From my Nextdoor neighborhood group:

https://nextdoor.com/embed/sxW7MxB4bd-p

Okay, laziness is the mother of invention, so I’m trying to hit two birds with one stone, so to speak. The above is a link to my Nextdoor post this morning showing a few species of plants and animals related to Central Texas.

You might notice that the group there is also named Return To The Natives/Native Plants Are The Answer. If you think that’s a coincidence, you’d be wrong.

Dance, Dance, Dance

As in All I Wanna Do is post some links to research on Dance and effects on PD symptoms and other related aspects of being a living human being on the face of the planet Earth. As I was going through these, some of the titles looked familiar. If so, no biggie – if I posted the links before, and am being repetitious, “I blame it on the Parkinson’s”©. And repetition is useful in learning.

de Almeida HS, Porto F, Porretti M, Lopes G, Fiorot D, Bunn PDS, da Silva EB. Effect of Dance on Postural Control in People with Parkinson’s Disease: A Meta-Analysis Review. J Aging Phys Act. 2021 Feb 1;29(1):130-141. doi: 10.1123/japa.2019-0255. Epub 2020 Jul 31. PMID: 32736345.

 The statistically significant results of this meta-analysis indicate that dance can improve postural control in people with PD in a short period of time and therefore contribute to the prevention of falls.

Hackney ME, Earhart GM. Effects of dance on balance and gait in severe Parkinson disease: a case study. Disabil Rehabil. 2010;32(8):679-84. doi: 10.3109/09638280903247905. PMID: 20205582; PMCID: PMC2837534.

Twenty partnered tango lessons improved balance, endurance, balance confidence, and quality of life in a participant with severe PD. This is the first report of the use of dance as rehabilitation for an individual with advanced disease who primarily used a wheelchair for transportation.

Zhen, K., Zhang, S., Tao, X. et al. A systematic review and meta-analysis on effects of aerobic exercise in people with Parkinson’s disease. npj Parkinsons Dis. 8, 146 (2022). https://doi.org/10.1038/s41531-022-00418-4

Karpodini CC, Dinas PC, Angelopoulou E, Wyon MA, Haas AN, Bougiesi M, Papageorgiou SG and Koutedakis Y (2022) Rhythmic cueing, dance, resistance training, and Parkinson’s disease: A systematic review and meta-analysis. Front.Neurol.13:875178.doi:10.3389/fneur.2022.875178

Rhythmic cueing, dance, or RT positively affect the examined outcomes, with rhythmic cueing to be associated with three outcomes (Gait, Stride, and UPDRS-III), dance with three outcomes (TUG, Stride, and UPDRS-III), and RT with two outcomes (TUG and PDQ-39). Subgroup analyses confirmed the beneficial effects of these forms of exercise. Clinicians should entertain the idea of more holistic exercise protocols aiming at improving PD manifestations.

Overall, the reviewed evidence demonstrated that dance can improve motor impairments, specifically balance and motor symptom severity in individuals with mild to moderate PD, and that more research is needed to determine its effects on non-motor symptoms and QOL

Ismail, S.R., Lee, S.W.H., Merom, D. et al. Evidence of disease severity, cognitive and physical outcomes of dance interventions for persons with Parkinson’s Disease: a systematic review and meta-analysis. BMC Geriatr 21, 503 (2021). https://doi.org/10.1186/s12877-021-02446-w

Although certainty of evidence was low, our review suggests that dance intervention modestly reduced motor disease severity and improved certain aspects of balance, while there is insufficient evidence on all other outcomes. The wide variety of dance intervention types and outcome assessed diluted the strength of the evidence base on the effectiveness of dance in people with PD.

It is getting close to my bedtime, so let me just leave a few titles as links in order to expedite this.

Dance for Chronic Pain Conditions: A Systematic Review

Dance for neuroplasticity: A descriptive systematic review

Physiotherapy management of Parkinson’s disease

and now it’s waay past my meds time, and my errors have increased, so time to put this blog post to bed.

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In praise of Tetraneuris scaposa

Last post was nearly 6 months ago, after having gotten elected to my subdivision’s Home Owners Association (HOA). Fortunately for me, the new President has an excellent leadership style and a sense of humor – he’s commented a few times on my lack of love for Crape Myrtle (aka Crepe Myrtle) (Lagerstroemia spp.), and I have made a gavel from the remains of a few branches which had the misfortune of hanging over my property. (I have four longer pieces which I hope will become walking sticks or canes).

