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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 mail@viartis.net.

                                   

 
 

21st May 2015 - New research

THE PLACE OF DEATH IN PARKINSON'S DISEASE

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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 [2015] 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

Ben Weinstock

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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

 

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30th April 2015 - New research

NEW GENETIC CAUSE OF PARKINSON'S DISEASE

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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 [2015] 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

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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

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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.

Reference : Progres en Urologie [2015] Apr 2 [Epub ahead of print] (J.Romain, F.Torny, J.P. Dumas, X.Gamé, A.Descazeaud) Complete abstract  In order to refer to this article on its own click here

 

3rd April 2015 - New research

MONITORING PARKINSON'S DISEASE USING SMARTPHONES

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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 Smartphone
                                                                                                                                                                      Participants were provided with smartphones with an Android operating system containing a smartphone application that assessed voice, posture, gait, finger tapping, and response time. They underwent in-clinic assessments, including the Unified Parkinson's Disease Rating Scale (UPDRS), which is the most used Parkinson's Disease symptom questionnaire.

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 [2015] 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

 

22nd March 2015 - News release

PRX002 - NEW IMMUNOTHERAPY FOR PARKINSON'S DISEASE

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Prothena Corporation have reported a reduction of Alpha-Synuclein by up to 96% after a single dose of PRX002, which is a new protein immunotherapy for Parkinson's Disease. Alpha-synuclein has been claimed to cause Parkinson's Disease. PRX002 is the focus of a worldwide collaboration between Prothena and Roche. For more information go to the News release

Five doses were used (0.3mg/kg, 1mg/kg, 3mg/kg, 10mg/kg, 30mg/kg). Only healthy volunteers were involved. The clinical trial did not involve people with Parkinson's Disease and no efficacy was demonstrated in Parkinson's Disease. There were mild adverse events in 5% to 10% of subjects. It was claimed that "there is genetic and pathological evidence that supports a causal role of alpha-synuclein in Parkinson's disease" and that this approach may "translate into a clinically meaningful delay or reversal of disease progression in patients with Parkinson's disease".

However, a lot of people with Parkinson's Disease do not accumulate alpha-synuclein. So there is none to get rid of. There is no evidence that Alpha-synuclein is a primary cause of Parkinson's Disease as has been claimed. Most people that have an accumulation of alpha-synuclein in the brain do not have Parkinson's Disease and have other medical disorders instead. L-dopa can readily rid symptoms in most people without affecting alpha-synuclein, thereby proving that the ridding of alpha-synuclein in the brain is not needed in order to rid Parkinson's Disease. In order to refer to this article on its own click here

 

12th March 2015 - New research

EARLY WARNING SIGNS OF PARKINSON'S DISEASE

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Researchers assessed the association between the first presentation of prediagnostic features and a subsequent diagnosis of Parkinson's Disease. Those symptoms considered were motor features (tremor, rigidity, balance impairments, neck pain or stiffness, and shoulder pain or stiffness), autonomic features (constipation, hypotension, erectile dysfunction, urinary dysfunction, and dizziness), neuropsychiatric disturbances (memory problems, late-onset anxiety or depression, cognitive decline, and apathy), and additional features (fatigue, insomnia, anosmia, hypersalivation and rapid-eye-movement sleep behaviour disorder). Apathy, REM sleep disorder, anosmia, hypersalivation, and cognitive decline were excluded because they were infrequently reported.

At 10 years before the diagnosis of Parkinson's disease, the prevalence of tremor was an average of 7 times more likely, and constipation was twice as likely in those people who went on to develop Parkinson's disease than in those people who did not have Parkinson 's Disease. At 5 years before diagnosis, people who went on to develop Parkinson's Disease had a far higher prevalence of tremor (from 7 to 24 times more likely), and also had a higher likelihood (in order or likelihood) of : hypotension, constipation, balance impairments, dizziness, urinary dysfunction, depression, fatigue, anxiety and erectile dysfunction.

At 2 years before Parkinson's disease diagnosis, the prevalence of all studied prediagnostic features except neck pain or stiffness was higher in people who went on to develop Parkinson's Disease.

Reference : Lancet Neurology [2015] 14 (1) : 57-64 (A.Schrag, L.Horsfall, K.Walters, A. Noyce, I.Petersen) Complete abstract  In order to refer to this article on its own click here

 

26th February 2015 - New books

ENCYCLOPEDIA OF PARKINSON'S DISEASE (8 volumes)

Kate White

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Encyclopedia of Parkinson's Disease is an 8 volume series of encyclopedias covering all different aspects of Parkinson's Disease including : etiology, pathphysiology, clinical aspects, diagnosis, rehabilitation, models and modules, therapeutics, novel treatments, advanced therapies. It is certainly the most extensive encyclopedia of Parkinson's Disease.

Volume I (Etiology and Pathophysiology)  Click here for more details
Volume II (Pathophysiology and Clinical Aspects)   Click here for more details
Volume III (Diagnosis)   Click here for more details
Volume IV (Rehabilitation)   Click here for more details
Volume V (Models and Modules)   Click here for more details
Volume VI (Therapeutics)   Click here for more details
Volume VII (Novel Treatments)   Click here for more details
Volume VIII (Advanced Therapiess)   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

 

23rd February 2015 - New research

EFFECT OF RESISTANCE TRAINING ON PARKINSON'S DISEASE

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Resistance training is any exercise that causes the muscles to contract against an external resistance with the expectation of increases in strength, tone, mass, and/or endurance. The external resistance can be weights, dumbbells, your own body weight, or any other objects that are heavy enough to cause the muscles to contract. For more information go to : Resistance training

Seven electronic databases were systematically searched for studies from 1946 to 2014 for the effect of resistance training on Parkinson's Disease. Seven studies, comprising of 401 participants with early to advanced Parkinson's Disease were included. The analyses demonstrated significant effects (from a possible range of effect from -1.00 to +1.00) in favour of resistance training compared to non-resistance training or no training at all for : muscle strength (+0.61), parkinsonian motor symptoms (+0.48), and balance (+0.36). There was no significant effect on : gait, balance confidence and quality of life.

This review demonstrated that moderate intensity progressive resistance training, 2 to 3 times per week over 8 to 10 weeks, can result in significant strength, balance and motor symptom gains in people with early to moderate Parkinson's Disease.

Reference : Clinical Rehabilitation [2015] Feb 17 [Epub ahead of print] (C.L.Chung, S. Thilarajah, D.Tan) Complete abstract  In order to refer to this article on its own click here

 

19th February 2015 - New research

EFFECTS OF TRANSCRANIAL MAGNETIC STIMULATION ON PARKINSON'S DISEASE

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Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique that relies on electromagnetic induction using an insulated coil placed over the scalp. The coil generates brief magnetic pulses, which pass easily and painlessly through the skull into the brain. When pulses are administered in rapid succession, it is referred to as "repetitive TMS" or "rTMS", which can produce longer lasting changes in brain activity. For more information go to : Transcranial magnetic stimulation  However, results evaluating the effectiveness of rTMS in Parkinson's Disease are mixed. So an assessment was made of all studies concerning the use of rTMS in Parkinson's Disease.

Twenty studies with a total of 470 patients were included in the assessment of the efficacy of rTMS. The overall average effect of rTMS showed a significant reduction in motor symptoms. Analysis showed that the size of the effects estimated from high-frequency rTMS targeting the primary motor cortex and low-frequency rTMS applied over other frontal regions were significant. A greater number of pulses per session or across sessions was associated with larger rTMS effects. rTMS has been shown to be well tolerated. The pooled evidence therefore suggests that rTMS improves motor symptoms of people with Parkinson's Disease. Combinations of rTMS site and frequency as well as the number of rTMS pulses are key modulators of rTMS effects.

