Category Archives: Parkinson’s

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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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A couple of abstracts on sleep and restless legs

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Sleep quality as prodromal PD symptom

Although the above link only leads to an abstract, there is enough information to accept their conclusion that “in the general population, deterioration of sleep quality and duration are markers of the prodromal phase of parkinsonism, including Parkinson’s disease.”

Restless Legs Syndrome and whether or not it is improved by DBS is apparently not a matter of consensus RLS improved by DBS although, again, this is not a full text article.

 

depression, Music, Parkinson's, Research, Reviews , , Leave a comment

Searching for the secret chord…

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These came out of a search, so might have been previously covered in a post:

This review covers music performed in groups and is not directly related to Parkinson’s: Collaboration and improvisation

Music performance is inherently social. Most music is performed in groups, and even soloists are subject to influence from a (real or imagined) audience. It is also inherently creative. Performers are called upon to interpret notated music, improvise new musical material, adapt to unexpected playing conditions, and accommodate technical errors. The focus of this paper is how creativity is distributed across members of a music ensemble as they perform these tasks

This article does cover Parkinson’s – singing as a way to help with vocal issues and depression. Positive results, but not a randomized control type experiment, so conclusions are tentative:

Individualized singing program

Here’s an interesting experiment in which participants are asked to improvise music which reflects varied feeling states. Not sure how the results can be applied, except that creating music or dance/movement to express emotions is probably of benefit to the brains of people with Parkinson’s, regardless of the strength of the research.
Effects of music making

This study has gotten some wide distribution – on how musicians (people who play an instrument) react more quickly than people who do not. This article digest is from Science Daily (January 2017)

Play an instrument?

“fine” as they say on the sheet music.

Dance for Parkinson's, Exercise, Music, Parkinson's, Research, Reviews , , , , , Leave a comment

Dance and exercise – a study and a publications review

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Not much new here – more evidence that dance exercises and physical exercise in general, is beneficial for people with PD.

Shall We Dance – master’s thesis  by Brittni Lynn McAlister, University of North Colorado

 In the words of one participant, the dance classes have been “. . . completely life-changing.”

Systematic review of exercises for Parkinson’s

This review revealed that people with Parkinson’s disease viewed physical activity as an enjoyable and positive experience, which aided with control of their symptoms and enhanced their wellbeing and quality of life.

 

Dance for Parkinson's, Drumming, Music, Parkinson's, Research , , Leave a comment

Almost let these references get away

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Some recent articles about music and dance – thought I had already published this – it appears not. Either that, or I’m more cognitively impaired than I thought I was. If this keeps up, I’ll have normal intelligence:

Dopamine, Oxytocin, Serotonin, and Endorphins 

Acronym is DOSE, and it’s a short article talking about how dance is good for you because it releases several different hormones and neurotransmitters – and not just because it makes you feel good – but because it does….😎

Language of music and psychophysical foundations  

from the abstract: “Application of music in rehabilitation medicine requires an understanding of the mechanisms of music perception. This article discusses differences in character of the basic melodic elements and addresses some of the specifics of tonal space. Colloquially, music is called the language of emotion. Bearing in mind that high-level cognitive functioning in humans is inseparable from affective consciousness, investigating the mechanisms of emotional processing belongs to an important area of cognitive sciences. Studying music perception can help to advance methods of music therapy and to elucidate major aspects of human consciousness.” (emphasis added)(Article is on ReseaechGate; membership(.

Drumming program to improve social interactions

Although the article is about subjects with autism spectrum disorder (ASD), I think that the results are likely to be replicable with or generalizable to Parkinson’s Disease folks.

” results suggest that the children with ASD significantly improved in the domains of enjoyment and fun, and showed a positive trend for developing improved social relationships with peers and camp counselor partners.”

 

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Parkinson's, Research, Reviews , Leave a comment

Dance/movement, quality of life, and social skills, oh my!

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First, an abstract:

Use of Dance/Movement therapy for autism spectrum

“… future research must demonstrate greater scientific rigor in documenting the efficacy of DMT treatment interventions. It also found that imitation (mirroring) interventions helped individuals with ASD improve their social skills.” (Bold added) (This article was one of those reviews of published articles. The abstract does include a list of references, many of which are available online).

Next, an open access article on multidisciplinary approach:
(This sounds like another article recently posted. Would investigate, but having Parkinson’s means there’s never enough time to do everything you want to do).

Enhanced Quality of Life

Objectives: To compare the effects of inpatient enhanced multidisciplinary care (EMC) and multidisciplinary rehabilitation (MR)
on the symptoms and quality of life (QOL) of patients with Parkinson disease (PD) and to clarify the relation between reduction in
symptoms and the improved QOL. Methods: This study was a quasi-randomized controlled (alternate allocation), assessor blinded, single-center study. We recruited 80 patients with idiopathic Parkinson disease, Hoehn and Yahr stage 2 to 4, on stable
medication. Patients were included in an EMC or MR group. Both rehabilitation programs were performed for 8 weeks (17 h/wk).
Main outcome measures were Parkinson’s Disease Questionnaire-39 and Unified Parkinson’s Disease Rating Scale. Results: The
EMC induced significant improvements in QOL compared to MR. We found that body axis symptoms (rising from a chair,
posture, postural stability, falling, and walking) as well as nonmotor symptoms (depression) in patients with PD were relieved by
the inpatient EMC. Conclusions: Enhanced multidisciplinary care for patients with PD appears to be effective in improving the
QOL. The improvement in motor and nonmotor symptoms, including depression, may contribute to the improved QOL.

