Category Archives: Research

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

To sleep, perchance to dream… or to stay up all night, that is the question

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Other than the sound of Shakespeare rolling in his grave at that title, what else might be involved in insomnia? (disregarding the occasional benefits such as hearing Isaac Hayes’ version of “By The Time I Get To Phoenix” on a radio show titled “For Mushrooms and Night People,” or reading through James Joyce’s “Finnegan’s Wake” in one sleepless night).

Insomnia related to PD – according to this study abstract, the authors found that insomnia disorder co-morbid with Parkinson’s Disease was consistent with that of folks without PD, and they recommend a cognitive behavioral therapy approach to help treat people with this problem.

Insomnia co-morbid with Parkinson’s Disease

On the other hand, insomnia can lead to daytime drowsiness. And that, as this author can attest, can be co-morbid with REM Sleep Behavior Disorder (RSBD) or as narcolepsy for many years without a diagnosis.

Here are a couple of other articles on longitudinal studies related to PD and sleep issues. They are open access, so one can read and draw one’s own conclusions. As usual, one of the conclusions one might reach is that further research is needed on the topic.

Long term effects of STN DBS on sleep     In this study, it was found that DBS improved nocturnal sleep quality but had no effect on excessive daytime sleepiness.

10 year study on daytime drowsiness and PD   In this long term study, it was found that daytime drowsiness did not improve, even while other symptoms of PD progressively got worse.

The author refers you to the paragraph above in which RSBD was co-morbid and precedent to PD diagnosis, as well as narcolepsy, which was only diagnosed in recent years. Although symptoms may be associated with Parkinson’s, they might not be a part of the Parkinson’s Disease, and other causes must be ruled out in order to arrive at accurate diagnoses. For this, a team of medical personnel is required, and not specialists, each working alone in their own silo. (Opinions provided free of charge).

 

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

Music on the brain

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Why do we like some kinds of music but not others?

Back in college, Jerry Coker (who taught jazz improvisation, said that we tended to like music that was not entirely predictable, but that a certain level of surprise increased our enjoyment of jazz. Music that was too unpredictable led to diminished enjoyment. Now, a study has been done that mathematically analyzed people’s enjoyment of musical snippets, and basically confirmed what Jerry taught us. Surprise us every now and then, but don’t make us feel like we’re stupid and can’t guess the next note that’s coming along.

Here’s the article with a reference and link to the original research (if you can afford it): The brain’s favorite type of music

Dopamine’s role in music enjoyment.

In this study, researchers looked at people’s responses to music under three separate conditions. One group received levodopa, another received risperidone, a dopamine antagonist, and a third group received a placebo. Folks in the levodopa group reported and were recorded as having higher levels of enjoyment, and those taking the antagonist, lower levels of enjoyment. Each group[ went through all the conditions, separated by a week in between sessions. The results clearly indicate that dopamine is the brain is related to musical pleasure. Now, if  playing and singing music promote an increase of dopamine in the brain, we have a prescription for Parkinson’s Disease (and depression) that can’t be beat (although it can be counted off).

Dopamine role in musical pleasure    

the actual research article which appears to be available in its entirety online: Dopamine modulates the reward experiences elicited by music

 

 

 

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

Oh, I’m walking to New Orleans… or maybe the Outback

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Here’s a conference poster reporting some recent research on music and gait… and the effects of dual tasks on Parkinson’s Disease diagnosed people. It seems that all the researchers are in Australia, hence the title to this post.

Walkin’ and Talkin’: dual task effects on Gait

They had a few different tasks – just walking, walking while saying all the words one could think of starting with the letter (name a letter), and walking while counting in intervals. The conclusion was that Dance For Parkinson’s® had a positive effect. Naturally, they called for more research with larger numbers of participants.

In the meantime, as I always say: Don’t stop moving to the music!

 

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Music, Parkinson's, Research , Leave a comment

We’ve got the beat… or maybe not

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Research into rhythmic deficits in Parkinson’s:

Previous research has demonstrated that people with Parkinson’s disease (PD) have difficulties with the perceptual discrimination of rhythms, relative to healthy controls…. insight into how people with PD process and perceive rhythm can refine our understanding of the well known problems of temporal processing in the disease

Subjective judgments of rhythmic complexity in Parkinson’s disease

In this study, conducted over the internet,

People with PD rated all rhythms as more complex across tempi, with significant group differences in complexity ratings at 120 and 150bpm, but not at 90bpm. Our analysis found a uniform elevated baseline for complexity judgments in the PD-group, and a strong association between the two groups’ rank-ordering the rhythms for complexity. This indicates a preserved ability to discriminate between relative levels of complexity. …we speculate that Parkinson’s disease affects judgment of complexity but not judgment of likeability.