But I digress. This year Central Texas faced a drought throughout the Spring and Summer. Then, throughout November, we’ve had plenty of rain to raise our hopes for an abundant crop of wildflowers in the Spring. With the warmest December day we’ve ever had (82º F) this week, however, we should be cautious in making predictions.

So, recently, I’ve stepped outside and found Gulf Fritillary caterpillars still on green Passiflora leaves (photo 1), and further below, bunches of yellow Tetraneuris scaposa flowers taking advantage of the extended growing season.

Gulf Fritillary caterpillar( Dione vanillae) Photo taken December 2, 2022

Photo taken December 2, 2022 of caterpillar.

Four Nerve Daisies (Tetraneuris scaposa)  (photo 2) planted in the “nuisance strip” between the sidewalk and the curb; blooms are still going strong into December.

However, Tetraneuris scaposa can and will bloom throughout the year, here in Central Texas.Four Nerve Daisies Conditions have to be right, of course. They bear up to the heat of 100º F summers, but do need some water. And, as always, rain water seems to be the best for promoting growth in these and in BlackFoot Daisies (Melampodium leucanthum) of which I recently added a small plant and which has responded well to the recent rains.

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Low cholesterol levels – could be a biomarker for PD?

A couple of articles that look at cholesterol levels and PD.

Fu X, Wang Y, He X, Li H, Liu H, Zhang X. A systematic review and meta-analysis of serum cholesterol and triglyceride levels in patients with Parkinson’s disease. Lipids Health Dis. 2020 May 19;19(1):97. doi: 10.1186/s12944-020-01284-w. PMID: 32430016; PMCID: PMC7236933.

The results suggested that elevated serum levels of triglycerides (TG), low density cholesterol (LDL) and total cholesterol (TC) may be protective factors for the pathogenesis of PD.

And here’s another meta analysis that bottom lines the results in the title:

Hong X, Guo W, Li S. Lower Blood Lipid Level Is Associated with the Occurrence of Parkinson’s Disease: A Meta-Analysis and Systematic Review. Int J Clin Pract. 2022 Jun 9;2022:9773038. doi: 10.1155/2022/9773038. PMID: 35801143; PMCID: PMC9203242.

This meta review  looked at

  • total cholesterol (TC),
  • triglycerides (TG),
  • high-density lipoprotein cholesterol (HDL-C), and
  • low-density lipoprotein cholesterol (LDL-C).

Fifteen cohort studies with 9740 participants, including 2032 PD patients and 7708 controls were analyzed, and the analysis found that lipid levels in the PD patients was significantly lower than that of healthy controls. So dyslipidemia might have a predictive value.

As a Person With PD (PwP), this sort of information could have been useful, say, oh, between 50 or 60 years ago. Of course, it would have taken general practitioners with a broad knowledge of factors affecting the prodromal symptoms and signs of PD to pick up on it. (And that information wasn’t available at that time).

As it so happened, I had essential tremors, and could feel resting tremors oscillating away, even though they were not visible to the human eye. And other prodromal symptoms were present, too, and at an early age. Fortunately, I did not have the LRRK or PARK gene variations that cause early onset PD that can not be denied (Michael J. Fox’s case comes to mind). Unfortunately, my particular set of symptoms did not result in an actual diagnosis of PD until after I had been retired early due to one of my other prodromal symptoms (MDD) put me on disability leave for over 9 months, and I was unable to hold down a steady job for a couple of years.  Fortunately, the Social Security Administration provided me with retroactive disability benefits to the day following the date the insurance company gave up on trying to recoup their losses by representing my case to the OASDI. Fortunately, I have been able to find folks who have supported me through the years, intellectually and socially, as my continuing journey with PD has become a larger part of my life.

Perhaps the future of medicine lies in something like the application of IBM’s Big Blue computer (or other advanced Artificial Intelligence systems) to assimilating the huge (not just big) data residing in the NIH and other medical libraries, so that correlations among various signs could be identified and point to diagnostic criteria and effective treatment modalities, so that until there is a cure for Parkinson’s (and other diseases), we can do what we can to identify the probability of an eventual diagnosis (provided decent medical information and observations) and then to  defer or delay and to mitigate the symptoms.

And until then, I will do my best to forgive those who have caused me harm, whether through omission or commission, while asking forgiveness of those against whom I have “trespassed,” to use the word in the KJV.

(Didn’t mean to take an ethical/religious tangent at the end, but there it is. I’ve said too much, I haven’t said enough… I was sentenced to twenty years of boredom, for trying to change the system from within…[insert your favorite poplar song phrase here]).

