Category Archives: Research

Parkinson's, Research , Leave a comment

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.

 

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

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.

 

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

Exergame based therapy and other stuff

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Rehab through exer-games

Conclusion:Recent evidence indicates exergame-based therapy has been widely proven to be feasible, safe, and atleast as effective as traditional PD rehabilitation. Further insight into new sensors, best practices and different cognitivestadiums of PD (such as PD with Mild Cognitive Impairment), as well as task specificity, are required. Also, studieslinking game parameters and results with traditional assessment methods, such as UPDRS scores, are required.

Study protocol re: PD movement interventions

The goal of this study is to begin to address this
challenge by piloting a novel, hypothesis-driven, non-
pharmacological intervention to improve motor function
and diminish motor fatigue in PD. This novel approach is
based on the use of hypothesis-driven cognitive task inter-
ventions to stimulate the motor system and ameliorate
motor symptoms

Palmomental reflex is an important clinical marker of REM sleep behavior disorder in patients with Parkinson’s disease Yadav R, Mahale R, Pal PK – Ann Mov Disord

 

Music, Parkinson's, Research , Leave a comment

Autism and Parkinson’s, and data-driven subtyping of PD

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Found this reference to a study involving autistic children.
Since Parkinson’s is a movement disorder, it stands to reason that music would be beneficial to both groups as a therapy (and it is).
http://irj.uswr.ac.ir/article-1-889-en.pdf
“Highlights
● A growing body of evidence suggests that motor impairments are frequently present in children with autism.
● Music therapy along with physical activity might benefit children with autism.
● We observed a significant difference between the experimental and control group after applying music therapy along with play therapy.
Plain Language Summary: Children with autism show motor impairments. Music therapy along with physical activity is a significant treatment in improving motor coordination. In this study, 30 children with autism were participated in 15 music therapy sessions. Music therapy are presented in two methods: (a) inactive one; listening to music and (b) active one; playing and rhythmic movements. Based on the results, motor coordination was achieved in the posttest.”
 
Directly related to Parkinson’s is this research paper on data-driven subtyping of PD:
“466 patients with idiopathic PD were investigated and three subtypes were identified. Subtype I (Mild Baseline, Moderate Motor Progression) is comprised of 43.1% of the participants, with average age 58.79 ± 9.53 years, and was characterized by moderate functional decay in motor ability but stable cognitive ability. Subtype II (Moderate Baseline, Mild Progression) is comprised of 22.9% of the participants, with average age 61.93 ± 6.56 years, and was characterized by mild functional decay in both motor and non-motor symptoms. Subtype III (Severe Baseline, Rapid Progression) is comprised 33.9% of the patients, with average age 65.32 ± 8.86 years, and was characterized by rapid progression of both motor and non-motor symptoms. These subtypes suggest that when comprehensive clinical and biomarker data are incorporated into a deep learning algorithm, the disease progression rates do not necessarily associate with baseline severities, and the progression rate of non-motor symptoms is not necessarily correlated with the progression rate of motor symptoms.”
 
In other words, everybody’s Parkinson’s journey is unique.
Exercise, Parkinson's, Research , , , Leave a comment

A couple of studies on gait improvement in PD, and a thesis on music therapy

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What looked promising turned out to be fairly lackluster as far as results – although it appears that putting in time on a treadmill might be better for Parkinson’s patients than some other forms of exercise, when it comes to gait and balance. And challenging courses of treatment were recommended for people with PD.

Exercise and Parkinson’s – comparison

Background and Purpose: Impaired gait, balance, and motor function are common in Parkinson disease (PD) and may lead to falls and injuries. Different forms of exercise improve motor function in persons with PD, but determining which form of exercise is most effective requires a direct comparison of various approaches. In this prospective, controlled trial, we evaluated the impact of tango, treadmill walking, and stretching on gait, balance, motor function, and quality of life. We hypothesized tango and treadmill would improve forward walking and motor symptom severity, and tango would also improve backward walking, balance, and quality of life.
Results: In this study, treadmill walking improved forward and backward walking.

