Category Archives: Research

Exercise, Maimonides, Parkinson's, Research, Reviews , , , Leave a comment

Discrete choice experiment

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Published in the Australian Journal of Physiotherapy as an open access article, we have an experiment in which several factors were used to determine participants’ preferences in a hypothetical exercise program.

People with Parkinson’s disease are more willing to do additional exercise if the exercise program has specific attributes

Conclusions were:

People with Parkinson’s disease were more willing to participate in exercise programs that cost less, involve less travel, provide physical or psychological benefits and are supervised by qualified professionals. To enable more people with Parkinson’s disease to exercise, health services should provide programs addressing these factors and account for sex differences. [emphasis added. Men were more likely to favor strength training, women were averse to aerobic exercise, and folks already exercising 300 minutes per week were less likely to favor adding more exercises.]

The group to which I subscribe on their YouTube channel, and support in various ways, is Power For Parkinson’s® (PFP). I also am a member of the Georgetown Area Parkinson’s Support group (GAPS) and the Capital Area Parkinson’s Society (CAPS) Both PFP and GAPS sponsor several exercise groups aimed directly at people with Parkinson’s Disease (PD) and their needs, so I am usually working out at least one hour daily. So I might fall into the last group of folks not willing to add more exercises.

On a different tangent, A couple of articles showed up that deal with the idea of Multiple Intelligences. Actually, one is a book excerpt with selected portions available on Google Books, and the other is the cover, Table of Contents, Bibliography, and Index of a different book. Granted, the Index does list Parkinson’s Disease on at least 2 pages. Why bother? Because, as those who have read the earlier blog post(s) on Moses Maimonides and Me, I don’t particularly subscribe to Maimonides’ categories of four ways in which humans strive to achieve perfection.

These books are:

Eastern European Perspectives on Emotional Intelligence

in which some of the available pages include charts of Howard Gardner’s Multiple Intelligences, and some of the results which seem to show a clustering of several factors (using factor analysis). Since that is outside of my area of expertise, I won’t comment on it. (This is all copyrighted material, provided only for personal education, etc.

The other is Mind Ecologies: Body, Brain and World which has the extensive bibliography and index. Probably well worth looking into the bibliography, if one has a mind to do so (but not today). The TOC reads:

1. Life, Experimentalism, and Valuation 16
2. Pragmatism and Embodied Cognitive Science 51
3. Social Cohesion, Experience, and Aesthetics 94
4. Pragmatism and Affective Cognition 124
5. Perception, Affect, World 156
6. Broadening Ecologies 184 

and the whole thing is copyright The Columbia University Press.

My pulmonologist prescribed a nap in the morning and afternoon, and since I missed the morning nap, will head off to do one this afternoon.

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

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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Parkinson's, Research, Sleep , , , Leave a comment

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…

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

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

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

 

Exercise, Parkinson's, Research, Reviews , , Leave a comment

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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depression, Mediclal Marijuana, Parkinson's, Research, Reviews , , , Leave a comment

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…

 

Parkinson's, Research , Leave a comment

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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Music, Research , , , Leave a comment

Say what?

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Not specifically related to Parkinson’s, this study looked into whether providing musical training to older non-musicians would have an effect on the experimental task.

Experienced musicians outperform non-musicians in understanding speech-in-noise (SPIN). The benefits of lifelong musicianship endure into older age, where musicians experience smaller declines in their ability to understand speech in noisy environments…  results suggest that short-term musical training in older adults may enhance neural encoding of speech, with the potential to reduce age-related decline in speech perception. [emphasis added]

The effects of short-term musical training on the neural processing of speech-in-noise in older adults

… these findings suggest that music training enhances neural responses to speech in speech-motor and control regions.The absence of training-related interactions with noise level suggests that the benefit of music training is related to processing speech in general, and not separating it from background noise;

– BUT analysis of functional Magnetic Resonance Imaging showed electrical activities in a couple of areas of the brain related to speech perception for those who were in the musical training group.

Obviously, “further research is needed,” as the saying goes, and perhaps for longer periods of time.

Whatever type of musical training one chooses, singing, keyboard, string, or wind instruments, there’s another saying that applies to that as well: “It may not help, but it can’t hurt.”

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Research, Reviews, Sleep Leave a comment

Just the facts, ma’am

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As Sergeant Friday used to say on Dragnet: Just the facts.

Well, here they are.

Narcolepsy-Fact-Sheet

Which answers all those questions that keep you up at night:

What is narcolepsy?
Who gets narcolepsy?
What are the symptoms?
What are the types of narcolepsy?
What causes narcolepsy?
How is narcolepsy diagnosed?
What treatments are available?
What behavioral strategies help people cope with symptoms?
What is the state of the science involving narcolepsy?
What research is being done?
How can I help research?
Where can I get more information?

Then again, a little background information doesn’t hurt, and reading a historical review just might be what you need to put you to sleep:

Historical review of narcolepsy