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Exercise & Sleep disorders and Parkinson’s – Oh my!

My first draft of this got lost in the computer (Thanks, all you coders who think you know how to create intuitive, ease to use interfaces). So here’s another attempt to get stuff from one location to another. We’ll see how it it goes…

A while back I posted a Powerpoint presentation on research on music, dance, and singing, which cited a review in the Movement Disorders Society (2018, I believe), in which the conclusion was that exercise did not affect Parkinson’s Disease (PD) symptoms. Since then, there have been many more studies on the effects of different modalities of exercise. In this first article, a meta review of publications, found that exercise is good for you if have PD.

Yang Y, Wang G, Zhang S, et al. Efficacy and evaluation of therapeutic exercises on adults with Parkinson’s disease: a systematic review and network meta-analysis. BMC Geriatrics. 2022 Oct;22(1):813. DOI: 10.1186/s12877-022-03510-9. PMID: 36271367; PMCID: PMC9587576.

The purpose of the review was to compare and rank the types of exercise that improve PD symptoms by quantifying information from randomised controlled trials.  Out of 10,474 citations, 250 studies were included involving 13,011 participants. The results (drumroll, please):

  • Power training (PT) had the best benefits for motor symptoms
  • Body weight support treadmill training showed the best improvement in balance, gait velocity  and walking distance
  • Robotic assisted gait training had the most benefits for freezing of gait
  • Dance showed the best benefits for depression
  • Only Yoga significantly reduced anxiety symptom compared with controls
  • Only resistance training significantly enhanced sleep quality and cognition
  • Physical Therapy showed the best results for muscle strength
  • Five types of therapy showed improvement in concerns about falling versus control groups.

If interested, the full free text is available at the linked citation above. Other reviews have shown different results. Best recommendation is to find a variety of exercises that you enjoy, and do them as often as you can. But don’t try so hard that you wind up hurting yourself.

The second meta review alluded to in the title has to do with sleep disorders.

Xu Z, Anderson KN, Pavese N. Longitudinal Studies of Sleep Disturbances in Parkinson’s Disease. Current Neurology and Neuroscience Reports. 2022 Oct;22(10):635-655. DOI: 10.1007/s11910-022-01223-5. PMID: 36018498; PMCID: PMC9617954.

Fifty-three longitudinal studies of sleep in PD were identified, which included:

  • Excessive daytime sleepiness,
  • Insomnia,
  • Obstructive sleep apnea,
  • Rapid eye movement sleep behavior disorder (RBD),
  • Restless legs syndrome, and
  • Shift work disorder were studied in addition to other studies that had focused on either multiple sleep disorders or broadly on sleep disorders as a whole.

RBD is now considered an established prodromal feature of PD, but other sleep disorders do not clearly increase risk of subsequent PD.

I’ll throw in one last citation. Not just because it plays on the title to one of Bob Dylan’s songs, but also because it is one of many nutritional supplements prescribed to aid in cleaning out neural cell debris in (where else?) Bob’s Brain:

Kalyanaraman B. NAC, NAC, Knockin’ on Heaven’s door: Interpreting the mechanism of action of N-acetylcysteine in tumor and immune cells. Redox Biology. 2022 Oct;57:102497. DOI: 10.1016/j.redox.2022.102497. PMID: 36242913; PMCID: PMC9563555. 

and that ends this day.

Don’t Stop Moving To The Music department

I’m not sure why the line numbers were included in the PDF, my guess is that it is/was pre-publication. At any rate, it just adds to the body of evidence that rhythm and movement helps get rid of the blues. 

Exploring the Use of Music to Promote Physical Activity Adherence: An Integrated Theoretical Approach. Kyoung Shin Park1*, David M. Williams, Jennifer L. Etnier  

Abstract …

Music can help people make more positive evaluations of acute exercise as an affective and
113 ergogenic stimulant. A recent meta-analysis of 139 studies revealed that listening to music during
114 acute bouts of exercise and sport activities increases positive affective valence (g = 0.48, CI [0.39,
115 0.56]), reduces ratings of perceived exertion (RPE; g = 0.22, CI [0.14, 0.30]), enhances physical
116 performance (g = 0.31, CI [0.25, 0.36]), and improves oxygen consumption (VO2max; g = 0.15, CI
117 [0.02, 0.27]) compared with activities without music (Terry et al., 2020). These findings support the
118 notion that music helps physical activity to be more joyous, less arduous, and more energetic and
119 efficient, arguably motivating the exerciser to join additional bouts. It is noteworthy that the
120 beneficial effects of music on affect and RPE were not moderated by physical activity intensity in the
121 meta-analysis (Terry et al., 2020), which indicates that music provides psychological benefits across
122 the full range of intensities.

