) Complete abstract In order to refer to this article on its own click here
10th July 2015 - New research
COMBINED METHODS OF DIAGNOSING PARKINSON'S DISEASE
The method of diagnosing Parkinson's Disease using DATSCAN has been found to
be more accurate when combined with the additional use of olfactory testing
(using B-SIT, which involves a smell identification test). DATSCAN is used
in the SPECT scan.
A reduced risk of ParPeople with Parkinson's Disease were assessed using DATSCAN, which is used in SPECT scans, and the Brief 12-item The visual assessment of DaTSCAN had a higher sensitivity, specificity and diagnostic accuracy than olfactory testing. Smell Identification Test (B-SIT). scores were significantly lower for people with Parkinson's Disease, but were not significantly different between Atypical Parkinsonian Syndrome and people without Parkinsonism.
However, the combined use of DaTSCAN and B-SIT (olfactory testing) led to a higher rate of correctly diagnosed Parkinson's Disease, thereby suggesting their combined use instead of using a SPECT scan alone.
Reference : Journal of Neurology  Jun 30 [Epub ahead of print] (C.Georgiopoulos, A. Davidsson, M.Engström, E.M.Larsson, H.Zachrisson, N.Dizdar) Complete abstract In order to refer to this article on its own click here
5th July 2015 - New research
ARTISTS HAVE A GREATLY REDUCED RISK OF PARKINSON'S DISEASE
Artists have been found to have a greatly reduced risk of Parkinson's
Disease that is way below that known for any other occupation.
A reduced risk of Parkinson's Disease was found for men with an artistic occupation late in life that was only 14% of normal. However, being an artist as a first occupation made the likelihood of developing Parkinson's Disease far more likely than that but at 72% still less likely than normal. Conventional occupations showed no increased likelihood of Parkinson's Disease apart from farming, in which Parkinson's Disease was 2.7 times more likely, most probably because of pesticide use. Although artistic occupations late in life are associated with a greatly reduced risk it is probable that because higher dopamine levels are required for visual creativity, that people whose dopamine levels are low, as they are in Parkinson's Disease, would be less inclined to be artistic visually.
Reference : Journal of Neurology  Jul 3 [Epub ahead of print] (C.A.Haaxma, G.F. Borm, D.van der Linden, A.C.Kappelle, B.R.Bloem) Complete abstract In order to refer to this article on its own click here
2nd July 2015 - New research
ANTI-EPILEPTIC IMPROVES WEARING-OFF IN PARKINSON'S DISEASE
Zonisamide, despite being an anti-epileptic, reduced "off" time in Parkinson's Disease during clinical trials. Zonisamide is presently being assessed for use in the treatment of Parkinson's Disease. Zonisamide activates dopamine biosynthesis by increasing the level of mRNA of tyrosine hydroxylase, which is the enzyme responsible for dopamine formation. For more information on zonisamide go to : Zonisamide
To determine the efficacy of zonisamide for the treatment of "off" time in Parkinson's Disease, people with Parkinson's Disease who had wearing-off received a placebo for 4 weeks and were then treated for 12 weeks with either 25mg per day zonisamide, 50 mg per day zonisamide, or placebo, in addition to their previous therapy. The "off" time significantly reduced by 45 minutes when taking 50mg zonisamide per day. Although the incidence of somnolence was just a bit higher for zonisamide, the incidences of other adverse events, including dyskinesia or hallucinations, for zonisamide were comparable to those of only a placebo.
The study provides evidence that confirms the efficacy of zonisamide 50 mg
per day for reduction in "off" time in people with Parkinson's Disease with
25th June 2015 - News release
INHALED L-DOPA - PARKINSON'S DISEASE CLINICAL TRIAL RESULTS
CVT-301 is the name of an inhaled version of L-dopa presently being developed for the treatment of Parkinson's Disease. Clinical trial results demonstrated improved efficacy that was apparent in only 10 minutes. CVT-301 uses the ARCUS inhalation technology, which delivers a reliable and consistent drug dose with a compact, breath actuated inhaler. The inhaled version of L-dopa would be used alongside the use of oral L-dopa.
The clinical trial showed that patients experiencing an OFF episode, treated with either 35mg or 50mg CVT-301, had significantly greater improvements in motor function than patients treated with inhaled placebo. The difference in improvement was already apparent 10 minutes after dosing and was durable for at least an hour, the longest time point at which patients were measured. This enables fast working L-dopa unlike what has ever been seen before.