Reference : JAMA Neurology [2015] Feb 16 [Epub ahead of print] (Y.H.Chou, P.T.Hickey, M.Sundman, A.W.Song, N.K.Chen) Complete abstract  In order to refer to this article on its own click here

 

18th February 2015 - New book

PARKINSON'S DISEASE (DISEASES AND DISORDERS)

Lizabeth Craig

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Publisher's description : This title in Lucent's Diseases and Disorders series focuses on Parkinson's Disease. The book describes how the disease is contracted, its symptoms, and treatments. It also discusses the issues that caregivers face. These books offer readers a means of understanding various ailments; clear, careful explanations offer insight into what these conditions are, what causes them, how we cope with them, and the latest information about treatment and prevention. All volumes in the series include primary and secondary quotations, annotated bibliographies, detailed indexes, and lists of organizations to contact for additional information 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 February 2015 - New research

ELTOPRAZINE REDUCES DYSKINESIA IN PARKINSON'S DISEASE

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Eltoprazine has been found to reduce L-dopa induced dyskinesias in Parkinson's Disease. Eltoprazine is a 5HT partial agonist being developed by Amarantus for the treatment of L-dopa induced dyskinesias in Parkinson's Disease, Attention Deficit Hyperactivity Disorder and Cognition. Simultaneous activation of 5-HT1A and 5-HT1B receptors effectively blocked L-dopa induced dyskinesias in animal models, thereby suggesting its use in humans. For more information go to : Eltoprazine  

A clinical trial was conducted using 2.5mg, 5.0mg and 7.5 mg eltoprazine in combination with Sinemet in people with Parkinson's Disease who had L-dopa induced dyskinesias. They found that 5mg eltoprazine caused a significant reduction of L-dopa induced dyskinesias, and that there was also an antidyskinetic effect with 7.5 mg eltoprazine. Parkinson's Disease symptoms scores did not otherwise alter. The most frequent adverse effects after eltoprazine use were nausea and dizziness. It was concluded that a single dose of eltoprazine has beneficial antidyskinetic effects without altering normal motor responses to L-dopa. All doses of eltoprazine were well tolerated, with no major adverse effects.

Reference : Brain [2015] Feb 10 [Epub ahead of print] (P.Svenningsson, C.Rosenblad, K.Af Edholm Arvidsson, K.Wictorin, C.Keywood, B.Shankar, D.A.Lowe, A.Björklund, H. Widner)  Complete abstract  In order to refer to this article on its own click here

 

11th February 2015 - New research

APDM MOBILITY LAB FOR PARKINSON'S DISEASE ASSESSMENT

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The diagnosis and estimation of disease severity in Parkinson's Disease was assessed using the APDM Mobility Lab. The APDM Mobility Lab uses wearable sensors and sophisticated signal processing to track even subtle changes in gait, stride, balance, rotation, and efficiency and range of movement in upper and lower limbs and torsos. Sensors are simply strapped on to the subject on various parts of the body, including the chest, waist, wrists and ankles. Subjects then perform a test after which a report is generated. For more information go to : APDM Mobility Lab  

Each person performed iTUG (instrumented Timed-Up-and-Go) and iSway (instrumented Sway) using the APDM Mobility Lab. They were assessed according to a range of Parkinson's Disease scores. iTUG and iSway variables differentiated people with Parkinson's Disease from people who did not have Parkinson's Disease. They correlated with all Parkinson's Disease severity measures. Objective scores correlated more strongly with iTUG than iSway.

The study identified sets of iTUG and iSway variables that correlate with Parkinson's Disease severity measures and differentiate people with Parkinson's Disease. The authors suggest that these gait and balance measures could therefore potentially serve as markers of Parkinson's Disease progression. They are consequently under evaluation for this purpose in the ongoing NIH Parkinson Disease Biomarker Program.

Reference : Journal of Neurological Science [2014] 345 (1-2) : 131-138 (D.C.Dewey, S. Miocinovic, I.Bernstein, P.Khemani, R.B.Dewey, R.Querry, S.Chitnis, R.B.Dewey Jr)  Complete abstract  In order to refer to this article on its own click here

 

23rd January 2015 - New research

RELUCTANCE TO START PARKINSON'S DISEASE TREATMENT

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The first study to assess the reluctance to start medication in Parkinson's Disease has found a reluctance to begin medication that is primarily due to a fear about side effects and a refusal to accept a diagnosis of Parkinson's Disease.

The most common reasons reported by patients for not starting Parkinson's Disease treatments were : the fear of side effects (55%), followed by the refusal to acceptance a diagnosis of Parkinson's Disease (36%). However, the main concern of physicians in starting Parkinson's Disease drugs was their temporary and limited benefits (34%). Patients were more than twice as reluctant to start dopamine agonists compared with starting L-Dopa.
In contrast, physicians perceived starting L-dopa to be far more associated with greater reluctance.

People with Parkinson's Disease and physicians therefore clearly have a very different perspective on the issue of reluctance to start medication. The researchers suggest that there is a need to bring physicians and patients with Parkinson's Disease closer to a shared vision of the problem reluctance to start medication.

Reference : Parkinsonism Related Disorders [2014] 20 (6) : 608-612 (T.A.Mestre, T. Teodoro, W.Reginold, J.Graf, M.Kasten, J.Sale, M.Zurowski, J.Miyasaki, J.J.Ferreira, C. Marras)  Complete abstract  In order to refer to this article on its own click here

 

18th January 2015 - New research

HYDROCARBONS INCREASE THE RISK OF PARKINSON'S DISEASE

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Exposure to hydrocarbons has been found to significantly increase the likelihood of developing Parkinson's Disease. This was based on by far the largest assessment of its kind. Prior to this study there had not been a consensus concerning hydrocarbons as a cause of Parkinson's Disease.

Hydrocarbon poisoning such as that of benzene and petroleum usually occurs accidentally by their inhalation or ingestion. Sources of hydrocarbons include : natural gas, cooking gas, petrol, gasoline. For more information go to : Hydrocarbon 

People with Parkinson's Disease were assessed according to several factors including their previous working exposure to hydrocarbons. Thirteen case controlled studies were made use of in assessing the likelihood of developing Parkinson's Disease. Hydrocarbon exposure increased the likelihood of Parkinson's Disease by 1.32 times normal. Occupational exposure of hydrocarbons increased the likelihood of developing Parkinson's Disease to 1.61 times normal. The biochemical cause of the association was not proposed.

This systematic review supports a positive association between hydrocarbon exposure and Parkinson's Disease. In some people the likelihood of devloping Parkinson's Disease was four times normal. A more emphatic relationship may have been obtained if the degree of exposure was also considered.

Reference : Parkinsonism Related Disorders [2014] Dec 26 [Epub ahead of print] (O.Palin, C.Herd, K.E.Morrison, A.C.Jagielski, K.Wheatley, G.N.Thomas, C.E.Clarke) Complete abstract  In order to refer to this article on its own click here

 

10th January 2015 - New research

DUAL RELEASE L-DOPA APPROVED FOR PARKINSON'S DISEASE

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Rytary, which is produced by Impax, has been approved by the FDA (in the USA) for use in the treatment of Parkinson's Disease. Impax expects Rytary to be available for use in February 2015. Most forms of L-dopa are either immediate release, which can cause an excessive effect, or controlled release, which can be slow to start having effect. Rytary is advantageous due to including both immediate release and prolonged release L-dopa.

Rytary can also be used for post-encephalitic parkinsonism, and parkinsonism that may follow carbon monoxide intoxication or manganese intoxication. Rytary is designed to address one of the most significant unmet needs for patients living with Parkinson's disease, which is to reduce the amount of time during the day when their symptoms are not adequately controlled.

Rytary is combined with carbidopa in a 4 : 1 ratio in order to maintain its effect. There are four strengths of Rytary (carbidopa/ levodopa) :, 23.75mg/95mg, 36.25mg/145mg, 48.75mg/195mg, and 61.25mg/ 245mg. Rytary may be swallowed whole or, for patients who have trouble swallowing, the capsule may be opened and the beads sprinkled on to food and consumed immediately.

In advanced Parkinson's Disease Rytary reduced the percentage of "off" time (by 37% to 23%) when compared to immediate-release carbidopa-levodopa. The most common adverse reactions with Rytary (in at least 5% of patients and more frequently than in placebo) were nausea, dizziness, headache, insomnia, abnormal dreams, dry mouth, dyskinesia, anxiety, constipation, vomiting, and orthostatic hypotension. The most common adverse reactions in advanced Parkinson's Disease were nausea and headache. For more information go to the News Release for 08 Jan 2015 News release   In order to refer to this article on its own click here

 

1st January 2015 - New research

CLINICAL TRIALS OF SUBCUTANEOUS L-DOPA

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NeuroDerm has announced results of Phase IIa pharmacokinetic Study of ND0612H and ND0612L. They led to clinically-significant plasma levels of L-dopa. ND0612 is a combination of L-dopa and carbidopa in a liquid formula administered continuously sub-cutaneously through a patch pump. ND0612 is designed to provide steady L-dopa blood levels for the reduction of motor complications in Parkinson's Disease. There is a high dose form ND0612H. For more information go to ND0612H  There is a low dose form of ND0612 called ND0612L. For more information go to ND0612L

L-dopa plasma levels were found to be proportionate to the dose. ND0612H achieved maximum daytime concentrations of 1,333ng/ml and 1,436ng/ml. With oral entacapone the levels were even higher, at 1,807ng/ml. ND0612L achieved lower maximum daytime concentrations of 528ng/ml and 477ng/ml. With oral entacapone the L-dopa levels were slightly higher, at 596ng/ml. Fluctuations in L-dopa plasma levels were markedly reduced when compared with oral L-dopa. Treatment with ND0612L and ND0612H did not raise safety and tolerability concerns, causing only minimal and transient local reactions at the infusion site. Due to the short half-life of oral L-dopa, patients are required to take multiple L-dopa doses daily. This results in sharp fluctuations in L-dopa levels which are associated with erratic "off" and "on" periods experienced by many patients.

