Category Archives: Reviews

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

Discrete choice experiment

by

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.

###

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

by

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

###

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

A review on dance and PD

by

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

by

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

###

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

PD Treatment with Cannabis?

by

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…

 

Research, Reviews, Sleep Leave a comment

Just the facts, ma’am

by

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

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

A review of non-traditional treatments for PD

by

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).

 

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

Strength training can help with PD symptoms

by

A review of studies indicates that strength training can help with mild to moderate Parkinson’s cases. (An earlier blog post here noted that a dance training program increased grey matter volume in the brain versus repetitive strength training. So don’t exclude either from your wellness program, is my [non-medical advice).

Review of strength training in people with Parkinson’s Disease

From the abstract:

Objective: To investigate the evidence on efficacy and limits of strength training in rehabilitation of Parkinson’s disease

Method:A comprehensive search on pubmed, clinical keys database using keywords Parkinson’s disease, physical therapy, strength training ,resistance training. The studies including Randomized controlled trails and systematic reviews published since 2005 are reviewed.

Results:36 studies identified through database searching. 25 studies are excluded due to duplicates, irrelevance, based on titles, outcome diversity. 5 systemic reviews and Meta analysis, 6 RCT are included. Review and analysis of articles is going on

Conclusion : The result of this review suggests that strength training program can be effective in people with mild and moderate parkinson’s disease. It can improve functional independency with increased muscle strength, gait parameters, posture and balance, all of these positive role on participation and quality of life

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

Kazoos are good for youse

by

All of the following links have to do with improving voice for PD folks, and also the use of kazoos.

I used to write for this student newspaper:

Music therapy helps tackle Parkinson’s (The Miami Hurricane July 5, 2019)

This is a fairly long honors project paper reviewing voice therapy techniques:

Voice Therapy Techniques in Combination with the Group Therapy Setting for Individuals withParkinson’s Disease

Not necessarily for PD, but the study used spectrographic analysis to measure the improvement in voice in addition to qualitative results.

Finger Kazoo: spectrographic acoustic modifications and vocal self-assessment

I might have already mentioned this in a previous entry, but kazoos were used:

Individual Therapeutic Singing Program for Vocal Quality and Depression in Parkinson’s Disease

Vocal warmups for the individual: Vocal warmups

Vocal warmups for the group: Anatomy of a choral warmup