Both doses of CVT-301 were well tolerated, with no increase relative to placebo in troublesome or non-troublesome dyskinesias during ON periods. The most common adverse events were dizziness, headache and cough. There were no adverse events on cardiovascular or lung function. For more information go to Acorda
Based on the results of the Phase 2b clinical trial, Acorda has initiated a Phase 3 clinical trial in order to assess efficacy that is expected to enroll approximately 345 participants who will take either 50mg, 35mg, or placebo, just as were used in the Phase 2b clinical trial. In order to refer to this article on its own click here
20th June 2015 - New research
PARKINSON'S DISEASE ASSOCIATED WITH 16 CANCERS
Parkinson's Disease has previously been reported to be associated with a reduced risk of cancer, but has now been found to be associated with an increased risk of 16 types of cancer.
The overall risk of cancer in Parkinson's Disease was found to be 1.58 times the normal likelihood. Those cancers associated with Parkinson's Disease in order of the risk of likelihood are : malignant brain tumors 3.42, melanoma 2.75, bladder cancers 1.99, liver 1.89, uterine 1.83, gastrointestinal tract cancers 1.81, skin cancers (besides melanoma) 1.81, prostate 1.80. gallbladder 1.73, lymphoma or leukemia 1.62, kidney 1.59, stomach 1.59, lung cancers 1.56, pancreas 1.48, colorectal 1.47, cervical 1.36.
Of the 19 types of cancer assessed, Parkinson's Disease was not associated with breast, ovarian, or thyroid cancers but was associated with 16 others. It has not been indicated whether the risk of cancer is as a result of Parkinson's Disease or instead related to it indirectly for other reasons. The increased risk of some cancers is quite marginal.
The cause is only established for melonoma. The reduced ability in Parkinson's Disease to produce L-dopa reduces the capacity to produce melanin. Given that melanin helps to protect skin cells from Ultra Violet induced damage, melanoma is very probably increased in Parkinson's Disease because of the reduced capacity to produce L-dopa in the melanocytes. In other studies the risk of developing melanoma has been found to be even higher.
Reference : JAMA Oncology  June 18 [Epub ahead of print] (Pei-Ying Lin, Shih-Ni Chang, Tzu-Hung Hsiao, Bo-Tsang Huang, Ching-Heng Lin, Pan-Chyr Yang) Complete abstract In order to refer to this article on its own click here
18th June 2015 - News release
NONINVASIVE BRAIN STIMULATOR FOR PARKINSON'S DISEASE
John Hopkins University is developing a non-invasive brain stimulator, called Stimband, for the treatment of Parkinson's Disease. STIMband is a headband shaped device that is placed on the head. It does not require any surgery. For more information go to STIMband brain stimulator
For people in advanced stages of Parkinson's Disease, one treatment option is deep brain stimulation. In this procedure, a surgeon implants thin electrical leads into the region of the brain that controls movement. The leads are connected to a pulse generator, similar to a pacemaker for the heart, that is placed under the skin below the collarbone. This implant sends electrical signals to the brain to help curb symptoms caused by Parkinson's Disease. However, this procedure is really invasive and can take 10 to 15 hours to complete.
STIMband is based on transcranial direct current stimulation in which low-level current is passed through two electrodes placed over the head to tweak the electrical activity in specific areas of the brain. The STIMband prototype, which involves no surgery, enables a patient to activate the battery powered treatment by touching a large easy-to-press button. With patient safety in mind, the prototype delivers current for only 20 minutes daily at a doctor prescribed level. It is inexpensive, safe and relatively easy to administer without any side effects.
It is easy to put on, comfortable to wear and is positioned so that the electrodes remain stable and properly target the motor cortices areas of the brain. The inventors obtained provisional patents covering the design of the device, dubbed the STIMband.
Another Johns Hopkins team is taking over the project in September to further enhance the design and move it closer to patient availability. One addition may be a wireless connection to allow a doctor to adjust a patient's treatment level from a remote location. In order to refer to this article on its own click here
15th June 2015 - New research
THE SENSE-PARK SYSTEM FOR PARKINSON'S DISEASE DIAGNOSIS
The SENSE-PARK System has been developed to enable an objective, continuous and relatively unobtrusive system to monitor Parkinson's Disease. It consists of wearable sensors, three of which are worn during the day and one of them worn at night, a smartphone-based App, and a balance board and computer software. For more information go to SENSE-PARK system
The SENSE-PARK System was tested 24/7 over 12 weeks in a study involving people with Parkinson's Disease. During the first four weeks of the study, patients did not get feedback about their performance, during the last eight weeks they did. The study included seven clinical visits with standardised interviews, and regular phone contact. The primary outcome was the number of drop-outs during the study. Yet all patients completed the study.