Continuous sub-cutaneous L-dopa administration using ND0612 can overcome this limitation without having to undergo invasive surgical procedure. For more information go to Neuroderm  In order to refer to this article on its own click here

 

28th December 2014 - New research

EFFECT OF PRAMIPEXOLE ER FOR PARKINSON'S DISEASE

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The long term use of pramipexole as a once-daily extended-release oral formulation in early or advanced Parkinson's Disease demonstrated efficacy, but also adverse events. Pramipexole is a dopamine agonist that is most widely sold as Mirapex ER. For more information go to : Mirapex ER

In early Parkinson's Disease the main adverse events of extended release pramipexole were somnolence (15%), peripheral edema (11%) and back pain (10%). In advanced Parkinson's Disease the main adverse events were dyskinesia (27%) and somnolence (13%).

Parkinson's Disease symptom scores (using the UPDRS) were improved in early Parkinson's Disease, with reductions of 6.6 and 6.3 points. In advanced Parkinson's Disease the scores were reduced even further, by 11.5 and 9.1 points after over two years.

These results support the long-term efficacy of pramipexole ER in early and advanced Parkinson's Disease. Adverse Events were typical for dopaminergic medications. UPDRS (Parkinson's Disease) scores suggested sustained symptomatic benefit.

Reference : European Journal of Neurology [2014] 21 (5) : 736-743 (R.A.Hauser, A.H. Schapira, P.Barone, Y.Mizuno, O.Rascol, M.Busse, C.Debieuvre, M.Fraessdorf, W.Poewe) Complete abstract  In order to refer to this article on its own click here

 

27th December 2014 - New book

NON-MOTOR SYMPTOMS OF PARKINSON'S DISEASE

K.Ray Chaudhuri, Eduardo Tolosa, Anthony H.V.Schapira, Werner Poewe

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Publisher's description : Patients with Parkinson's disease (PD) are known to suffer from motor symptoms, but also experience non-motor symptoms (NMS) that are often present before diagnosis or that inevitably emerge with disease progression. The motor symptoms of Parkinson's disease have been extensively researched, and effective clinical tools for their assessment and treatment are readily available. Researchers have recently begun to focus on the NMS of Parkinson's Disease, which are poorly recognized and inadequately treated. NMS have an impact on patient quality of life and mortality and include neuropsychiatric, sleep-related, autonomic, gastrointestinal, and sensory symptoms. Some NMS can be improved with available treatments, but others will require research into novel therapies. This new edition summarizes the current understanding of NMS in Parkinson's disease and future research. 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

 

22nd December 2014 - New research

LONG TERM EFFECTS OF DBS ON PARKINSON'S DISEASE

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Deep Brain Stimulation of the Subthalamic Nucleus (STN-DBS) is an effective treatment for Parkinson's Disease, but in the long term Parkinson's Disease symptoms have been found to still deteriorate very significantly. 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. For more information go to : Deep Brain Stimulation

After 11 years, DBS significantly improved the motor symptoms of people with Parkinson's Disease by 35%. Motor complications were well controlled, with an 84% improvement of dyskinesias and a 65% improvement of motor fluctuations. Despite this, the Parkinson's Disease symptom score (the UPDRS-II-on score) worsened by 88%, mainly for the worsening of poorly L-dopa-responsive symptoms. More than 70% of the patients performed in the normal range in most of the neuropsychological tests, despite the development of dementia in 22% of them.

The study confirmed the long-term safety of STN-DBS in Parkinson's Disease. However, the functionality of patients worsens over time, mainly for the onset and progression of L-dopa-resistant and non-motor symptoms. The role of PD-subtype seems to be relevant in the long-term outcome.

Reference : Parkinsonism Related Disorders [2014] 20 (4) : 376-381 (M.G.Rizzone, A. Fasano, A.Daniele, M.Zibetti, A.Merola, L.Rizzi, C.Piano, C.Piccininni, L.M.Romito, L. Lopiano, A.Albanese) Complete abstract  In order to refer to this article on its own click here

 

12th December 2014 - New research

AMPHETAMINES INCREASE THE RISK OF PARKINSON'S DISEASE

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Previous neurotoxicity findings raised concerns that Amphetamines and Methamphetamines might damage dopaminergic neurons, resulting in dopamine-related medical disorders such as Parkinson's Disease. However, despite widespread use of methamphetamines and other amphetamine type stimulants little was known about the long-term medical consequences of their abuse and dependence.

A retrospective design was used to examine medical records from 1996 until 2011. Patients were divided between (1) Amphetamine and Methamphetamine users, (2) Cocaine users, (3) those people that have not been exposed to drugs or alcohol. They were assessed to see if they were at an increased risk of developing either (1) Parkinson's Disease, or (2) Parkinson's Disease / Parkinsonism / Essential Tremor when compared to people that did not take drugs. In Methamphetamine and Amphetamine users there was a nearly three fold increased risk of Parkinson's Disease, thereby indicating them as a cause of Parkinson's Disease. However, Cocaine users did not show any elevated risk of Parkinson's Disease.

The greatly increased likelihood of developing Parkinson's Disease probably occurs because of the long term effect of amphetamines on the dopamine receptors, which they affect.

Reference : Drug and Alcohol Dependence [2014] Nov 16 [Epub ahead of print] (K.Curtin, A.E.Fleckenstein, R.J.Robison, M.J.Crookston, K.R.Smith, G.R.Hanson) Complete abstract  In order to refer to this article on its own click here

 

7th December 2014 - New research

SIGNS OF PARKINSON'S DISEASE BEFORE DIAGNOSIS

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By the time somebody has been diagnosed with Parkinson's Disease many people have already had Parkinson's Disease for years or have had symptoms that were progressing towards it.

Researchers compared those symptoms before diagnosis to their subsequent diagnosis. Those symptoms assessed were : motor features (tremor, rigidity, balance impairments, neck pain or stiffness, and shoulder pain or stiffness), autonomic features (constipation, hypotension, erectile dysfunction, urinary dysfunction, and dizziness), neuropsychiatric disturbances (memory problems, late-onset anxiety or depression, cognitive decline, and apathy), and fatigue, insomnia, anosmia, hypersalivation and REM sleep disorder) prior to diagnosis.

At 10 years before diagnosis the incidence of tremor was many times higher and constipation was higher in those who went on to develop Parkinson's Disease. At 5 years before diagnosis those who went on to develop Parkinson's Disease had a much higher incidence of tremor, a higher incidence of imbalance, constipation, hypotension, and a slightly higher incidence of erectile dysfunction, urinary dysfunction, dizziness, fatigue, depression, and anxiety. At 2 years before diagnosis the incidence of all studied features except neck pain or stiffness was higher in people who went on to develop Parkinson's Disease.

A range of symptoms can therefore be detected years before diagnosis of Parkinson's Disease, with tremor being especially common prior to diagnosis.

Reference : Lancet Neurology [2014] Nov 26 [Epub ahead of print] (A.Schrag, L.Horsfall, K.Walters, A.Noyce, I.Petersen) Complete abstract  In order to refer to this article on its own click here

 

2nd December 2014 - New research

SONOGRAPHY FOR DIAGNOSIS OF PARKINSON'S DISEASE

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Transcranial sonography is a non-invasive diagnostic technique that makes use of sound waves to create a digital image to aid the diagnosis of Parkinson's Disease.

The sound waves are typically produced by a transducer. Strong, short electrical pulses from the ultrasound machine make the transducer ring at the desired frequency. Materials on the face of the transducer enable the sound to be transmitted efficiently into the body. The sound wave is partially reflected from layers between different tissues. Sound is reflected anywhere there are density changes in the body. Some of the reflections return to the transducer. The return sound wave vibrates the transducer, which turns the vibrations into electrical pulses that travel to the ultrasonic scanner where they are processed and transformed into a digital image. For more information go to Transcranial Sonography

The primary area of the brain concerning Parkinson's Disease is the substantia nigra. The substantia nigra echogenic area was found to be larger in those people with Parkinson's Disease. Substantia nigra echogenicity was also larger in males than in females. Age did not correlate with substantia nigra echogenicity in any group. After multivariate analysis, only the substantia nigra hyperechogenicity was associated with the diagnosis of Parkinson's Disease. Transcranial sonography consequently showed good diagnostic validity for the diagnosis of Parkinson's Disease. However, in a previous study the diagnostic accuracy in the early stages of Parkinson's Disease was not sufficient for routine clinical use.

