Category Archives: diet

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Dee Bee Ess (Deep Brain Stimulation (DBS))

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First of all, something I have suspected seems to have some clinical evidence:

It seems that the earlier one has Deep Brain Stimulation (DBS) following a Parkinson’s Disease diagnosis, the better one fares:

Pre-dopa Deep Brain Stimulation: Is Early Deep Brain Stimulation Able to Modify the Natural Course of Parkinson’s Disease?

This observational study evidences that DBS treatment exerts beneficial effects on motor symptoms and quality of life in early stages of PD, if applied when first functional and QoL-impairments occur, even before L-Dopa treatment initiation. These novel data and paradigm shift proposal challenge current algorithms for PD treatment and grants further studies evaluating the disease course-modulating potential of very early DBS application in larger populations.

I was fortunate enough to have opted for DBS due to Essential Tremors, when eventually the testing revealed the cardinal traits of Parkinson’s. Had I not received DBS implants at that time, but waited until the disease had progressed to a later stage, I would not likely be in the shape I am today.

Another Item of Interest is the article titled “Personality dimensions of patients can change during the course of parkinson’s disease” to which I can also add an affirmation. DBS programming has enabled me (along with a long term psychiatric neurobehavioral specialist  relationship) to stop having episodes of Major Depressive Disorder (MDD) and have now been off antidepressants for over a year. Although this is not necessarily what the authors had in mind when they did their study, it does suggest that DBS had something to do with it. Particularly after one DBS programming session, I apparently went into a manic state, which caused my wife to report the change in mood and behavior to my Movement Disorders Specialist, so that the programming was “dialed back a few notches.”

And of course, a good deal of the credit goes to my wife, who looks after my diet so that I am eating nutritious and organic foods as much as possible, and the good folks at Power for Parkinson’s and the Georgetown Area Parkinson’s Support group, which provide exercise classes and social connections. I have noticed a more outgoing personality than previously, though it would be difficult to disentangle the various factors influencing any supposed changes in my alleged personality. 

As Michael Jackson said to Paul McCartney in “The Girl Is Mine,” I’m a lover, not a fighter.” 

or as David Bowie sang, “Ch-ch-ch-changes.”

okay, now I’m just being silly.

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The link between environmental chemicals and Parkinson’s

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Jane Brody of the New York Times wrote a recent review of a new book, co-written by several experts in the field of neurology. These include Dr. Ray Dorsey, neurologist at the University of Rochester; Todd Sherer, neuroscientist with the Michael J. Fox Foundation for Parkinson’s Research; Dr. Michael S. Okun, neurologist at my other hometown at the University of Florida; and Dr. Bastiaan R. Bloem, neurologist at Radboud University Nijmegen Medical Center in the Netherlands.

The book titled “Ending Parkinson’s Disease” calls the occurrence of PD a “man-made pandemic” with references to to many studies that show the high correlation of PD to the exposure to toxic chemicals on farms and in the workplace, as well as animal studies in which PD symptoms were replicated.

Here’s one YouTube video about the book:

Brief overview of the book of Ending Parkinson’s Disease

And here’s a forty minute Zoom presentation by Dr. Michael Okun at the University of Florida on the book’s topics. (unfortunately, there are distracting sounds from participants/attendees who didn’t mute their microphones):

Ending Parkinson’s Disease with Dr. Michael Okun

My next action will be to order the book.

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I would definitely volunteer…

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For a longitudinal followup study. The longer the better. This is the sort of study you can sink your teeth into…

Food for thought, indeed.

Dark chocolate consumption versus depressive symptoms

Well, the results aren’t conclusive, but apparently the theory is that dark chocolate contains Flavonoids and possibly activates the endocannabinoid receptors in the brain, which make folks feel good instead of angry and hostile or depressed.

And chocolate is still legal in all 50 states of the USA.