So if I understand this correctly, folks with PD find rhythms, especially faster rhythms, to be more complex than do “normal” people.

As for me, I will still prefer syncopated rhythms, especially calypso, maybe because I heard them when I was too young to remember. Military marches in 2/4 time no longer appeal to me. In fact, I believe that the march that I wrote in high school during band camp, “To The Rear March, ” had a syncopated melody, but I can’t swear to it. Guess I’ll have to dig up the old sheet music and take a look.

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

Oh, the title is long, and I can’t get through it in one breath

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Music and Metronomes Differentially Impact Motor Timing in People with and without Parkinson’s Disease: Effects of Slow,Medium, and Fast Tempi on Entrainment and Synchronization Performances in Finger Tapping, Toe Tapping, and Stepping on the Spot Tasks

Well, the title is a mouthful, isn’t it?

Basically, this study looked at the different effects of external Rhythmic Auditory Stimulation (RAS) on folks with Parkinson’s Disease (PD) compared with folks without PD, using different tempi and different ways to observe the ability to synchronize with the beat.

Although this blog has noted a previous study which indicated that an internal RAS (e.g., singing a song) was superior to external RAS to immprove one’s gait, I have received feedback from several caretakers that their person with PD can not sing or carry a tune, but has been able to improve gait and reduce freezing with external RAS. Thus, this study should be of interest.

Bottom line: This study showed that music was superior to a metronome stimulus in “entrainment” of the motor systems involved after the cue was removed. (look up entrainment in biomusicology on Wikipedia for a full description of what it means). In other words, once a body gets synchronized to the musical RAS, they can continue to walk at the same pace as if the music were still playing.

Of course, there is more to it than this brief report. For that, I’ve provided the link to the full article above.

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

A review of non-traditional treatments for PD

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Exercise is generally accepted as beneficial for the alleviation of Parkinson’s Disease (PD) symptoms. The Clinical Neurologist International has just published an open-access article that reviews the most recent research with a focus on types of exercise and their benefits for specific motor symptoms:

Martinez-Ramirez D, Kraslow M, Armstrong MJ, Ramirez-Zamora A, Almeida L, Besharat A, et al. Update on Non-Traditional Exercises in Parkinson’s Disease: A Motor Symptom-Focused Approach. Clin Neurol Int. 2019; 1(1): 1004.

From the abstract:

… it is crucial to better characterize the benefits of exercise in PD. … we discuss the most recent studies analyzing the clinical effects of various modalities of exercise in PD, including physical therapy, aerobic exercise, strength and resistance training, and nontraditional forms of activity such as tai chi, dancing, aquatics, and boxing. We also provide … expert recommendations based on current evidence and highlight issues that remain unresolved (e.g. the best type of exercise, symptomatic benefits based on different modalities, optimal frequency and duration, and duration of benefit).

It appears that the authors limited their search to those studies that looked into motor symptoms of PD, and perhaps this is why their list of references doesn’t include Rehfield et al.’s 2018 article on the superiority of a dance program to repetitive physical exercise in increasing brain plasticity. Nor do they look into other approaches, such as musical training and practice, as possible ways to improve cognitive function, brain plasticity, and quality of life.

As a person with PD, I personally find that an eclectic and inclusive approach, using medications, Deep Brain Stimulation (DBS), physical exercise (including dance-related, vocal/singing and breathing exercise), diet, and social activities related to specific interests (like native plants and photography) works best for me. For others, the mix will differ.

The authors of this review reach much the same conclusion:

…evidence suggesting that any and all types of exercise can provide short-term clinical and quality of life benefits. More research is needed to help understand if exercise programs provide generalized benefits or what strategies should be used to address particular deficits. Balance, flexibility, and stretching seem to improve motor symptoms and decrease falls, contributing to an improvement in overall function. Aerobic training appears to improve cognition, cardiovascular health, gait, and reaction time. Resistance training provides the strongest benefit in strength. Nontraditional exercise programs, including tango, tai chi, cycling, aquatic therapy, and boxing are potentially beneficial options for each patient

In short: Find out what types of exercise you like to do, do what you like to do, and keep on doing it to help reduce the symptoms of PD.

(Coincidentally, most of the authors are associated with my alma mater, the University of Florida in Gainesville, FL).

 

Dance, Research , , , , , , , Leave a comment

Art, Dance, Medicine, Parkinson’s, Genetics, Oh My!