Reference : Journal of Ultrasound in Medicine [2014] 33 (12) : 2069-2074 (A.Alonso- Cánovas, J.L.López-Sendón, J.Buisán, A.deFelipe-Mimbrera, M.Guillán, N.García-Barragán, I.Corral, M.C.Matute-Lozano, J.Masjuan, J.C.Martínez-Castrillo, U.Walter) Complete abstract  In order to refer to this article on its own click here

 

22nd November 2014 - New music

IT'S ALL IN MY HEAD (AN ALBUM ABOUT PARKINSON'S DISEASE)

Bill Schmalfeldt

Publisher's description : This is a music  album by a cranky 60-year old with Parkinson’s disease. If there’s one thing that drives him nuts, it’s when people try to cheer him out of his PD doldrums with sappy, silly, “everything’s gonna be FINE!” songs. Everything is NOT going to be fine, not for Bill, and not for the people with this progressive neurological disorder. Still, there’s reason for hope as Bill shares in the last song on this album. People are working day and night to find better treatments and, hopefully, a cure for this beast of a disease. Bill’s album deals with the stuff a person with advanced Parkinson’s disease deals with every day. The feeling that you could be doing more for yourself and easing some of the burden on your caregiver.  There’s a lot of snark, sass, sarcasm and sardonic humor in this album. But one thing that comes through is that Bill is not done living. Not just yet. Click here for more details

 

13th  November 2014 - New book

DEEP BRAIN STIMULATION FOR NEUROLOGICAL DISORDERS

Toru Itakura

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Publisher's description : Chronic electrical stimulation of the brain has demonstrated excellent outcomes in patients with Parkinson’s disease and has recently also been applied to other neurological diseases. This comprehensive, up-to-date book will meet the needs of all who wish to learn more about the application of deep brain stimulation and will provide a sound basis for safe and accurate surgery. The book comprises two main parts, the first of which presents relevant anatomical and functional background information on the basal ganglia, thalamus and other brain structures as well as on the mechanism of brain stimulation. The second part describes clinical studies on deep brain stimulation, covering results in a range of movement disorders and psychiatric diseases and also important aspects of instrumentation and technique. The authors are outstanding scientists and experts from across the world. 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

 

8th November 2014 - New research

DELAYING L-DOPA IN PARKINSON'S DISEASE

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During the past decade, a number of large drug trials have suggested that the initiation of L-dopa therapy should be delayed in order to reduce the risk of motor complications in people with Parkinson's Disease.

Researchers therefore assessed what happened when L-dopa was withheld for a long time after somebody had developed Parkinson's Disease. They studied Ghana, because in Ghana access to medication for Parkinson's Disease means that initiation of L-dopa is often delayed for many years after the onset of Parkinson's Disease. Their data was compared to people with Parkinson's Disease in Italy, where the use of L-dopa is initiated far earlier. Demographic features, frequency and severity of motor and non-motor symptoms were comparable in the two populations. Although L-dopa therapy was introduced much later in Ghana, the duration of Parkinson's Disease when motor fluctuations and dyskinesias started was similar to people in Italy who initiated the use of L-dopa far earlier.

Instead of how early L-dopa was initiated, what was most associated with motor fluctuations and dyskinesias was (1) the duration of Parkinson's Disease and (2) the daily dose of L-dopa (mg/kg of body weight). The average time to the development of motor fluctuations and dyskinesias after the initiation of L-dopa was surprisingly short as it was only six months.

Reference : Brain [2014] 137 (10) : 2731-2742 (R.Cilia, A.Akpalu, F.S.Sarfo, M.Cham, M.Amboni, E.Cereda, M.Fabbri, P.Adjei, J.Akassi, A.Bonetti, G.Pezzoli)  Complete abstract 

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2nd November 2014 - New book

GUIDE TO ASSESSMENT SCALES IN PARKINSON'S DISEASE

Pablo Martinez-Martin, Carmen Rodriguez-Blazquez, Maria Joao Forjaz, Kallol Ray Chaudhuri

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Publisher's description : This Guide assesses the key clinimetric attributes in the assessment of Parkinson's Disease, with the intention to offer rapid and pragmatic information on the most relevant scales used. The use of scales for assessment in neurological disorders such as PD arises from the need to quantify disorders and states (such constructs as disability, symptoms, quality of life). Assessment scales are often categorised into two categories: generic (i.e. those scales usable in any health condition), and specific (i.e. scales developed for exclusive use in PD). They can have a variety of components: single-item and multi-item or composite scale; unidimensional and multidimensional; and as disease-centered and patient-centered measures. The creation and validation of scales is complex, with scales undergoing numerous studies to assess criteria such as acceptability, reliability, and responsiveness.  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

 

20th October 2014 - New research

CLINICAL TRIAL RESULTS OF DUAL LAYER L-DOPA

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Dual layer L-dopa (IPX066), which is being developed for the treatment of Parkinson's Disease, unusually and advantageously combines the immediate release version of L-dopa with the controlled release version of L-dopa. An application by Impax is with the FDA for the marketing of IPX066 as Rytary. For more information go to Rytary 
                                                                                                                                                                                      The effect of Dual Layer L-dopa on Parkinson's Disease was compared to the effect of Sinemet plus Entacapone, which is one of the most effective formats of L-dopa. IPX066 demonstrated improved efficacy. The average dosage of L-dopa used in IPX066, after accounting for availability, was 22% higher than in Sinemet and Entacapone.

IPX066 demonstrated less "off" time (3.8 hours instead of 5.2 hours per day). IPX066 demonstrated higher "on" time without dyskinesia (11.4 hours instead of 10 hours per day). Other measures favoured IPX066. There were more adverse events when taking IPX066. The most common adverse events were dyskinesia, insomnia, and confusional state for IPX066, and falling for Sinemet and Entacapone.

Reference : Parkinsonism Related Disorders [2014] Aug 15 [Epub ahead of print] (F.Stocchi, A.Hsu, S.Khanna, A.Ellenbogen, A.Mahler, G.Liang, U.Dillmann, R.Rubens, S.Kell, S. Gupta)
Complete abstract 

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13th October 2014 - New research

AIR POLLUTION AND PARKINSON'S DISEASE

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Exposure to air pollution has been implicated as a cause of Parkinson's Disease. The first prominent descriptions of Parkinson's Disease came at the time of the Industrial Revolution when pollution levels escalated. Yet, no prospective study has examined the association between particulate matter and the risk of Parkinson's Disease.

After adjusting for age in months, smoking, region, population density, caffeine and ibuprofen intake, there was found to be no statistically significant associations between exposure to air pollution and the risk of Parkinson's Disease. The relative risk of Parkinson's Disease was 1.08 for pollution particles that were less than 2.5 microns in diameter, 0.92 for pollution particles that were 2.5 to 10.0 microns in diameter, and 0.99 for pollution particles that were more than 10.0 microns in diameter. These likelihoods are little different from what would be expected normally.

There are areas of the world where pollution is definitely a serious cause of Parkinson's Disease. One of the world's highest prevalences of Parkinson's Disease is in the vicinities of ferromanganese plants near Brescia in Italy. Manganese concentrations in settled dust were found to be significantly higher in the surroundings and downwind from the ferromanganese plants. In high concentrations, manganese is a known cause of Parkinson's Disease.

Reference : Environmental Health [2014] 13 (1) : 80 [Epub ahead of print] (N.Palacios, K.C.Fitzgerald, J.E.Hart, M.G.Weisskopf, M.A.Schwarzschild, A.Ascherio, F.Laden) Complete abstract 

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10th October 2014 - New research

TWENTY YEARS WITH PARKINSON'S DISEASE

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Having Parkinson's Disease for more than twenty years has been found to be associated with major milestones of disease disability, fractures, or being confined to a wheelchair or bed. There are a very limited number of studies on the clinical features of Parkinson's Disease twenty years after onset. So an assessment was carried out for several years on people who had Parkinson's Disease for more than twenty years

Those people considered were those who had Parkinson's Disease for 20 to 22 years. They were assessed for an average of nearly four years. Older age at onset and longer duration of Parkinson's Disease were each associated with a higher prevalence of major motor and non-motor milestones of disease disability. Confinement to a wheelchair or bed had by then occurred in just over 1 in 5 people (21%). Those factors making confinement to a wheelchair or bed were older age, postural instability and institutionalisation. Fractures occurred in 16% of people. Fractures were associated with postural instability.