Finally, another open access article that might be of interest to those using technology: analysis of respiration to evaluate movement.

The role of respiration audio in multimodal analysis of movement qualities

A little out in left field, but who knows?

That’s all for today, folks. Read and ponder.

depression, diet, Exercise, Parkinson's, Research , , , , Leave a comment

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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New approach – direct brain infusions to regrow dopaminergic neural cells

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This approach might help, but apparently it will take about 18 months to get results in moderately advanced cases. (emphasis added to abstract below).

One wonders whether complementary therapeutic treatments (exercise, dance (movement + rhythm), singing, or music instrument training were being used by any of the participants, or whether this was the only treatment these subjects were using during this time. Certainly worth trying this in combination with other, non-invasive treatments (says the cyborg with electrodes stimulating the subthalamus nigra substantia).

Journal of Parkinson’s Disease research pre-press

Abstract.
Background: Intraputamenal glial cell line-derived neurotrophic factor (GDNF), administered every 4 weeks to patients with moderately advanced Parkinson’s disease, did not show significant clinical improvements against placebo at 40 weeks,
although it significantly increased [18F]DOPA uptake throughout the entire putamen.
Objective: This open-label extension study explored the effects of continued (prior GDNF patients) or new (prior placebo patients) exposure to GDNF for another 40 weeks.
Methods: Using the infusion protocol of the parent study, all patients received GDNF without disclosing prior treatment allocations (GDNF or placebo). The primary outcome was the percentage change from baseline to Week 80 in the OFF state
Unified Parkinson’s Disease Rating Scale (UPDRS) motor score.
Results: All 41 parent study participants were enrolled. The primary outcome decreased by 26.7 ± 20.7% in patients on GDNF for 80 weeks (GDNF/GDNF; N = 21) and 27.6 ± 23.6% in patients on placebo for 40 weeks followed by GDNF for 40 weeks
(placebo/GDNF, N = 20; least squares mean difference: 0.4%, 95% CI: –13.9, 14.6, p = 0.96). Secondary endpoints did not show significant differences between the groups at Week 80 either. Prespecified comparisons between GDNF/GDNF at Week 80 and placebo/GDNF at Week 40 showed significant differences for mean OFF state UPDRS motor (–9.6 ± 6.7 vs. –3.8 ± 4.2 points, p = 0.0108) and activities of daily living score (–6.9 ± 5.5 vs. –1.0 ± 3.7 points, p = 0.0003). No treatment-emergent safety concerns were identified.

Conclusions: The aggregate study results, from the parent and open-label extension suggest that future testing with GDNF will likely require an 80- rather than a 40-week randomized treatment period and/or a higher dose.

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Might mitophagy be enlisted in the fight against Parkinson’s?

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Mitochondrial dysfunction and Parkinson’s

During aging, the process of mitophagy, a system that allows the removal of dysfunctional mitochondria through lysosomal degradation, starts to malfunction. Because of this defect, damaged mitochondria are not removed correctly, and their decomposing components accumulate inside the cells. Dysfunctional mitochondria that are not removed by mitophagy produce high amounts of reactive oxygen species (ROS) and, thus, cause oxidative stress. Oxidative stress, in turn, is very harmful for the cells, neuronal cells, in particular. Consequently, the process of mitophagy plays a crucial role in mitochondria-related disease. Mitochondrial dysfunctions and oxidative stress are well-established factors contributing to Parkinson’s disease (PD), one of the most common neurodegenerative disorders. In this review, we report various known antioxidants for PD treatments and describe the stimulation of mitophagy process as a novel and exciting method for reducing oxidative stress in PD patients. We describe the different mechanisms responsible for mitochondria removal through the mitophagy process. In addition, we review the functional connection between mitophagy induction and reduction of oxidative stress in several in vitro models of PD and also agents (drugs and natural compounds) already known to be antioxidants and to be able to activate mitophagy. Finally, we propose that there is an urgent need to test the use of mitophagy-inducing antioxidants in order to fight PD.

 

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Music on the brain

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Rhythmic Auditory Stimulation (RAS) and Argentinean Tango

Results: Results showed significant improvements in the Tinetti scale total (mean±SD of post-pre change: 5.3±2.8, p<0.01), gait (2.5±1.2 p<0.01), and balance scores (2.8±2.0 p<0.01). TUG also improved by 3.6±0.8 seg (p<0.01). Statistically non-significant changes were recorded in mobility, bodily discomfort, stigma, social support and cognition PDQ-39 domains, with Cohen’s d sizes of 0.5-0.6 and NNTs of 5-7.

Conclusion: RAS could be combined with Argentinean Tango. Positive effects on gait and balance were observed, together with a trend towards improvement in some quality of life domains. A randomized, blinded, controlled trial in a larger number of patients followed-up during a longer period is underway.

And this:Brief review of music and cognition

Given that the participants were not musicians, it can be inferred that the results of the research can be applied in other non-musical contexts, what we call “generalization” in cognitive rehabilitation, which means, non-musical gains can be transferred to daily activities. In this perspective Billhiartz et. al. (2000) argue that there is a link between musical instruction and development in non-musical skills.

… we agree that music is an important element in human life that can be used in many contexts. The musical activity is multisensorial, simultaneously integrating several systems, mainly the sensorimotor, cognitive, and affective, within a specific context, which consecrates in the sphere of embodied musical cognition.

An interview with Tom Moore

This is just a darn interesting interview with a musician and musicologist. You can’t make this stuff up.