Category Archives: Parkinson’s

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Research on the arts and outcomes related to Parkinson’s – and more related research and hypotheses

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For our first article, we have a review on group based dance, singing, music, and theatrical treatments on a variety show of outcomes. 

A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson’s disease

Basically, they found that the arts seemed to have positive effects for folks with PD – but that not all types of arts were evaluated against all of the outcomes listed. So “More research is needed” to look into all aspects. But it’s a good thing.

Next up is a review of the effects of oxytocin and the effects of music on the human brain. And on social behavior and bonding. While not specifically directed at Parkinson’s disease, it is certainly applicable to treatments for people with Parkinson’s.

Links Between the Neurobiology of Oxytocin and Human Musicality

 It is argued that many of these characteristics of oxytocin biology closely mirror the diverse effects that music has on human cognition and emotion, providing a link to the important role music has played throughout human evolutionary history and helping to explain why music remains a special prosocial human asset. Finally, it is suggested that there is a potential synergy in combining oxytocin- and music-based strategies to improve general health and aid in the treatment of various neurological dysfunctions.

Keywords: oxytocin, music, dance, reward, empathy, trust, therapy

If there is a link between neurobiology and music, then it stands to reason that music played a part in the evolution of modern Homo sapiens. That is the topic of the brief review of:

Music and the Meeting of Human Minds by Alan Harvey

The author addresses

  1. when and why  modern humans evolved musical behaviors,
  2. the evolutionary relationship between music and language, and 
  3. why humans, perhaps unique among all living species, universally
    continue to possess two complementary but distinct communication streams.

He argues that “early in our history, the unique socializing and harmonizing power of music acted as an essential counterweight to the new and evolving sense of self, to an emerging sense of individuality and mortality that was linked to the development of an advanced cognitive capacity and articulate language capability.”

Dopamine is one of the keywords, so it should be of interest to People with Parkinson’s.

Another article along similar lines is Music as a coevolved system for social bonding,  The authors put forth an hypothesis and

make testable predictions for future research, including neurobiological bases of musicality and relationships between human music, language, animal song, and other domains. The music and social bonding (MSB) hypothesis provides the most comprehensive theory to date of the biological and cultural evolution of music.

More materials on this area of interest:

Four principles of bio-musicology (2015)

Without it no music: cognition, biology and evolution of musicality (2015)

Motor constraints influence cultural evolution of rhythm 

Music and Language in Social Interaction: Synchrony, Antiphony, and Functional Origins

How to sum it all up?  In the words of James Brown: 

I Feel Good

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Sleep, drowsiness, DBS and PD

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Here are a few links to articles that look at the effects of Deep Brain Stimulation (DBS) on sleep, and daytime drowsiness, which could be a side effect from poor sleep. Or it could be something else.

Long term effects of DTN DBS on sleep

10 year study on daytime drowsiness and PD

REM Sleep Behavior Disorder is one of the more highly correlated conditions that end up with Parkinson’s.I remember having to spend the night on the floor of a motel when traveling with the college marching band. I was dreaming about a girl, and reached out to put my arm around her,  waking the guy who was sharing the queen bed with me.  It’s funny, now. I’ve had worse dreams. Still act out some of them.  Which as a lead-in to:

The largest clinical investigation to date of Prodromal Parkinsonism and Neurodegenerative Risk Stratification in REM Sleep Behavior Disorder

Abstract from a chapter in a book on sleep disorders:

 Significant progress has been made in understanding the pathophysiology of sleep and wake disruption in alphasynucleinopathies during the past few decades. Despite these advancements, treatment options are limited and frequently associated with problematic side effects. Further studies that center on the development of novel treatment approaches are very much needed. In this article, the author discusses the current state of the management of disturbed sleep and alertness in PD and MSA. © 2017 International Parkinson and Movement Disorder Society (emphasis added)

accessed at this link:

Management of sleep disorders in Parkinson’s disease and multiple system atrophy

As someone once wrote: To sleep, perchance to dream…

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Self management and care partnerships

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I don’t know about y’all, but without my care partner I would have been dead a long time ago. As it is, I am able to let her go off for a couple of weeks to help take care of her elderly old father and still manage to handle all the Activities of Daily Living (AD). This thesis looked into care partnerships and clinicians, and what could be done to improve outcomes. Four insights emerged:

Self-Management as a means to Achieving Client-Centred Care for the Care Partnership Living withParkinson’s disease

This research program has given rise to four main insights, grounded in the perspectives of both care partnerships and the clinicians who provide their care.

First, is the importance of incorporating the care partner into clinical care discussions, both about how to support the person diagnosed with PD, and for their own health.

Second, is to consider self management education as a means of achieving client-centered care by supporting the care partnership to effect the cognitive, emotional and behavioural responses required to manage the many dimensions of PD.