The most frequent outcome was death (28%). However, given the age of diagnosis and the duration of Parkinson's Disease this might have been no more than normal. Mortality was associated with male gender, older age, dysphagia (difficulty in swallowing), orthostatic hypotension, postural instability, fractures and institutionalisation.

Reference : Journal of Neurology, Neurosurgery and Psychiatry [2014] Oct 3 [Epub ahead of print] (R.Cilia, E.Cereda, C.Klersy, M.Canesi, A.L.Zecchinelli, C.B.Mariani, S.Tesei, G.Sacilotto, N.Meucci, M.Zini, C.Ruffmann, I.U.Isaias, S.Goldwurm, G.Pezzoli) Complete abstract  In order to refer to this article on its own click here

 

8th October 2014 - New book

LEVODOPA-INDUCED DYSKINESIA IN PARKINSON'S DISEASE

Susan H.Fox (Editor), Jonathan M.Brotchie (Editor)

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Publisher's description : This book aims to provide a single reference source on levodopa-induced dyskinesias (LID) from ‘bench to bedside’. Initial chapters review the clinical features and phenomenology of LID with video examples; epidemiology and genetic risk factors for LID are covered as a background to understanding risk factors for developing LID. The chapters cover the latest preclinical studies aiming to understand the pathophysiology of LID at the cellular, neurochemical, neurophysiological and circuitry level with detailed discussion of mechanisms and future directions to take the field forward; clinical studies from phase II to phase IV; on going RCTs in LID and evidence-based medicine reviews of treatment options. Levodopa-Induced Dyskinesia in Parkinson’s Disease is aimed at an international audience of movement disorder neurologists; neuroscientists; trainees and graduate and post-graduate students. Click here for more details  In order to refer to this article on its own click here For more books concerning Parkinson's Disease go to Parkinson's Disease books

 

5th October 2014 - New research

HANDEDNESS AND PARKINSON'S DISEASE SYMPTOMS

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Whether somebody with Parkinson's Disease is right handed or left handed has been found to greatly affect the side on which their Parkinson's Disease symptoms initiate and persist.

Handedness determines a better performance or preference for the use of one hand rather than the other. For more information go to Handedness 

Out of those people with Parkinson's Disease, 92% were right handed. Nearly 62% of them had an initial onset of symptoms on the right hand side. Out of those people with Parkinson's Disease, 8% were left handed. Around 75% of them had an initial onset of symptoms on the left hand side. Out of those people with Parkinson's Disease who were right handed 77% had Parkinson's Disease symptoms that were dominant on the right hand side. Out of those people with Parkinson's Disease who were left handed 58% of them had Parkinson's Disease symptoms that were dominant on the left hand side.

In general, the dominant side of Parkinson's Disease symptoms was in accordance with which handed they were. In people who were right handed, rest tremor was the most common initial symptom. In people who were left handed, rest tremor and rigidity and bradykinesia were the most common initial symptoms. In order to refer to this article on its own click here Reference : Medicina Clinica [2014] 142 (4) : 141-144 (J.Shi, J.Liu, Q.Qu) Complete abstract

 

1st October 2014 - New research

HORMONES CAN INCREASE THE RISK OF PARKINSON'S DISEASE

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ParkinsonismMovement Disorders [2014] Sep 25 [Epub ahead of print] (J.I.Lundin, T.G.Ton, A.Z. LaCroix, W.T.Longstreth, G.M.Franklin, P.D.Swanson, T.Smith-Weller, B.A.Racette, H. Checkoway) Complete abstract

Certain types of commonly used oral contraceptives have been found to greatly increase the risk of developing Parkinson's Disease. Oral contraceptives, which includes estrogen and progestin, are a class of drugs widely prescribed to women.  For more information go to Oral contraceptives

Oral contraceptive use by people with Parkinson's Disease were classified as conjugated estrogens, esterified estrogens, or progestin. Ever having used a hormone therapy formulation demonstrated a suggested elevated risk with esterified estrogen use that was three times the normal. However, there was no increase in the risk of developing Parkinson's Disease in those people who had taken conjugated estrogen. Restricting this analysis to prescriptions that included progestin greatly increased the risk associated with esterified estrogen use, making Parkinson's Disease SEVEN times more likely. Progestin also moderately increased the risk of developing Parkinson's Disease in those people who taken conjugated estrogen.

The findings from this study suggest a great increase in Parkinson's Disease risk associated with the use of esterified estrogen combined with progestin, but no risk is associated with conjugated estrogen on its own. In order to refer to this article on its own click here

 

28th September 2014 - New research

WEARING OFF IN PARKINSON'S DISEASE

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Parkinsonism Related Disorders [2014] 20 (2) : 204-211 (F.Stocchi, A.Antonini, P.Barone, M.Tinazzi, M.Zappia, M.Onofrj, S.Ruggieri, L.Morgante, U.Bonuccelli, L.Lopiano, P. Pramstaller, A.Albanese, M.Attar, V.Posocco, D.Colombo, G.Abbruzzese) Complete abstract

Wearing off of the effect of drugs for Parkinson's Disease has been found to occur far earlier and in more people with Parkinson's Disease than previously assumed. Wearing off is very individual and there is no standard time frame for when this may occur or which symptoms are experienced. For more information go to Wearing off

Neurologists found that there was wearing off in 57% of people with Parkinson's Disease. However, when this was assessed by the patients themselves, there was found to be wearing off in 67% of people with Parkinson's Disease. Even in people who had Parkinson's Disease for less than 2.5 years there was wearing off in 21% of people when assessed by neurologists and in 41% when patients assessed themselves. The most frequent wearing off symptoms were slowness of movements (55%) and reduced dexterity (48%). Those factors most associated with wearing off were : younger age, female gender, severer symptoms, and duration of treatment.

Wearing Off is already common in the early stages of Parkinson's Disease and is underestimated by routine neurological clinical evaluation. The effect of Parkinson's Disease drugs is therefore often relatively short lived. In order to refer to this article on its own click here

 

25th September 2014 - New Audiobook

PUT ON YOUR PARKY FACE ! THE EXPANDED VERSION

Bill Schmalfeldt

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Publisher's description : Put on your Parky face is a narrated Audiobook about Parkinson's Disease by widely known Parkinson's Disease blogger Bill Schmalfeldt. Bill is serving notice. It's time for Parkinson's disease patients to stop being invisible. It's time for a nationwide effort to raise awareness about this crippling degenerative neurological disorder and the havoc it wreaks. Having had Parkinson's Disease since 2000 at the age of 45, Bill volunteered for experimental brain surgery in 2007. He spins a humorous, poignant, and sometimes angry tale about his life with this progressive neurological condition. He uses his time, focus and energy to help fund the research that will find the cure. 100% of the author proceeds from this book will be donated to Parkinson's research charities. On the web site there is a good audio sample. Click here for more details   In order to refer to this article on its own click here

 

19th September 2014 - New research

TOZADENANT CLINICAL TRIALS FOR PARKINSON'S DISEASE

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Lancet Neurology [2014] 13 (8) : 767-776 (R.A.Hauser, C.W.Olanow, K.D.Kieburtz, E. Pourcher, A.Docu-Axelerad, M.Lew, O.Kozyolkin, A.Neale, C.Resburg, U.Meya, C.Kenney, S.Bandak)  Complete abstract

Clinical trials assessed the use 60mg, 120mg, 180mg, or 240mg tozadenant in people with Parkinson's Disease who were being treated with L-dopa and who had motor fluctuations that involved at least 2·5 hours off-time per day. Tozadenant (SYN115) is an inhibitor of the adenosine 2a (A2a) receptor that is being developed for the treatment of Parkinson's Disease. For more information go to SYN115

Compared with the use of a placebo, daily off-time was reduced by more than an hour when taking either 120mg or 180mg tozadenant. The most common adverse events were dyskinesia (16% of people taking 120mg, 20% of people taking 180mg), nausea (11% of people taking 120mg, 12% of people taking 180mg), dizziness (5% of people taking 120mg, 13% of people taking 180mg). Tozadenant, 60 mg twice daily, was not associated with a significant reduction in off-time. Tozadenant, 240 mg twice daily, was associated with an increased rate of discontinuation because of adverse events that occurred in 20% of people taking that dosage.