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You are what you eat…

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But before we get into the articles about the gut microbiome, from 2015, a review of the various signs that predate full motor symptoms

non-motor and pre-motor symptoms of PD

Recent studies provide new insights on the frequency, pathophysiology, and importance of non-motor features in Parkinson’s disease as well as the recognition that these non-motor symptoms occur in premotor, early, and later phases of Parkinson’s disease.

This study (2017) looks at the progression of PD and problems with the bacteria in the stomach:
Progression of PD and gut dysbiosis
from the conclusions:

The total counts of intestinal bacterial decrease in the course of PD progression. Temporal profiles of lowering of bacterial counts are likely to be different from bacteria to bacteria, and also between the deteriorating and stable groups, which may be able to be exploited to differentiate patients with rapidly and slowly progressive PD pathology.

The search for biomarkers for PD goes for the gut (2018):
Gut Microbiota Dysfunction as Reliable Non-invasive Early Diagnostic Biomarkers in the Pathophysiology of Parkinson’s Disease: A Critical Review

future directions should therefore, focus on the exploration of newer investigational techniques to identify these reliable early biomarkers and define the specific gut microbes that contribute to the development of Parkinson’s disease. This ultimately should pave the way to safer and novel therapeutic approaches that avoid the complications of the drugs delivered today to the brain of Parkinson’s disease patients.

Another article on the role of gut bacteria in PD (2018): Parkinson’s disease and bacteriophages as its overlooked contributors

Our findings add bacteriophages to the list of possible factors associated with the development of PD, suggesting that gut phagobiota composition may serve as a diagnostic tool as well as a target for therapeutic intervention, which should be confirmed in further studies. Our results open a discussion on the role of environmental phages and phagobiota composition in health and disease.

A review of the relationship between the gut microbiome and PD (2018):
Microbes Tickling Your Tummy: the Importance of the Gut-Brain Axis in Parkinson’s Disease

Looking back a few years, one can hope that diet might be a way to affect the course of PD, if diet can change the gut microbiome (2014) :Diet rapidly and reproducibly alters the human gut microbiome

Long-term diet influences the structure and activity of the trillions of microorganisms residing in the human gut1–5, but it remains unclear how rapidly and reproducibly the human gut microbiome responds to short-term macronutrient change. Here, we show that the short-term consumption of diets composed entirely of animal or plant products alters microbial community structure and overwhelms inter-individual differences in microbial gene expression.

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Teamwork helps

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An open access article:

Multi-disciplinary approach for rehab to improve QOL

From the abstract:

Results:Patients reported higher functional status (d=0.37,p<0.001), general self-efficacy(d=0.28,p<0.01), and quality of life (d=0.32,p<0.001) at three weeks follow-up, comparedto their baseline scores. The regression analysis showed that having a better initial functionalstatus (β=−0.26,p<0.05) and lower quality of life (β=0.51,p<0.001) were associated withmore improvements in quality of life.
Conclusion:The study suggests that actual functioning in persons with Parkinson’s diseaseis a better predictor of improved quality of life than self-efficacy beliefs and that those whohave lower levels of initial quality of life benefit more from rehabilitation.

The program was only three weeks long, but was inpatient and apparently intensive:

The multidisciplinary rehabilitation program had a duration of three weeks and was an inpatient program. Upon arrival, participants were awarded a primary contact to ensure a unified team working toward goals set by the participant him/herself. The multidisciplinary team consisted of 10 different professions, such as occupational therapists, physical therapists, doctors, neurologists, nurses, sports educators, cognitive behavioral therapists, and nutritionists. Commencing the multidisciplinary rehabilitation program, participants were assessed by the relevant professional/s and typically had close follow-up the first week with individual and group-based exercise

 

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High cholesterol < lower Parkinson's Risk

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http://www.medscape.com/viewarticle/881576?src=wnl_edit_tpal

Higher levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) are associated with a decreased risk for Parkinson’s disease (PD) in men, a large observational study shows.

Just my luck – my total cholesterol has always been low, even though recently my HDL has been a high percentage of LDL and total cholesterol.