Third, is the importance of supporting the care partnership to assemble a healthcare team of relevant professionals and connecting them with appropriate community resources.

Finally, identifying and managing expectations through empathetic,
effective communication is paramount to the care partnership’s satisfaction with their clinical care.

Understanding how care partnerships learned to care for themselves while living with PD carries important implications for clinical practice in various disciplines. Healthcare professionals may reflexively contemplate these insights and consider how they may be applied in their clinical settings.

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Where it’s at (at this moment )

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As a person who was diagnosed in late 2011 with Parkinson’s disease after several years of treatment for Essential Tremors that had gotten uncontrollable, I had Deep Brain Stimulation (DBS) shortly thereafter (I had already decided to go for DBS to control the tremors, and in the additional testing, rigidity was observed, allowing the diagnosis).

Since then, thanks to a supportive care partner, a supportive community that provides exercise and dance classes, and now vocal exercises (singing) which I had initiated in 2015 along with a friend, now deceased, I am able to function fairly well. I consider my self ” the luckiest guy” to paraphrase Lou Gehrig.

So instead of my usual posting of an article or a few on a specific topic, I thought I would post this YouTube video documenting my current situation (albeit somewhat exaggerated for dramatic effect) as far as Parkinson’s Disease goes:

I Blame The Parkinson’s

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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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A review on dance and PD

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Dance classes for Parkinson’s patients was one of the things that got me involved in Power for Parkinson’s© and the Georgetown Area Parkinson’s Support group to begin with. For me, it has helped to improve symptoms and quality of life tremendously.

In this desk review of many studies, the authors came to the following conclusions:

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. RCTs that use a mixed-methods approach and include larger sample sizes will be beneficial in fully characterizing effects and in determining which program elements are most important in bringing about positive, clinically meaningful changes in people with PD.

 Carapellotti AM, Stevenson R, Doumas M (2020) The efficacy of dance for improving motor impairments, non-motor symptoms, and quality of life in Parkinson’s disease: A systematic review and meta-analysis. PLoS ONE 15(8): e0236820. https://doi.org/10.1371/journal.pone.0236820

I have come to the conclusion that every study or review has to include the phrase “more research is needed.” And it is true.

You can read the article in its entirety at the URL in the citation, or download it directly from this link:

The efficacy of dance for improving motor impairments, non-motor symptoms, and quality of life in Parkinson’s disease: A systematic review and meta-analysis

 

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That famous essay

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James Parkinson wrote an essay on “The Shaking Palsy” just over 200 years ago. Although science doesn’t stand still, and folks like Louis Pasteur, Alexander Fleming, and Jonas Salk came along to make important contributions in medical science, the field of Movement Disorders has, until recently, relied almost exclusively on the traits described by Parkinson in his essay to diagnose the disease. French neurologist Jean-Martin Charcot made some advances in making distinctions between some of the symptoms and championed naming the disease after Dr.Parkinson.

Curious about the essay itself? it’s available online as a full access article in The Journal of Neuropsychiatry (downloadable as a PDF file.

An essay on the Shaking Palsy 

An Essay on the Shaking Palsy, by James Parkinson, was originally published as a monograph by Sherwood, Neely, and Jones (London, 1817). Punctuation and spelling follow the original text. Introduction Copyright © 2002 American Psychiatric Publishing, Inc.

 

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Lifestyle effects on PD

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In a nutshell: Exercise helps to keep your mitochondria working, and that helps to slow down the loss of your dopaminergic neurons. Here we have an application of the old rat race to a rat model of PD – in which treadmill exercise helped to keep mitochondria functioning properly, while sedentary rats lost dopaminergic cells.

Physical exercise protects against mitochondria alterations in the 6-hidroxydopamine rat model of Parkinson’s disease

These “results suggest a neuroprotective and progressive effect of intermittent treadmill exercise, which could be related to its benefits on mitochondrial biogenesis signaling and respiratory chain modulation of the dopaminergic system in PD.”

But other studies and reviews have shown other factors that affect the progression of PD, so don’t put all of your metaphorical eggs in one basket – a review that covers some of those various factors:

Narrative Review of Lifestyle Factors Associated with Parkinson’s Disease Risk and Progression

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PD Treatment with Cannabis?

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One form of treatment that has a lot of anecdotal evidence but has resisted scientific inquiry due to archaic legal issues is the use of Cannabis. Although there haven’t been a lot of studies related to Parkinson’s Disease, quite a few have been conducted related to other medical conditions, including addiction and other drug abuse/misuse issues and psychiatric conditions. This post provides a look at a few studies that are open access and which might have a relationship to mental issues related to Parkinson’s Disease (such as anxiety, depression, apathy…not that anyone cares…)

Cannabis, a complex plant…   

Atakan Z. (2012). Cannabis, a complex plant: different compounds and different effects on individuals. Therapeutic advances in psychopharmacology, 2(6), 241–254. https://doi.org/10.1177/2045125312457586

an overview of the biochemical basis of cannabis research by examining the different effects of the two main compounds of the plant and the endocannabinoid system, and then go on to review available information on the possible factors explaining variation of its effects upon different individuals.