The researchers concluded that Tozadenant at 120 or 180 mg twice daily was generally well tolerated and was effective at reducing off-time. Further investigation of tozadenant treatment in phase 3 trials is warranted. In order to refer to this article on its own click here

 

11th September 2014 - New research

ENTACAPONE EFFICACY IN PARKINSON'S DISEASE

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Acta Neurologica Scandinavica [2014] Sep 3 [Epub ahead of print] (M.Kuoppamäki, M. Vahteristo, J.Ellmén, K.Kieburtz) Complete abstract

A retrospective analysis of randomised, double-blind, placebo-controlled clinical trials of entacapone show that it improves Parkinson's Disease symptoms but often at the expense of dyskinesia or nausea. Entacapone is marketed as Comtan. In combination with L-dopa and carbidopa (the active constituents of Sinemet) Entacapone is marketed as Stalevo. For more information go to Comtan

Entacapone improved daily OFF and ON times by 0.8 hours (48 minutes) compared with a placebo. People taking entacapone also did better in the standard Parkinson's Disease symptom questionnaire the UPDRS II, UPDRS III, and also global evaluation. Similar benefits of entacapone were seen in subgroups of patients with and without dopamine agonists or selegiline. Entacapone was generally well tolerated. Dyskinesia and nausea were more frequently reported by people taking entacapone, with 25% getting dyskinesia and 14% getting nausea. There was no difference in reports of hallucinations.

The researchers suggest that results of this pooled analysis of entacapone clinical trials potentially serve as a useful benchmarking data for new therapies, especially those including L-dopa, in people with advanced Parkinson's Disease. In order to refer to this article on its own click here

 

8th September  2014 - News release

SUBCUTANEOUS LIQUID L-DOPA FOR PARKINSON'S DISEASE

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NeuroDerm have announced that the first patients with severe Parkinson's Disease have been enrolled and dosed in a Phase IIa trial of ND0612H. ND0612H is a high-dose form of liquid L-dopa and carbidopa (which is the same as Sinemet) but which is delivered continuously through subcutaneous administration (via the skin) by a belt-pump. Unlike the most comparable methods of administering L-dopa, no surgery at all is needed.

ND0612H is intended to replace current treatments for people with severe Parkinson's Disease that require highly invasive surgery that is associated with serious side effects.

ND0612L is the low dose drug form intended for moderate Parkinson's Disease. ND0612L has just completed patient enrolment and treatment in a Phase II double-blind, randomised, placebo-controlled study. ND0612L was shown in previous phase I and phase IIa studies to be safe and tolerable, reaching steady state, clinically meaningful L-dopa blood concentrations.

ND0612L and ND0612H are the first liquid formulations of L-dopa and carbidopa to be administered subcutaneously (via the skin) to conveniently achieve steady state L-dopa plasma levels. L-dopa and carbidopa are otherwise nearly always administered orally, which can cause motor fluctuations and non-motor complications in Parkinson's Disease. For more information go to NeuroDerm In order to refer to this article on its own click here

 

23rd August 2014 - New book

WINDOW OF OPPORTUNITY : LIVING WITH THE REALITY OF PARKINSON'S AND THE THREAT OF DEMENTIA

Kirk W.Hall

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Publisher's description : Window of Opportunity is the story of one person's journey through the initial signs of cognitive impairment brought on by Parkinson's disease and how this potentially disabling diagnosis turns into a "Window of Opportunity" to help others on the path. Kirk Hall began noticing small signs of mild cognitive impairment. He tells his story with directness, candor, sensitivity and humor. He describes the long and challenging visits to doctors seeking answers to his disturbing symptoms and the confusion caused by conflicting opinions about the nature and progression of his disease. His journal notes allow him to describe in vivid detail his slowly coming to grips with disability. He shares the internal struggle, anxiety and stress that uncertainty causes, not only for himself but for his family as well. Click here for more details

Kirk W.Hall has also written two children's books concerning Parkinson's Disease - Carina and Her Care Partner Gramma Click here for more details and Carson and His Shaky Paws Grampa Click here for more details

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15th August 2014 - News release

ROBIN WILLIAMS DIES WITH PARKINSON'S DISEASE

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Robin Williams (1951-2014) was an American actor and comedian who appeared in numerous films. He recently committed suicide. His wife, Susan Schneider, has made a statement that, at the time of his death, Robin Williams was in the early stages of Parkinson's Disease.

His wife, Susan Schneider wrote : "Robin's sobriety was intact and he was brave as he struggled with his own battles of depression, anxiety as well as early stages of Parkinson's Disease, which he was not yet ready to share publicly. It is our hope in the wake of Robin's tragic passing, that others will find the strength to seek the care and support they need to treat whatever battles they are facing so they may feel less afraid."

Starting as a stand-up comedian in San Francisco and Los Angeles, Robin Williams soon rose to fame as Mork in the TV series Mork & Mindy (1978-1982). His film career included : Popeye (1980), The World According to Garp (1982), Good Morning Vietnam (1987), Dead Poets Society (1989), Awakenings (1990), The Fisher King (1991), Hook (1991), Mrs. Doubtfire (1993), Jumanji (1995), and Night at the Museum (2006). He was nominated for the Academy Award for Best Actor three times and won the Academy Award for Best Supporting Actor. He sometimes suffered from depression and struggled with drug and alcohol addiction for much of his career. On 11th August 2014 he was found dead after committing suicide by hanging. For more information go to Robin Williams  In order to refer to this article on its own click here

 

14th August 2014 - News release

WEARABLE SENSORS FOR PARKINSON'S DISEASE

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The Michael J. Fox Foundation and Intel Corporation are partnering to gather and analyse data from Wrist-worn devices worn by people with Parkinson's Disease that track users' movement. The results could help individuals and their doctors better manage their Parkinson's Disease.

A study was launched earlier this year to evaluate three wearable devices for tracking measurable features of Parkinson's Disease such as slowness and frequency of movement. People with Parkinson's Disease wore the devices during two clinic visits and at home over a few days.

Intel engineers are comparing the data obtained from the device to clinical observations and patient diaries in order to test the devices' accuracy. They are developing mathematical formulas to measure the symptoms and the progression of Parkinson's Disease. These devices can capture up to 300 observations per second. So formulas to interpret all that data and report what it means related to someone's Parkinson's Disease can help individuals and their physicians monitor disease.

The next phase of the MJFF-Intel study will capture data to measure medication response such as on/off episodes. Recruitment is expected to begin soon in locations including New York City, Boston and Tel Aviv, Israel. The Michael J.Fox Foundation plans to expand their use to other clinical studies. For more information go to The Michael J.Fox Foundation  In order to refer to this article on its own click here

 

29th July 2014 - New research

DISCOVERY OF NEW PARKINSON'S DISEASE GENETIC FACTORS

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Nature Genetics [2014] (27 July) (M.A.Nalls, N.Pankratz, C.M.Lill, C.B.Do, D.G. Hernandez, M.Saad, A.L.De Stefano, E.Kara, J.Bras, M.Sharma, C.Schulte, M.F.Keller, S.Arepalli, C.Letson, C.Edsall, H.Stefansson, X.Liu, H.Pliner, J.H.Lee, R.Cheng, et al) Complete abstract
                                                                                                                                                                                    
Six new genetic risk factors for Parkinson's Disease have been discovered. Scientists have identified more than two dozen genetic risk factors involved in Parkinson's Disease, including six that had not previously been reported.

They conducted an extensive analysis of Parkinson's Disease genetic studies. Twenty six sites were identified as having a significant genetic association with Parkinson's Disease. These and six additional sites that had previously not been reported were then tested. In total, they identified and replicated 28 independent risk variants for Parkinson's disease across 24 loci (positions on the gene). Although the effect of each individual genetic risk was found to be small, a risk profile analysis showed that there was a substantial cumulative risk of developing Parkinson's Disease because of them. The risk was actually tripled when several genetic risk factors occurred simultaneously.

Their results suggested that the more variants a person has the greater the risk, which is up to three times higher for developing Parkinson's Disease in some cases. Genetic causes of Parkinson's Disease usually make Parkinson's Disease more likely rather than inevitable. Although genetic causes of Parkinson's Disease are uncommon the actual prevalence is unknown. In order to refer to this article on its own click here

 

27th July 2014 - New research

NASAL DELIVERY OF PARKINSON'S DISEASE TREATMENT

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Expert opinion on drug delivery [2014] 11 (6) : 827-842 (S.Md, S.Haque, M.Fazil, M. Kumar, S.Baboota, J.K.Sahni, J.Ali) Complete abstract
                                                                                                                                                                                     Researchers evaluated whether prepared nanoparticles would be able to target Parkinson's Disease treatments to the brain via the nasal route, thereby enhancing their bioavailability. They tested the method using an optimised nanoformulation of the dopamine agonist bromocriptine for direct nose-to-brain delivery.