The participants rated the usability of the SENSE-PARK System favourably. The interviews revealed that most participants liked using the system and appreciated that it signalled changes in their health condition. This study demonstrated that the acceptance level of people with Parkinson's Disease using the SENSE-PARK System as a home-based 24/7 assessment is very good. Motivation to use the system can be increased by providing feedback about the health condition.
Reference : BMC Neurology  15 : 89 (J.J.Ferreira, C.Godinho, A.T.Santos, J. Domingos, D.Abreu, R.Lobo, N.Gonçalves, M.Barra, F.Larsen, Ø.Fagerbakke, I.Akeren, H. Wangen, J.A.Serrano, P.Weber, A.Thoms, S.Meckler, S.Sollinger, J.van Uem, M.A.Hobert, K.Maier, H.Matthew, T.Isaacs, J.Duffen, H.Graessner, W.Maetzler) Complete abstract In order to refer to this article on its own click here
3rd June 2015 - New book
PARKINSON'S DISEASE AND MOVEMENT DISORDERS
Dr. Joseph Jankovic, Eduardo Tolosa
Publisher's description : Trusted as the leading text in the field, Parkinson's Disease and Movement Disorders, 6th Edition, brings you fully up to date with new developments in this rapidly-changing subspecialty. International experts provide thorough coverage of basic science and clear guidance for your day-to-day clinical challenges – from innovative medical and surgical treatments to new drug delivery systems and recent discoveries in genetics, plus much more. In addition, an extensive online video atlas demonstrates movement and posture abnormalities, as well as unique and unusual phenomenology. Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books In order to refer to this article on its own click here
30th May 2015 - New research
CARBON MONOXIDE GREATLY INCREASES THE RISK OF PARKINSON'S DISEASE
Carbon monoxide poisoning has been found to be able to greatly increase the risk of Parkinson's Disease. Common sources of carbon monoxide include cigarette smoke, gas cookers, gas fires, vehicle exhaust, gasoline-powered tools. For more information go to Carbon monoxide
The overall prevalence of Parkinson's Disease (per 100,000 people per year) in those people that had suffered carbon monoxide intoxication was 27.4. After this figure was adjusted for age, sex, and comorbidities, those people that had carbon monoxide intoxication had nine times the normal risk of developing Parkinson's Disease. This makes it one of the most potent uncommon causes of Parkinson's Disease. Those people with carbon monoxide intoxication who were receiving hyperbaric oxygen therapy, which is used to treat carbon monoxide poisoning had a risk of Parkinson's Disease 14 times above normal. The therapy does not cause Parkinson's Disease but instead shows that it is used in more extreme cases.
The risk of Parkinson's Disease increased a lot in those people suffering carbon monoxide intoxication. The significance was increased in young people. Therefore, in some people, carbon monoxide intoxication can be a serious factor leading to Parkinson's Disease.
26th May 2015 - New research
SWEDD IN PEOPLE WITH PARKINSON'S DISEASE
Parkinson's Disease can usually be diagnosed conclusively using scanning methods such as the SPECT scan and the PET scan. The term SWEDD (scans without evidence for dopaminergic deficit) refers somebody initially being assumed to have Parkinson's Disease but whose scan shows the absence of any dopamine deficiency or imaging abnormality that would diagnose them as actually having Parkinson's Disease. For more information go to : SWEDD
While many authors have suggested that medical disorders similar to Parkinson's Disease may account for a proportion of SWEDD cases, others claim that some of them may have a benign subtype of Parkinson's Disease.
There has consequently been some controversy and confusion concerning this term. Researchers systematically reviewed all the studies involving patients with SWEDD with the aim of shedding light on what these patients actually have. After an analysis of all the studies it becomes clear that while most SWEDD cases are due to a clinical misdiagnosis of Parkinson's Disease, there exists a small proportion of patients with SWEDD who may have Parkinson's Disease on the basis of : a positive L-dopa response, clinical progression, imaging and genetic evidence. The latter challenge the seemingly incontrovertible relationship between dopaminergic tracer binding and the diagnosis of Parkinson's Disease.