Don’t Stop Moving To The Music

Prodromal symptoms, Parkinson’s Disease (PD), and that old song and dance…

Here’s a few studies that came up in my news feed from  PubMed Central (PMC) or elsewhere for articles recently published on the topics in which I’m interested – namely, prodromal symptoms related to PD, the relationship of REM sleep disorder and depression to PD, and, of course, the use of singing and dance therapies as complementary approaches to dealing with the symptoms of PD.

Prevalence and duration of non-motor symptoms in prodromal Parkinson’s disease

The prevalence and duration of non-motor symptoms (NMS) in prodromal Parkinson’s disease (PD) has not been extensively studied. The aim of this study was to determine the prevalence and duration of prodromal NMS (pNMS) in a cohort of patients with recently diagnosed PD.

…subtracted the duration of the presence of each individual NMS reported from the duration of the earliest motor symptom. NMS whose duration preceded the duration of motor symptoms were considered a pNMS. Individual pNMS were then grouped into relevant pNMS clusters based on the NMSQuest domains. Motor subtypes were defined as tremor dominant, postural instability gait difficulty (PIGD) and indeterminate type according to the Movement Disorder Society Unified Parkinson’s Disease Rating Scale revision.

Results: Prodromal NMS were experienced by 90.3% of patients with PD. … males reporting more sexual dysfunction, forgetfulness and dream re-enactment, whereas females reported more unexplained weight change and anxiety. There was a significant association between any prodromal gastrointestinal symptoms and urinary symptoms  and the PIGD phenotype.[n.b.: phenotype includes inherent traits or characteristics that are observable]. [Emphases added].

Citation:  Durcan R, Wiblin L, Lawson RA, Khoo TK, Yarnall AJ, Duncan GW, Brooks DJ, Pavese N, Burn DJ; ICICLE-PD Study Group. Prevalence and duration of non-motor symptoms in prodromal Parkinson’s disease. Eur J Neurol. 2019 Jul;26(7):979-985. doi: 10.1111/ene.13919. Epub 2019 Mar 1. PMID: 30706593; PMCID: PMC6563450.

Associations of Sleep Disorders With Depressive Symptoms in Early and Prodromal Parkinson’s Disease

Purpose: To explore the effect of sleep disorders, including the probable rapid eye movement (REM) sleep behavior disorder (pRBD) and the daytime sleepiness, on depressive symptoms in patients with early and prodromal PD.

5-year follow-up study showed that sleep disorders, including pRBD and daytime sleepiness, were associated with the increased depressive-related score in individuals with early and prodromal PD.

Conclusion:Sleep disorders, including pRBD and daytime sleepiness, are associated with depression at baseline and longitudinally, …  partially mediated by the autonomic dysfunction in early and prodromal PD, …  implication that sleep management is of great value for disease surveillance.

Citation: Ma J, Dou K, Liu R, Liao Y, Yuan Z, Xie A. Associations of Sleep Disorders With Depressive Symptoms in Early and Prodromal Parkinson’s Disease. Front Aging Neurosci. 2022 Jun 10;14:898149. doi: 10.3389/fnagi.2022.898149. PMID: 35754965; PMCID: PMC9226450.

Group therapeutic singing improves clinical motor scores in persons with Parkinson’s disease

Abstract
Background Previous reports suggest that group therapeutic singing (GTS) may have a positive effect on motor symptoms in persons with Parkinson’s disease (PD).

Objective To determine the effect of a single session of GTS on clinical motor symptoms.

Methods Clinical motor symptom assessment was completed immediately before and after 1 hour of GTS in 18 participants.

Results A significant decrease in average scores for gait and posture and tremor, but not speech and facial expression or bradykinesia was revealed.

Conclusion These results support the notion that GTS is a beneficial adjuvant therapy for persons with PD that warrants further research.

Citation: Stegemoller E, Forsyth E, Patel B, et al. Group therapeutic singing improves clinical motor scores in persons with Parkinson’s disease BMJ Neurology Open 2022;4:e000286. doi: 10.1136/bmjno-2022-000286

On hiatus again…

unintended selfie

Seems that I went and got elected to my HOA board, which will require me to cut back or off on certain activities until my 3 year term is up, or I have to resign for any of a number of possible reasons that one might imagine. (Health is the most likely culprit). I might post on an even more irregular basis – maybe some of the stuff I do for my HOA, if it proves to be of value.