The percentage accuracy observed for intra-day and inter-day batch samples was very high. Bromocriptine was found to be stable in all exposed conditions. Bromocriptine nanoparticles also showed greater retention into the nostrils for about four hours. Direct bromocriptine nanoparticle nose-to-brain transport was shown to then bypass the blood-brain barrier. Most importantly, bromocriptine nanoparticles administered nasally showed significantly high dopamine concentrations.

The researchers concluded that Nanoparticle drug delivery system could be potentially used as a nose-to-brain drug delivery carrier for improving the existing means of treating Parkinson's Disease. In order to refer to this article on its own click here

 

23rd July 2014 - News release

APOMORPHINE CLINICAL TRIAL FOR PARKINSON'S DISEASE

Clinical trials are being undertaken of APL-130277, which is an easy-to-administer, fast acting reformulation of the dopamine agonist apomorphine. Apomorphine is the only approved drug for "off" episodes. As many as half of all people with Parkinson's Disease have "off" episodes in which they have impaired movement or speaking capabilities.

Apomorphine is normally sold as Apokyn, which is injectable. For more information go to Apokyn However, 85% of Apokyn patients have an injection site reaction due to apomorphine's acidity and so must continuously change the injection site. APL-130277 contains a buffer that protects the patient from the acidic properties of Apokyn.

CTH-105 is a Phase 2 clinical study of APL-130277. APL-130277 will be studied in 16 people with Parkinson's disease who have not used apomorphine and who experience at least one daily "off" episode, with a total duration of "off" in any 24-hour period of at least 2 hours. This open study will examine the effect of APL-130277 on relieving "off" episodes over a single day, with dose-titration used to determine dose strengths necessary for future clinical use.

In particular, the dose strength information is necessary in order to conduct the larger CTH-300a efficacy study in apomorphine naive patients, which is expected to commence at the end of 2014. The primary means of assessment will be the change in the UPDRS III score, which is the most widely used Parkinson's Disease symptom questionnaire. For more information go to Cynapsus  In order to refer to this article on its own click here

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17th July 2014 - New research

SOCIAL PHOBIAS ARE COMMON IN PARKINSON'S DISEASE

Neuropsychiatric Disease and Treatment [2014] 10 : 829-834 (B.K.Gultekin, B.Ozdilek, E.E. Bestepe) Complete abstract

Researchers aimed to investigate the frequency of social phobias in people with Parkinson's Disease. They also explored the relationship between social phobia and the characteristics of Parkinson's Disease, and the frequency of other psychiatric disorders in Parkinson's Disease.

Social phobia (Social anxiety disorder) is a persistent fear about social situations and being around people. Much more than just shyness it can causes intense, overwhelming fear over what may just be an everyday activity like shopping or speaking on the phone. People affected by it may fear doing or saying something they think will be humiliating. For more information go to Social Phobias Social phobia was diagnosed in 42% of people with Parkinson's Disease. Of those, 58% also had depression, 53% also had anxiety, and 17% also had panic disorders. Social phobia was more frequent in : males, early-onset Parkinson's Disease, people with a long duration of Parkinson's Disease, the presence of postural instability, and with the use of a high L-dopa intakes.

Social phobia is frequently observed in Parkinson's Disease. Therefore, the researchers suggest that the assessment of people with Parkinson's Disease patients should always include psychiatric evaluations, particularly for social phobia.  In order to refer to this article on its own click here

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14th July 2014 - New research

FREQUENT MISDIAGNOSIS OF PARKINSON'S DISEASE

Neurology [2014] Jun 27[Epub ahead of print] (C.H.Adler, T.G.Beach, J.G.Hentz, H.A.Shill, J.N.Caviness, E.Driver-Dunckley, M.N.Sabbagh, L.I.Sue, S.A.Jacobson, C.M.Belden, B.N. Dugger)  Complete abstract

Researchers aimed to determine the diagnostic accuracy of a clinical diagnosis of Parkinson's Disease using neuropathologic diagnosis as the standard. The accuracy of diagnosis was found to be very poor.

Data were used to determine the predictive value of a clinical Parkinson's Disease diagnosis, using two clinical diagnostic confidence levels : PossPD (never treated or not clearly responsive) and ProbPD (responsive to medications).

Using neuropathologic findings of Parkinson's Disease as the standard, this study established a finding of only 26% accuracy for a clinical diagnosis of Parkinson's Disease in untreated patients, 53% accuracy in early Parkinson's Disease of less than five years duration that was responsive to medication, and 85% diagnostic accuracy in Parkinson's Disease of longer duration that was medication-responsive. Clinical variables that improved diagnostic accuracy were medication response, motor fluctuations, dyskinesias, and hyposmia (reduced sense of smell).ic accuracy in Parkinson's Disease of longer duration that was medication-responsive.

This study showed that a clinical diagnosis of Parkinson's Disease identifies people who will have pathologically confirmed Parkinson's Disease with a sensitivity of 88% and specificity of 68%. For more information concerning the diagnosis of Parkinson's Disease go to Diagnosis of Parkinson's Disease In order to refer to this article on its own click here

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10th July 2014 - New research

ß-ASARONE INCREASES L-DOPA IN PARKINSON'S DISEASE

Clinical and Experimental Pharmacology and Physiology [2014] Jun 7 [Epub ahead of print] (L.Huang, M.Deng, S.Zhang, Y.Fang, L.Li)  Complete abstract

In order to increase the effect of L-dopa it is usually administered in combination with a dopa decarboxylase inhibitor. In Sinemet, L-dopa is combined with carbidopa. In Madopar, L-dopa is combined with benserazide. The co-administration of ß-asarone and Levodopa is being developed as a means of improving the effect of L-dopa even further.

ß-asarone is found in the flowering plant acorus and also in asarum, which is known as wild ginger. For more information go to Ansarone

In animal studies the use of L-dopa in combination with ß-asarone was compared to the use of existing methods of treating Parkinson's Disease. Dopamine levels were found to increase in the brain (in the striatum) and in blood plasma in response to ß-asarone. The co-administration of ß-asarone and L-dopa could also increase the levels in blood plasma of tyrosine hydroxylase, which is the enzyme responsible for the formation of L-dopa. Altogether, ß-asarone was found to have an effect on converting L-dopa into dopamine by modulating the activity of dopamine metabolism.

The mechanism of co-administration of ß-asarone and L-dopa is different from that of Sinemet and Madopar in the treatment of Parkinson's Disease. The co-administration of ß-asarone and L-dopa may be more beneficial to Parkinson's Disease treatment than the existing methods and so could eventually replace them.  In order to refer to this article on its own click here

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5th July 2014 - New research

THE WORLDWIDE PREVALENCE OF PARKINSON'S DISEASE

Movement Disorders [2014] Jun 28 [Epub ahead of print] (T.Pringsheim, N.Jette, A.Frolkis, T.D.Steeves)   Complete abstract

Researchers sought to synthesize studies on the prevalence of Parkinson's Disease to obtain an overall view of how the prevalence varies by age, gender, and geographic location. Geographic location was stratified by the following groups : Asia, Africa, South America, Europe / North America / Australia. Data were analyzed by age group, geographic location, and gender.

Analysis of worldwide data showed a rising prevalence of Parkinson's Disease with age, with (per 100,000) : 41 in 40 to 49 year olds, 107 in 50 to 59 year olds, 173 in 55 to 64 year olds, 428 in 60 to 69 year olds, 1087 in 70 to 79 year olds, and 1903 in those aged older than 80.A significant difference was seen in prevalence geographically only for people who were 70 to 79 years old, with a prevalence of 1601 (per 100,000) in people in North America, Europe, and Australia, compared to only 646 (per 100,000) in people from Asia. Differences in prevalence according to gender was found only for people who were 50 to 59 years old, with a prevalence of 41 in females and 134 in males.

Parkinson's Disease prevalence worldwide increases steadily with age. Some differences in prevalence according to geographic location and gender can be detected. For more information concerning the prevalence of Parkinson's Disease go to the Prevalence of Parkinson's Disease  In order to refer to this article on its own click here

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29th June 2014 - New research

COMPARISON OF L-DOPA, AGONISTS AND MAO INHIBITORS

Lancet [2014] Jun 10 [Epub ahead of print] (Pd Med Collaborative Group)  Complete abstract

Whether the initial treatment for Parkinson's disease should consist of L-dopa, dopamine agonists, or MAO B inhibitors is uncertain. So researchers aimed to establish which of these three classes of drug, as initial treatment, provided the most effective long-term control of symptoms and best quality of life for people with early Parkinson's Disease.