Healing Sounds: an anthropology of Music Therapy

explore embodiment, relationship – building and aesthetic creation as three areas n which music can allow the harnessing of affect towards health goals. I note music’s powerful affect on the human body and movement, and the ways in which these affects are mobilized towards specific clinical goals. I explore the various human –  to – human and human – to sound relationships that are mobilized, created or strengthened through music therapy interventions, and how they relate to health and to the affect of “becoming”. Finally, I note the strong evidence for musical and esthetic creation as a part of self – care, both by music therapists and by their clients, and argue for a broader understanding of how creativity impacts health, by allowing people to affect their environments

Exercise and Gait

Methods: Forty-seven PwPD (mean age: 73 years; 19 females, Hoehn and Yahr stages 2-3) who had participated in 10 weeks of highly challenging gait and balance training were included. Baseline demographics, disease-related factors, physical and cognitive ability, and perceived health were used for the prediction of percent change in balance performance (the Mini-BESTest) and comfortable gait speed between the pre- and postassessments, using multiple linear regression analyses.
Results: Thirty-five percent of the variance of change in balance performance was explained by General Health Perceptions (β = −0.36), the Timed Up and Go test (β = −0.33), and the single-task performance of a cognitive task (β = −0.24). Forty-nine percent of change in gait speed was explained by gait speed while performing a dual task (β = −0.46), dual-task interference while walking (β = 0.43), time to complete the Timed Up and Go test (β = −0.29), and percent error on a cognitive task (β = −0.25).
Discussion and Conclusions: The results may suggest that the PwPD with overall lower perceived health, functional mobility, and cognitive functions are the ones most likely to benefit from highly challenging and attention-demanding gait and balance training.
diet, Exercise, Parkinson's, Research Leave a comment

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.

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

Advice to People with PD: Sing while you walk

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Internal cueing improves gait more than external cueing in healthy adults and people with Parkinson disease 

Results indicate that internal cueing was associated with improvements in gait velocity, cadence, and stride length in the backward direction, and reduced variability in both forward and backward walking. In comparison, external cueing was associated with minimal improvement in gait characteristics and a decline in gait stability. People with gait impairment due to aging or neurological decline may benefit more from internal cueing techniques such as singing as compared to external cueing techniques.

The feasibility of singing to improve gait in Parkinson disease.

Abstract

Brain regions important for controlling movement are also responsible for rhythmic processing. In Parkinson disease (PD), defective internal timing within the brain has been linked to impaired beat discrimination, and may contribute to a loss of ability to maintain a steady gait rhythm. Less rhythmic gait is inherently less efficient, and this may lead to gait impairment including reduced speed, cadence, and stride length, as well as increased variability. While external rhythmic auditory stimulation (e.g. a metronome beat) is well-established as an effective tool to stabilize gait in PD, little is known about whether self-generated cues such as singing have the same beneficial effect on gait in PD. Thus, we compared gait patterns of 23 people with mild to moderate PD under five cued conditions: uncued, music only, singing only, singing with music, and a verbal dual-task condition. In our single-session study, singing while walking did not significantly alter velocity, cadence, or stride length, indicating that it was not excessively demanding for people with PD. In addition, walking was less variable when singing than during other cued conditions. This was further supported by the comparison between singing trials and a verbal dual-task condition. In contrast to singing, the verbal dual-task negatively affected gait performance. These findings suggest that singing holds promise as an effective cueing technique that may be as good as or better than traditional cueing techniques for improving gait among people with PD.

 

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

Amyloid-Beta and Parkinson’s Disease

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Amyloid-Beta and Parkinson’s Disease    (abstract only but list of references includes many available on PubMed)

From the abstract:

A better understanding of the role of this system and more specifically the role of Aβ in PD symptomatology, could introduce new treatment and repurposing drug-based strategies. For instance, apomorphine infusion has been shown to promote the degradation of Aβ in rodent models. This is further supported in a post-mortem study in PD patients although clinical implications are unclear. In this review, we address the clinical implication of cerebral Aβ deposition in PD and elaborate on its metabolism, its role in cognition and motor function/gait, and finally assess the potential effect of apomorphine on Aβ deposition in PD.

So it would seem that apomorphine might be a tool for helping with gait and balance problems…and cognitive decline.
 

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

Biomarkers,cardio training, singing and dancing, and how jokes work.

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This is a long post. Most of the links are to free, full text articles or reports.

Recent advances in Biomarkers for Parkinson’s A review of the advances currently being made in the search for a cure.

INTERVAL TRAINING FOR CARDIOMETABOLIC AND BRAIN HEALTH

 

1. Engaging in interval exercise can boost fitness and improve your mood in a time-efficient manner.

2. Short exercise breaks like climbing the stairs can refocus attention and help maintain productivity in the workplace.

3. Combining interval exercises with motor skill training in a clinical setting can augment the recovery of function.

Dance and Health Training research report   

The aim of this research was to create a best practice model of dance and health continuing professional development (CPD); to create a dynamic, interdisciplinary course of study for dancers who are engaged in facilitating dance across a range of dance genres within health care contexts.

