December in July

The title refers to the fact that this post was drafted back in December 2016 as an email InfoShare for the Capitol Area Parkinson’s Support (CAPS) group, which is meeting today (July 15 2017) at 2 PM. Never did send it out. So here it is, a few months late, but the news is still timely. Especially the value of early treatment and diagnosis of PD.  So, here it is:
The London School of Economics and Political Science recently released a report on the “Value of Early Diagnosis and Treatment in Parkinson’s Disease”, a literature review of recent studies with recommendations for action. It can be downloaded at http://www.braincouncil.eu/wp-content/uploads/2016/11/Parkinson-report-2016-1.pdf 
On a broader view of PD,  here’s a link to a page that has links to just about everything Parkinson’s – The National Institutes of Health (NIH) U.S. National Library of Medicine (NLM) Medline Plus topic page on Parkinson’s Disease.
OK – you can spend a week going through all of that information. 
So here are the items mentioned in the subject headline:
First, evidence that DBS is helpful in early stages of PDS, not just in later stages. Benefits extend for at least 5 years.
The PDF copy of the research paper referenced in the above news article can be found at this link:
A less drastic approach than brain surgery might be helpful for motor symptoms:
Next, contradictory evidence regarding whether statins used to lower cholesterol levels offer a protective effect for PD – previous analyses said yes, but further massage of the data reveals that the answer is not as simple as it seemed at first.
Here are links to related articles, papers, and abstracts:
Earlier this year, an analysis of ten reports that yielded different conclusions after adjusting for cholesterol levels.
In 2012, the JAMA Neurology journal published a prospective analysis that indicated statins reduced the risk of PD. (PDF of full article is available for free download):
Several years ago, an analysis found publication bias in favor of positive results, and both a protective effect for statin use and no protective effect for long term statin use:
And last year, an analysis of published reports that found that use of statins was not protective for PD, in contrast to the hypothesis that statins are protective.

Nordic Walking & PD – no decision yet.

Abstract

Background

It is well known that physical exercise is the main therapeutic element of rehabilitation programs for people with Parkinson’s disease (PD). As traditional forms of exercise can guarantee significant health benefits, the emergence of non-conventional physical activities, such as Nordic walking (NW), may add positive effects.

Objective

To appraise the available evidence on the main effects of NW in the rehabilitation programs for people with PD and to propose a design for upcoming research that might improve the uniformity of future trials.

Study Design

Systematic review

Literature Survey.

A literature search of five established databases (PubMed, MEDLINE, Scopus, Web of Science and Cochrane) was conducted.

Method

ology. Any relevant randomized controlled trials (RCTs) pertinent to NW in PD published in English from inception to February 2017, were included. PRISMA guidelines were followed and the methodological quality of each study was assessed by the PEDro scale.

Data Synthesis

Sixty-six studies were retrieved and 6 RCTs (221 subjects) entered the qualitative synthesis. Overall, these studies portrayed NW as feasible and likely to be effective in improving the functional and clinical outcomes of people with PD. When comparing NW with other exercise-based interventions such as treadmill training, free walking, a program of standardized whole-body movements with maximal amplitude (LSVT®BIG training) or a home-based exercise program, the findings proved controversial.

Conclusions

High heterogeneity and methodological discrepancies among the studies prevent from drawing firm conclusions on the effectiveness of NW in comparison with other exercise-based interventions currently employed in people with PD. Further investigations with a common design are necessary to verify whether NW may be included within conventional rehabilitation programs commonly recommended to people with PD.

Autoimmune response may play a role in Parkinson’s

Original of this story at: Medical News Today web site 21 June 2017

The exact causes of Parkinson’s disease are unknown, but an important hallmark is the buildup of damaged alpha-synuclein protein in dopamine-producing cells.

The new study reveals evidence that two fragments of alpha-synuclein can trigger T cells to initiate an attack by the immune system.

The researchers tested blood samples from 67 patients with Parkinson’s disease and control samples from 36 healthy patients.

They exposed the blood samples to fragments of proteins found in brain cells, including fragments of alpha-synuclein. The blood from the controls hardly reacted, but T cells in the blood from the Parkinson’s patients had a strong reaction to defined fragments from alpha-synuclein

The finding suggests that certain variants of MHC – such as those associated with Parkinson’s disease – may cause T cells to mistakenly identify the alpha-synuclein fragments as pathogens and thus trigger an autoimmune response that destroys the offending cells.

A lot of work still needs to be done,, but it could help to provide a diagnostic test for risk or early stages of PD, which is sorely needed.

I wonder – Could you get allergy shots with alpha synuclein protein fragments to reduce or eliminate the autoimmune response and thus keep T-Cells from attacking the dopaminergic neurons?

 

Contributing to Research via DNA sharing

I had my DNA analyzed by 23AndMe and in addition to getting some somewhat innocuous reports on my genetic makeup (including the revelation that there is about .5% match each with Askenazi and African groups somewhere in my ancestry, plus some Neanderthal genes) my data has been anonymously included in nine published articles/studies so far, including:

  1.   23and Me blog article on Depression and genes:  https://blog.23andme.com/23andme-research/new-genetic-findings-on-depression/     The original (abstract of) the article on genes associated with depression:  http://www.nature.com/ng/journal/v48/n9/full/ng.3623.html 
  2.  On genes related to risks of basal cell carcinoma:  https://blog.23andme.com/23andme-research/new-study-on-genetics-of-common-type-of-skin-cancer/   Original article in Nature Communications:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992160/  
  3.  AND OTHERS which can be found at 23AndMe Blog – Research category

    Live long and Prosper!