261,638 persons aged 40 to 79 years not taking statins.

…followed from baseline to death, end of study, or PD diagnosis.

From annual blood tests, researchers collected information on levels of TC, LDL-C, and high-density lipoprotein cholesterol (HDL-C).

They categorized TC levels into upper (210 mg/dL or more), middle (180 to 209 mg/dL), and low tertiles and LDL-C levels into upper (140 mg/dL or more), middle (110 to 139 mg/dL), and low tertiles.

Among men, compared with low levels, middle and upper levels of TC and LDL-C were significantly associated with lower risk for PD.

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I’ve got a (gut) feeling…

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Here’s a sample of links to Gut Microbiota For Health’s website and some of the research articles they’ve published, mostly in the last year. One talks about the linkage between certain bacteria and motor system disorders, another about relief for constipation for Parkinson’s patients, Another is a compilation of several articles, and finally, an article that explores the gut to brain relation regarding Parkinson’s, and to top it all off, the relationship of the bacteria in your stomach to the chemicals in your brain, and how the various microbial communities communicate. Life goes on within you and without you, it would seem.

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Eat now, exercise later, protect against insulin insensitivity – and more news!

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From Medical News Today:

 “Harm from a weeks overeating may be canceled by exercise”

That’s the limit to the good news, though. The article also reports that even occasional binging can cause problems, and a week of overeating could have a negative effect on insulin sensitivity. Exercise could protect against this metabolic damage.

 For certain, a lack of exercise and an unhealthy diet have been linked to obesity and metabolic syndrome. The article is at this link: http://www.medicalnewstoday.com/articles/313881.php

related article “Healthy living linked to higher brain function, delay of dementia”

A diet high in vegetables and fruits leads to better cognitive functioning, and when combined with exercise, the effect is extended downwards to those who reported eating half as many vegetables.

the original research article is at http://jpubhealth.oxfordjournals.org/content/early/2016/10/28/pubmed.fdw113

 In other news…

Mayo Clinic researchers found that it only takes 1 mutation in the PINK1 gene to increase the risk of early onslaught PD. Until this report, it had been thought you needed to have 2 mutated genes to make it happen.  Here are links to the pages:  http://www.medicalnewstoday.com/releases/313885.php or

Heterozygous PINK1 p.G411S increases risk of Parkinson’s disease via a dominant-negative mechanism

 

 

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Diet as medicine for depression

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Medscape reports on a new study from Australia which apparently shows that eating healthy can be good for the mood as well as the pocketbook.

Two researchers, Felice Jacka and Michael Berk, led a consortium of Australian Institutions based at the Food & Mood Centre at Deakin University in Victoria, Australia. Over 3 years, they recruited several hundred patients with moderate to severe depression and entered 67 into a 12-week parallel group trial. The treatment group received seven 60-minute sessions of dietary counselling. The parallel control group received a matching social support protocol. All but nine of the 67 participants were receiving another active treatment—either psychotherapy, medications, or both. . . .

… participants were implored to increase consumption of foods in 12 food categories. The food categories, as you may guess, included whole grains, fruits, vegetables, nuts and legumes, and lean meats, chicken, and seafood, and to decrease consumption of foods that are correlated with a higher risk for depression: empty carbohydrates, refined starches, and highly processed foods. . . .

. . . The outcome was quite robust. The researchers found a statistically significant 7.1-point difference on the Montgomery-Asberg Depression Rating Scale (MADRS) in favor of the treatment group, which was their primary outcome. The researchers extrapolated that there was a 2.2-point reduction in the MADRS for every 10% adherence to the healthier dietary pattern.. . .

. . . They developed that pattern, which they called the Modified Mediterranean Diet, or the Modi-Medi Diet, by combining recommendations from the Australian government and the Greek government, and data from an earlier analysis by Felice Jacka and her colleagues[2] that determined which dietary factors played the largest role in fighting depression with diet. . . .

source of quoted excerpts:  http://www.medscape.com/viewarticle/875236