A review of the chemical compounds of greatest interest to researchers.

The Genetic Structure of Marijuana and Hemp

journals.plos.org (2015)

We find a moderate correlation between the genetic structure of marijuana strains and their reported C. sativa and C. indica ancestry and show that marijuana strain names often do not reflect a meaningful genetic identity. We also provide evidence that hemp is genetically more similar to C. indica type marijuana than to C. sativa strains.

Hemp has more CBD and less THC, marijuana (as C. sativa is commonly referred to, as more THC,  in general.

The effectiveness of Cannabis Flower for the relief of depression

YALE JOURNAL OF BIOLOGY AND MEDICINE 93 (2020), pp.251-264.

The findings suggest that, at least in the short term, the vast majority
of patients that use cannabis experience antidepressant effects, although the magnitude of the effect and extent of side effect experiences vary with chemotypic properties of the plant.

Contrary to some of the other reports, this one suggests that most people get an antidepressant effect, although each person’s experience might be different.

The Impact of Cannabidiol on Psychiatric and Medical Conditions

J Clin Med Res. 2020;12(7):393-403

a systematic review of literature reviewing the available clinical data on
CBD, for use in various medical and psychiatric conditions with focus
on a review of the pharmacology and toxicity. 

As up to date a review one can get at this point in time.

Changes in patient health questionnaire (PHQ-9) scores in adults with medical authorization for cannabis

Round et al. BMC Public Health (2020) 20:987  https://doi.org/10.1186/s12889-020-09089-3

Although the majority showed no clinically important changes in PHQ-9 scores, a number of patients showed improvement or deteriorations in PHQ-9 scores. Future studies should focus on the parallel use of screening questionnaires to control for PHQ-9 sensitivity and to explore potential factors that may have attributed to the improvement in scores pre- and post- 3-6 month time period.

Similar to the last study cited, that supported the hypothesis that Cannabis use didn’t seem to have an effect of whether one was anxious or depressed.

Attenuated reward activations associated with cannabis use in anxious/depressed individuals

Spechler, P.A., Stewart, J.L., Kuplicki, R. et al. Attenuated reward activations associated with cannabis use in anxious/depressed individuals. Transl Psychiatry 10, 189 (2020). https://doi.org/10.1038/s41398-020-0807-9

… data support the hypothesis that cannabis use in individuals with mood/anxiety disorders is associated with attenuated brain processing of reward magnitude, which may contribute to persistent affective symptoms.

In other words, I think that what they are saying is that if you are anxious or depressed, Cannabis won’t necessarily change that.

Health-related quality of life in young people: the importance of education

Gil-Lacruz et al. Health and Quality of Life Outcomes (2020) 18:187
https://doi.org/10.1186/s12955-020-01446-5

The dimensions of HRQOL are influenced by educational level. The influence is greatest among girls and the youngest members of the poorest area of the district. Public authorities should contemplate the development of an equitable education system from the beginning of the life cycle as a public health strategy.

Not specifically related to PD either, this has a broader impact. Better education leads to better health (and probably better schools, better businesses, and better public services and elected officials, one might wager).

That’s all for now. Time to relax. Take five. Smoke ’em if you got ’em, as the saying goes…

 

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In search of a biomarker for Parkinson’s Disease

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This report was pretty darn technical and way above my head, but from what I understood:

      • Lewy bodies are formed by the aggregation of alpha-synuclein proteins long before loss of dopaminergic neurons becomes apparent
      • Alpha-synuclein proteins appear to affect the immune system to produce an inflammatory response in the body (and brain)
      • The inflammatory factor interleukin-1-Beta was found at significantly higher levels in Parkinson’s patients’ blood samples

This particular study can be found on PubMedCentral. Unfortunately, I seem to have lost the link (or WordPress lost it for me). I Blame The Parkinson’s©

Howsomever, as Pogo the Possum (or Albert the Alligator) might have said, here is an article on biomarkers, published even more recently:

Blood biomarkers in Parkinson’s cluster analysis and prognosis   

 “Baseline clinical subtyping identified a pro‐inflammatory biomarker profile significantly associated with a severe motor/nonmotor disease phenotype, lending biological validity to subtyping approaches. No blood biomarker predicted motor or nonmotor prognosis.  (Mov Disord. 2020 Feb; 35(2): 279–287. Published online 2019 Nov 6. doi: 10.1002/mds.27888)

In other words, inflammation seems to be associated with PD, but the blood biomarkers they used didn’t correlate to progression of the disease.

In the meanwhile, we’re still searching…

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