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Arts and Medicine research – my only wish is that they would look into the possibility of physical changes in the brains of people involved, and not just on co-creating knowledge:

Co-creating knowledge…

Next:

Dance therapy demonstrates a highly appropriate choice of intervention to stimulate plasticity processes, improve age-related deterioration, and thus contribute to successful aging. Health care professionals involved in the care of elderly individuals should whenever possible consider the feasibility of associating dance therapy as a stimulating and therapeutic activity.

Dance therapy in aging: A systematic review

“There were 2,334 studies, out of which 6 were chosen.” This review limited itself to dance as therapy for healthy aging adults, and excluded those studies that looked at Parkinson’s or Alzheimer’s people. Again, I would hope that future studies look at changes in brain activity and structure, as well as observable differences in movement, etc.

Next, an open access article reviewing genetic risks involving Parkinson’s: “This study provides evidence that alleles associated with Parkinson disease risk, in particular GBA variants, also contribute to the heterogeneity of multiple motor and nonmotor aspects. Accounting for genetic variability will be a useful factor in understanding disease course and in minimizing heterogeneity in clinical trials.”

Genetic risk of Parkinson disease and progression: An analysis of 13 longitudinal cohorts

(Will have to read it in order to see what it says,  and compare it with my genome files to see what it means for me).

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

I got rhythm, I got music…

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Put together a slide presentation trying to synthesize some of the research on Parkinson’s Disease (PD) and the possibility of music, singing, playing musical instruments, and dance as means to counteract the progressive effects of dopaminergic neurons lost in the course of PD. Due to the length of the presentation and the limits of my computer resources, the narration seems to have gotten a little out of sync towards the end. But it is what it is, as they say: (note: added a PDF file of the presentation on 6-9-19 to make it easier to download and view)

Rhythm, Music, Singing, Dancing and the Brain

2019-06-05-Rhythm Music Singing and the brain  (PDF file)

and an even smaller file with all the blue and yellow intact (6-15-2019):

Rhythm Music Singing Dancing and the Brain

Dance, Exercise, Research , , , , , Leave a comment

Progressively difficult or complex dance training is superior to repetitive physical exercise

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Yep, you read that correctly. This research was done using neuro-imaging and revealed that brain plasticity ( how experiences reorganize neural pathways in the brain) is increased by a program of increasingly difficult dance training. (The title of this entry was edited 04/28/2021 to make it more clear that the variable was increasing the difficulty, and not simply dance vs. exercise. ALL exercise is good, as long as not overdone, but to incorporate research findings into the program (like Power for Parkinson’s or Lew-Ortiz Pabon’s Apollo Rhythm Club do), takes some extra effort).

Dance training is superior to repetitive physical exercise in inducing brain plasticity in the elderly.

… Both interventions increased physical fitness to the same extent. Pronounced differences were seen in the effects on brain volumes: Dancing compared to conventional fitness activity led to larger volume increases in more brain areas, including the cingulate cortex, insula, corpus callosum and sensorimotor cortex. Only dancing was associated with an increase in plasma BDNF levels. Regarding cognition, both groups improved in attention and spatial memory, but no significant group differences emerged. The latter finding may indicate that cognitive benefits may develop later and after structural brain changes have taken place. The present results recommend our challenging dance program as an effective measure to counteract detrimental effects of aging on the brain.

On a personal note, I noticed during a year long period of reduced mobility that my Parkinson’s symptoms had progressed (or regressed, depending on how you look at it). Slurred speech was perhaps one of the more obvious or noticeable symptoms. That has now disappeared, though one has to be mindful to speak clearly and loudly in order to be understood.

Physical exercise of any kind is good, it seems. Weight resistance and other exercises can benefit from the high intensity interval approach. But move to the music, and join a dance class that increasingly challenges the brain (especially if you are classified among the elderly, even if you are Young At Heart).

depression, Parkinson's, Research , Leave a comment

Old drugs in new bottles

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An interesting development, or in this case, two interesting developments, is the finding that currently available medications might be repurposed for their neuroprotective effects. Here are two articles on two drugs that show promise.

This is a report on a hypertension medication that provides neuroprotection in mice and may be transferable to humans… Are mice brains similar enough to humans for it to work? A recent report on isradipine, another hypertension medication, reported no differences in symptoms between controls and those receiving the medications. We shall see.

Felodipine induces autophagy in mouse brains with pharmacokinetics amenable to repurposing

Nrct we have a case in which a tricyclic antidepressant, nortriptyline, has been found to slow down the aggregation of alpha synuclein proteins in the brain.

Nortriptyline inhibits aggregation and neurotoxicity of alpha-synuclein

 Not sure whether either will pan out, but anyone with either hypertension or depression could discuss these articles with their doctor(s) and come to a mutually agreeable course of action.

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