Therefore, I am once again abandoning this blog, although if you’ve seen one year’s worth of photos here, you’ve probably seen most of what there is to see within 1/2 mile of my home, or in my yard.

I will be posting directly to the Williamson County chapter of the Native Plant Society of Texas (NPSOT-Wilco) Facebook page from time to time.

Hopefully, I can help to improve my community by ensuring that the virtues and benefits of native plants are more than the appeal of  cheap prices and easy availability of common exotics.

So, as parting photos, I present one taken recently by my smartphone when I wasn’t trying to take a photo (above), and another of a volunteer in my backyard (below).

Maximilian Sunflower

Maximilian Sunflower

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Sing!

What research has found its way into the email inbox recently?

Although singing is a nearly universal human behavior, many adults consider themselves poor singers and avoid singing based on self-assessment of pitch matching accuracy during singing (here referred to as singing accuracy), in contrast to the uninhibited singing exhibited by children. In this article, I report results that shed light on how singing accuracy changes across the lifespan, using data from a large online sample, including participants ranging from 6 to 99 years old. Results suggest that singing accuracy improves dramatically from childhood to young adulthood, unperturbed by voice changes during adolescence, and remain at a similarly high level for the remainder of life, exhibiting no strong tendency toward age-related decline. Vocal or instrumental musical training has significant positive effects on singing accuracy, particularly in childhood, though there was no evidence for gender differences. Finally, pitch discrimination varied with age similarly to singing accuracy, in support of views that singing accuracy reflects sensorimotor learning. Taken together, these results are consistent with the view that singing accuracy is a learned motor skill that benefits from engagement and can remain a fruitful endeavor into old age. (emphasis added).

citation: Singing accuracy across the lifespan
Peter Q. Pfordresher preprint  article accessed 6-19-22 at https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/nyas.14815

Basically, this says that if you learned how sing accurately when you were young, you can probably sing well into your later years. And, since singing is a learned motor skill, one might assume that it can be learned even as one gets older.

Relevance to folks with Parkinson’s Disease (PD)?

Vocal strength exercises, such as those provided by Power for Parkinson’s as free YouTube video classes, can help with specific Parkinson’s related symptoms:

Many people with PD speak quietly and in one tone; they don’t convey much emotion. Sometimes speech sounds breathy or hoarse. People with Parkinson’s might slur words, mumble or trail off at the end of a sentence. Most people talk slowly, but some speak rapidly, even stuttering or stammering.

Parkinson’s motor symptoms, such as decreased facial expression, slowness and stooped posture, may add to speech problems. These can send incorrect non-verbal cues or impact the ability to show emotion. Source: https://www.michaeljfox.org/news/speech-swallowing-problems accessed June 20, 2022  (emphasis added).

Since our vocal cords are muscles, and singing is a learned motor skill, we can strengthen those muscles and push against the progressive, degenerative symptoms of PD through exercises that:

  • remind us to breathe deeply to sustain vocal volume,
  • improve our posture in order to enable deep breathing,
  • exercise the muscles of the face and mouth
  • to enable crisp diction instead of slurring and mumbling, and that
  • support emotional expression through inflection and singing.

And “Everybody Knows” that if exercise is fun, one is more likely to continue doing it.

Full disclosure: The author has attended Power for Parkinson’s ® vocal exercise classes since their inception in 2016, and co-founded a participant organized singing group (with the late Jeff Berke) in 2015.  Therefore, he might be (definitely is) biased in favor of this modality of treatment for vocal and speech related symptoms of PD.

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Back in my own backyard…

Early June 2022 and the heat is in the “triple digits”as the meteorologists like to say in TV-land. or 39 ° Celsius, as we were told we would have converted to 50 or more years ago. Either system, hot to humans is hot.

But to native plants that evolved in Central Texas for more years than Crepe Myrtle has been here, even these signs of Global Warming haven’t phased them. (Granted, I do some supplemental watering, especially of small trees for the first few years, but other plants like Passiflora incarnata grow like “weeds”).

I’ll  let the plants speak for themselves:

Those are just the photos I took on June 8, 2022, mostly in my yard. The Rain Lilies were just past the back fence (the ones in my yard had bloomed and gone to seed after the previous week’s mild spattering of rain drops).

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