Reference : Journal of Neurology, Neurosurgery and Psychiatry  May 19 [Epub ahead of print] (R.Erro, S.A.Schneider, N.P.Quinn, K.P.Bhatia) Complete abstract In order to refer to this article on its own click here
21st May 2015 - New research
THE PLACE OF DEATH IN PARKINSON'S DISEASE
Most people prefer to receive end-of-life care in familiar surroundings rather than in hospital. This study examined the variation in the place of death for people dying from Parkinson's disease in European and non-European countries. They used death certificates for deaths with Parkinson's Disease as an underlying cause.
The proportion of deaths in hospital ranged from 17% in the USA, which was the lowest, to 75% in South Korea, which was the highest. Hospital was the most prevalent place of death in France (40%), Hungary (60%) and South Korea (75%). Nursing homes were the most prevalent place of death in New Zealand (71%), Belgium (52%), USA (50%), Canada (48%) and Czech Republic (44%). Home was the most prevalent place of death in Mexico (73%), Italy (51%) and Spain (46%). The chances of dying in hospital were consistently higher for men (Belgium, France, Italy, USA, Canada), those younger than 80 years (Belgium, France, Italy, USA, Mexico), and those living in areas with a higher provision of hospital beds (Italy, USA).
In several countries a substantial proportion of deaths from Parkinson's Disease occurs in hospitals, although this may not be the most optimal place of terminal care and death. The wide variation between countries in the proportion of deaths from Parkinson's Disease occurring in hospital indicates a potential for many countries to reduce these proportions.
Reference : BMC Palliative Care  14 (1) : 28 . [Epub ahead of print] (K.Moens, D.Houttekier, L.Van den Block, R.Harding, L.Morin, S.Marchetti, A.Csikos, M.Loucka, W.A.Naylor, D.M.Wilson, J.Teno, M.Cardenas-Turanzas, Y.Rhee, F.J.Garcia-Leon, L. Deliens, J.Cohen) Complete abstract In order to refer to this article on its own click here
10th May 2015 - New book
PREVENTING PARKINSON'S : HOW TO CUT YOUR RISK BY STRENGTHENING YOUR MULTIPLE SHIELDS
Publisher's description : Preventing Parkinson's is the only book available that gives readers proactive lifestyle recommendations for optimizing health and lowering the risk of developing Parkinson’s Disease. With over 1,000 references, this extraordinary, groundbreaking work provides cutting-edge, evidence-based research. It is a comprehensive compilation that will benefit both lay people and medical professionals alike. Dr. Weinstock thoroughly evaluates how the synergy of diet, exercise, sleep, stress management, avoidance of toxins, prevention of head injuries, and proper medical care can reduce one’s chance of developing Parkinson’s Disease. Click here for more details For more books concerning Parkinson's Disease go to Parkinson's Disease books In order to refer to this article on its own click here
30th April 2015 - New research
NEW GENETIC CAUSE OF PARKINSON'S DISEASE
A new genetic cause of Parkinson's Disease has been discovered called CHCHD2. CHCHD2 is associated with the development of Parkinson's Disease. Most genetic causes of Parkinson's Disease do not inevitably cause Parkinson's Disease but make the person affected more likely to develop Parkinson's Disease.
The full name of the genetic cause is : Coiled-coil-helix-coiled-coil- helixdomain containing 2. The gene is on the Chromosome 7p11.2. The function of the gene is to mediate oxygen-dependent expression of cytochrome c oxidase subunit 4-2 gene expression. The researchers do not know how this function inclines somebody towards Parkinson's Disease. The type of inheritance is autosomal dominant, which means that if the abnormal gene is inherited from only one parent you can get the disease. Often, one of the parents may also have the disease. This gene is associated with an increased likelihood of Parkinsons' Disease.
There are now at least 32 known genetic causes of Parkinson's Disease : PARK 1 to 3, PARK 4 to 20, Tyrosine Hydroxylase deficiency, Aromatic L-amino acid decarboxylase deficiency, CHCHD2, CYP2D6, DRD2. DRD3, GLIS1, LINGO1, MAPT, NRA42, PITX3, RIT2, STH. Details of individual genes can freely accessed at the NCBI database
Reference : The Lancet Neurology  14 (3) : 274-282 (M.Funayama, K.Ohe, T.Amo, N.Furuya, J.Yamaguchi, S.Saiki, Y.Li, K.Ogaki, M.Ando, H.Yoshino, H.Tomiyama, K.Nishioka, K.Hasegawa, H.Saiki, W.Satake, K.Mogushi, R.Sasaki, Y.Kokubo, S.Kuzuhara, T.Toda, Y.Mizuno, Y.Uchiyama, K.Ohno, N.Hattori) Complete abstract In order to refer to this article on its own click here
29th April 2015 - News release
BASEBALL LEGEND DIAGNOSED WITH PARKINSON'S DISEASE
Kirk Gibson, the former American baseball player and manager, now aged 57, has been diagnosed with Parkinson's Disease. As a player he won two Baseball World Series.