Outcomes of the project:  Full listing of international and national examples of best practice, core literature, key expert practitioners, full course content and delivery requirements are set out in this report.

(Note: specifically related to Ireland).

Sing while you work

This pilot study is the first Irish study of the health and wellbeing benefits of HSE workplace choirs. It is one of few studies to investigate the health and
wellbeing benefits of choir for Health Service Staff internationally.  Qualitative data confirms previous study findings; namely that a workplace choir can promote social connectedness, enjoyment at work, and staff
engagement; reduce stress; and improve perception of health and wellbeing.
Benefits of attending are noticed across workplace communications.

Comparison of two different exercise programs  (abstract only)

After treatment, UPDRS-II scores improved (mean change: EXE, -4.5 points; CYC, -3.2 points). The results for the other outcomes (EXE and CYC, respectively) were: PDQ, 13 and 17%; BDI, -2.5 and -2.1 points; 6MWT, 129.6 and 141.6 m; and EQ-5D, 12 and 9% (all p < 0.05, but there was no difference between groups). EXE vs. CYC resulted in improved SE-ADL (8.4 and 4.0 points, effect size [ES]: 0.12), BBS (8.8 and 4.2 points, ES: 0.44), and 2 measures of posturography (ES: 0.11 and 0.21) (p 0.05).

CONCLUSION:
Two highly different exercise programs resulted in similar improvement of most motor and clinical symptoms in PD patients.

One thing Parkinson’s People do to help cope with  an incurable (so far), progressive, degenerative, neurological disease is to use humor.

The following showed up in the Dance+Parkinson’s search feed, and are included here with a caveat that some of the jokes used to illustrate the ways in which humor works (theoretically) can be be considered offensive.

How do jokes work?

Back before the Internet, there was a Humor list-serve, dedicated to the study of humor and how it works.  The above PDF attempts to address the varieties of jokes, and repeats some potentially offensive ones to illustrate its concepts. Much of the text refers to the following free e-book on the Gutenberg project.

Laughter: an essay on the meaning of humor   by Henri Bergson

 

 

 

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

Music, Rhythm, etc.

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therapeutic effects of singing on neurological diseases Don’t know if I’ve sent this out before. A review of benefits of singing on PD and other conditions.

“Walking to New Orleans” or rhythmic auditory cues improve gait

Results

Gait variability decreased and prefrontal HbO2 levels increased during cued walking relative to usual

walking. Older adults showed greater HbO2 levels in multiple motor regions during cued walking although the response reduced with repeated exposure. In older adults, lower depression scores, higher cognitive functioning and reduced gait variability were linked with increased HbO2 levels during RAC walking.

Conclusion

These findings suggest that walking improves with RAC in older adults and is achieved through increased activity in multiple cortical areas. The cortical response decline with repeated exposure indicates older adults’ ability to adapt to a new task

 

THE BEAT GOES ON AUDITORY CUES FOR PEOPLE WITH PARKINSON’S DISEASE A Powerpoint presentation that covers everything you might want to know about PD and auditory cues. Basically, folks did as well or better with music than a metronome beat, and enjoyed walking to music better. significant results reported and apparently both CMTs and PTs were in agreement.
 
Not Cure but heal: Music and Medicine  a chapter in a book, but the references are listed, and some of them are available free on PubMed Central

Internal cues better than external in improving gait

Results indicate that internal cueing was associated with improvements in gait velocity, cadence, and stride length in the backward direction, and reduced variability in both forward and backward walking. In comparison, external cueing was
associated with minimal improvement in gait characteristics and a decline in gait stability. People with gait impairment due to aging or neurological decline may benefit more from internal cueing techniques such as singing as compared to external cueing techniques.
Meter and learning (open access article) Both dance and music performers must learn timing patterns (temporal learning, or ‘when‘) along with series of different movements (ordinal learning, or ‘what‘). It has been suggested that the organization of temporal events into regular beat cycles (meter strength) may enhance both temporal and ordinal learning, but empirical evidence is mixed and incomplete. In the present study, we examined meter-strength effects on the concurrent temporal and ordinal learning of sequences. Meter strength enhanced ordinal learning (‘what’) when the concurrent temporal learning was incidental, but it had no effects on temporal learning itself (‘when’). Our findings provide guidelines for dance and music teaching as well as rhythm-based neurological rehabilitation.
 
just catching up on my inbox.
I got rhythm, I got music, and if I quote more than that UMG’s lawyers will probably sue me, too.