People newly diagnosed with Parkinson's disease were randomly assigned between the use of L-dopa, dopamine agonists and MAO B inhibitors. After three years PDQ-39 mobility scores averaged 1·8 points better in people assigned to L-dopa. PDQ-39 mobility scores were 1·4 points better in people assigned to MAO B inhibitors when compared to those taking dopamine agonists. L-dopa was not significantly advantageous for EQ-5D utility scores, dementia, admissions to institutions, and death rates. Treatments were discontinued in 28% of those taking dopamine agonists, 23% of those taking MAOB inhibitors, but only 2% of those taking L-dopa.

Small but persistent benefits are shown for patient-rated mobility scores when treatment is initiated with L-dopa compared with dopamine agonists and MAO B inhibitors. MAO B inhibitors were found to be at least as effective as dopamine agonists. L-dopa is also clearly more tolerable. In order to refer to this article on its own click here

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21st June 2014 - New research

CIRCADIAN RHYTHMS IN PARKINSONS' DISEASE

JAMA Neurology [2014] 71 (4) : 463-469 (A.Videnovic, C.Noble, K.J.Reid, J.Peng, F.W. Turek, A.Marconi, A.W.Rademaker, T.Simuni, C.Zadikoff, P.C.Zee)  Complete abstract

People with Parkinson's Disease have been found to have blunted circadian rhythms. Circadian rhythms are the alterations of endocrine functions that take place in a regulated manner over a roughly 24 hour period. The pineal gland produces melatonin, which is a hormone that regulates the circadian rhythms. For more information go to  Circadian rhythms

The differences and the range of secretion of melatonin from the pineal gland were found to be lower in Parkinson's Disease than in people that do not have Parkinson's Disease. Overall Parkinson's Disease symptoms and duration of symptoms were not significantly related to the circadian rhythm. So it was only daytime sleepiness and not Parkinson's Disease symptoms generally that are affected by the blunted circadian rhythm that can occur in Parkinson's Disease. Dopamine regulates melatonin secretion. Therefore, the reduced dopamine that occurs in Parkinson's Disease will lead to an altered circadian rhythm.

Circadian dysfunction can consequently underlie excessive sleepiness in Parkinson's Disease. Approaches aimed to strengthen circadian function, such as timed exposure to bright light and exercise, might therefore serve as complementary therapies for the nonmotor manifestations of Parkinson's Disease. In order to refer to this article on its own click here

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9th June 2014 - New research

FAHR'S SYNDROME IS A CAUSE OF PARKINSON'S DISEASE

Journal of the College of Physicians and Surgeons - Pakistan [2014] 24 (5) : S104-S106 (N.Dildar, H.Akram, I.M.Qasmi, M.N.Qureshi, S.Khan)  Complete abstract

Fahr's Syndrome is a rare inherited neurological disorder that can present with a wide spectrum of symptoms, including those of Parkinson's Disease. It is characterised by abnormal deposits of calcium in areas of the brain that control movement, including the basal ganglia and the cerebral cortex. For more information go to Fahr's Syndrome

Symptoms of Fahr's Syndrome that are similar to those of Parkinson's Disease may include deterioration of motor function, dementia, dysarthria (poorly articulated speech), tremors, muscle rigidity, a mask-like facial appearance, shuffling gait, and a "pill-rolling" motion of the fingers. These symptoms generally occur later in the development of the disease.

More common symptoms of Fahr's Syndrome include dystonia (disordered muscle tone) and chorea (involuntary, rapid, jerky movements). The age of onset of Fahr's Syndrome is typically in the 40s or 50s, which is similar to Parkinson's Disease, although it can also occur at any time in childhood or adolescence.

Due to the possible similarity of symptoms to those of Parkinson's Disease, Fahr's Syndrome should be considered as an important differential diagnosis in cases of Parkinsonism. In order to refer to this article on its own click here

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20th May 2014 - New research

PRAMIPEXOLE CLINICAL TRIAL RESULTS IN PARKINSON'S DISEASE

European Journal of Neurology [2014] 21 (5) : 736-743 (R.A.Hauser, A.H.Schapira, P. Barone, Y.Mizuno, O.Rascol, M.Busse, C.Debieuvre, M.Fraessdorf, W.Poewe) Complete abstract

The long term safety and efficacy of pramipexole was assessed as an extended-release oral formulation and immediate release formulation in early or advanced Parkinson's Disease. Pramipexole, which is marketed as Mirapex, Mirapexin, and Sifrol, is a dopamine agonist. For more information go to Pramipexole

In those people with early Parkinson's Disease the reported side effects were somnolence (15%), peripheral edema (11%) and back pain (10%). The scores on the Parkinson's Disease symptom score (UPDRS) after over 2 years were down by 6.6 when using extended release pramipexole and 6.3 when using immediate release pramipexole. In those people with advanced Parkinson's Disease the reported side effects were dyskinesia (27%), somnolence (13%), and impulse control disorders (1%). The scores on the Parkinson's Disease symptom score (UPDRS) after over 2 years were down by 11.5 when using extended release pramipexole and 9.1 when using immediate release pramipexole.

In both early and advanced Parkinson's Disease better efficacy was achieved when using the extended release version of pramipexole. The adverse events were typical for dopaminergic drugs. In order to refer to this article on its own click here

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16th May 2014 - New research

THE EFFECT OF ACUPUNCTURE IN PARKINSON'S DISEASE

Journal of Neurological Science [2014] Apr 24 [Epub ahead of print] (H.J.Kim, B.S.Jeon) Complete abstract

A comprehensive review was carried out to assess the evidence from recent clinical studies regarding the efficacy of acupuncture on Parkinson's Disease. Acupuncture is an ancient Chinese form of medicine in which fine needles are inserted and manipulated into the skin at certain points on the body for therapeutic purposes. For more information go to Acupuncture

Eleven suitable studies were indentified. Two randomized clinical trials failed to show any benefit. The other study did not show beneficial effects of needle acupuncture. Three randomized clinical trials that assessed effects of acupuncture in addition to conventional drugs reported beneficial effects of acupuncture. However, there was no control acupuncture group in those studies. Two uncontrolled studies showed significant positive effects of acupuncture, while other two uncontrolled clinical trials failed. Safety and tolerability were reported only in five clinical trials. No studies evaluated the long lasting effects of acupuncture following cessation of the treatment.

The number of clinical trials, their total sample size, and the way they were carried out, were not enough to prove the favorable effects of acupuncture. So far the evidence for the effectiveness of acupuncture for treating Parkinson's Disease is not convincing. In order to refer to this article on its own click here

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9th May 2014 - New research

DIABETES TREATMENT FOR PARKINSON'S DISEASE

Journal of Parkinson's Disease [2014] Mar 24 [Epub ahead of print] (I.Aviles-Olmos, J.Dickson, Z.Kefalopoulou, A.Djamshidian, J.Kahan, P.E.Fmedsci, P.Whitton, R.Wyse, T. Isaacs, A.Lees, P.Limousin, T.Foltynie)   Complete abstract

Exenatide, which is a treatment for diabetes, has been tested as a disease modifying treatment for Parkinson's Disease. Exenatide is an injected glucagon-like peptide-1 agonist medication marketed as Byett and Bydureon. It is used in the treatment of insulin resistance in patients with Type 2 diabetes. It differs in pharmacological action and chemical structure from insulin. For more information go to Exenatide

Using the MDS-UPDRS, which is a means of assessing the extent of Parkinson's Disease symptoms, people with Parkinson's Disease were assessed who had previously taken Exenatide. People with Parkinson's Disease had an advantage of 5.6 points (with a range of 2.2 to 9.0) on the assessment. They also had a better score when assessed concerning dementia. Unusually, the effect of Exenatide on Parkinson's Disease had continued beyond its use. The authors do not suggest how this diabetes drug can have effect in Parkinson's Disease.

In a previous study, when people with moderate Parkinson's Disease received subcutaneous injections of Exenatide for a year there were marginal improvements in Parkinson's Disease motor and cognitive measures. Exenatide treated patients had a mean improvement after one year on the UPDRS of 2.7 compared with a mean decline of 2.2 points in controls. Exenatide was well tolerated but weight loss was common. For more information go to the  Complete abstract In order to refer to this article on its own click here

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