He said "I have faced many different obstacles in my life, and have always maintained a strong belief that no matter the circumstances, I could overcome those obstacles. While this diagnosis poses a new kind of challenge for me, I intend to stay true to my beliefs. With the support of my family and friends, I will meet this challenge with the same determination and unwavering intensity that I have displayed in all of my endeavors in life. I look forward to being back at the ballpark as soon as possible." For more information go to News release
Kirk Gibson (born in 1957) was drafted by both the Detroit Tigers baseball team and the St. Louis Cardinals (Arizona Cardinals) football team, but he chose baseball. He played Major League baseball for Detroit Tigers (1979-1987), Los Angeles Dodgers (1988-1990), Kansas City Royals (1991), Pittsburgh Pirates (1992), Detroit Tigers (1993–1995). He won the Baseball World Series twice, with the Detroit Tigers in 1984, and the Los Angeles Dodgers in 1988. In the 1988 World Series, despite being injured, he hit a game winning home run. He was subsequently a coach for Detroit Tigers (2003-2005), Arizona Diamondbacks (2007-2010), and a manager for Arizona Diamondbacks (2010-2014) after which he retired from baseball. For more information go to : Kirk Gibson In order to refer to this article on its own click here
9th April 2015 - New research
NOCTURIA IN PARKINSON'S DISEASE
Nocturia (often waking at night to urinate) is a frequent complaint in Parkinson's Disease. Researchers aimed to assess the mechanism of nocturia in people with Parkinson's Disease by determining the prevalence of nocturnal polyuria in Parkinson's Disease. Nocturnal polyuria is an increase in urine production in the night but with a decrease in daytime urine production. For more information go to Nocturia
Nocturia was defined as one or more awakenings at night to urinate. Two definitions of nocturnal polyuria were used : NUV33 (33% or more of total urination occurs at night), and NUP90 (nighttime urination exceeds 90ml per hour or more. The prevalence of nocturnal polyuria was 64% according to the NUV33 definition, and 17% according to the NUP90 definition. Among those people with nocturia the prevalence of nocturnal polyuria was 66% according to the NUV33 definition and 21% according to the NUP90 definition. The duration of Parkinson's Disease did not increase the likelihood of nocturia or nocturnal polyuria. However, those people who had Parkinson's Disease who were 70 years old and older were more likely to have both - 72% instead of 55% for those younger than 70. Men had nocturia more frequently - 33% for men and 20% for women.
The prevalence of nocturnal polyuria and nocturia was not higher than in the general population of the same age. This suggests that they occur, not as was thought, because of Parkinson's Disease, but because of the older age that is usually associated with Parkinson's Disease.
3rd April 2015 - New research
MONITORING PARKINSON'S DISEASE USING SMARTPHONES
Smartphones have been assessed for their use in monitoring Parkinson's
Disease. A smartphone (smart phone) is a mobile phone with an advanced
mobile operating system.
For more information go to
Participants then took the smart phones home to perform the five tasks four times a day for a month. Once a week they had a remote visit with a Parkinson's Disease specialist in which a modified (excluding assessments of rigidity and balance) UPDRS was performed. The analyses of the five tasks differed between those people with Parkinson Disease and those people who did not have Parkinson's Disease. There was a high degree of accuracy. In discriminating participants with Parkinson's Disease the mean sensitivity was 96% and the mean specificity was 96%.
Measuring Parkinson's Disease symptoms via a smartphone is highly accurate in distinguishing people with Parkinson's Disease. The researchers conclude that it is therefore feasible and has potential value as a diagnostic support tool.
Reference : Parkinsonism Related Disorders  Mar 7 [Epub ahead of print] (S.Arora, V.Venkataraman, A.Hang, S.Donohue, K.M.Biglan, E.R.Dorsey, M.A.Little) Complete abstract In order to refer to this article on its own click here
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