20th October 2014 - New research

CLINICAL TRIAL RESULTS OF DUAL LAYER L-DOPA

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

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

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)

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

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

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