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

Keep on Dancing, folks!

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Conclusions first:

Conclusions
This study highlighted the challenges associated with the feasibility of using an RCT design in this setting, demonstrated the acceptability of implementing a dance program inspired by the Dance for PD® model in Belfast, Northern Ireland for people living with Parkinson’s, and made suggestions for future research. The results support existing evidence demonstrating that dance may improve functional mobility and symptoms of depression in people living with mild to moderate Parkinson’s, though these findings should be carefully interpreted in the context of the study design and limitations. The small sample size limits the generalizability of the statistical results, though it was not among the aims of this study to test the efficacy of the intervention. The findings also support the idea that meeting and dancing with other people living with Parkinson’s is motivating and fosters a sense of belonging, and that dancing has the potential to support several aspects of physical, emotional, mental, and social health. (emphasis added).

Working back in the article, the authors are very honest about the limitations, including not being able to  establish a large enough group of participants so that they might be able to compare the dance intervention against another form of exercise.

Only ten Parkinson’s Disease diagnosed participants were recruited, which makes generalization difficult, but modest improvements were seen. (I saw no mention of statistically significant results in the 12 week, 20 session study). Some participants noted that the dance intervention made them more aware of certain deficits, such as posture, and that the classes motivated them to make more mindful efforts to correct these outside of the classes.

Some participants also described using tools learned in class in everyday life. For example, one participant reported using breathing exercises when anxious or fatigued, and another reported using the warm-up exercises outside of class to “stop the stiffness” and “feel better as a result of that. (emphasis added).

So: Small number of participants. Some improved scores, but no statistically significant differences. Positive statements from exit interviews. Nothing to contradict other evidence that dance interventions have a positive effect on the lives of people with Parkinson’s Disease.

Don’t stop moving to the music / keep on dancing,  folks

The article is open access and may be downloaded for free at:

Evaluating the effects of dance on motor outcomes…

Citation for this article:

Carapellotti, A.M., Rodger, M. & Doumas, M. Evaluating the effects of dance on motor outcomes, non-motor outcomes, and quality of life in people living with Parkinson’s: a feasibility study. Pilot Feasibility Stud 8, 36 (2022). https://doi.org/10.1186/s40814-022-00982-9

Parkinson's, Research , 1 Comment

Participants needed for Narrative Study in Parkinson’s Disease – study starts February 26, 2022

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Robert Cochrane is recruiting participants for a new Parkinson’s Disease study. See below. Note the three categories of PD people needed:
” We are recruiting male and female persons diagnosed with idiopathic (unknown cause) Parkinson’s disease between and fit ONE of the following criteria:
– They have been diagnosed within the last year,
– are early onset (diagnosed before the age of 50)
– are active or former members of the U.S. military. “”
Here’s the full recruitment flyer:
Participants needed for Narrative Study in Parkinson’s Disease Principal Investigator, Dr. Gabriele Wulf, and Robert Cochrane, PhD student at UNLV, are looking for persons with Parkinson’s disease to participate in an online research study of heroic narrative upon Parkinson’s disease. Study participants will be asked to share their perceptions and experiences about Parkinson’s from the time they were diagnosed to today, and how they feel about their future quality of life expectations. They will be taught heroic storytelling structure and practical tools of how to explore and incorporate it into their own lives. Heroic storytelling is based on the works of Joseph Campbell’s monomyth. Campbell’s work is broken into a 12-step journey for this class that participants will follow and use to write their own heroic journey with Parkinson’s disease. Participation in this study will require completion of 12 sessions, meeting once a week on Saturday mornings from 9a-10:30a (Pacific Time). Participants Will also be required to write a one-page personal assessment each week outside of class. Finally,online surveys at the beginning, middle and end of the 12-session period will be required. All sessions will take place online via Zoom. All sessions will be recorded. Participants must have a WiFi enabled device in a safe location (e.g. participants’ home) for these sessions. Sessions will include writing, theatrical improvisation and lectures from guest subject matter experts in fields such as dance, art and mythology. We are recruiting male and female persons diagnosed with idiopathic (unknown cause) Parkinson’s disease between and fit ONE of the following criteria:
– They have been diagnosed within the last year,
– are early onset (diagnosed before the age of 50)
– are active or former members of the U.S. military. Participants must be between 1-3 on the Hoehn and Yahr scale. This assessment should be given by participants’ neurologist or movement disorder specialist prior to acceptance into the program. We cannot accept persons who have an inability to communicate verbally, are uncomfortable writing, or are unable using the Zoom platform. Please email Robert Cochrane at cochra58@unlv.nevada.edu with questions or to express your interest in participating.This program was made possible, in part, by a grant from the Parkinson’s Foundation. Thank you!
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January 2022: different state, same natives, other different plants

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Raccoon

In January 2022, made my first trip out of state of TX to sometime sunny North Central Florida. since the pandemic. Checked the CDC Covid alert, and found that all of the counties we would be going to were rated at the highest level as a hot spot. So it was like going from the frying pan into the fire. Fortunately we had our HazMat gear on hand, and managed to go to and fro without (apparently) contracting any viral infections, according to the Covid-19 15 minute results tests.

After landing in Florida, saw some species familiar in central Texas. Also saw a few that were not familiar.

2022-01-15-003574

Mistletoe, a parasite in Texas, also thrives in Florida.

2022-01-17-003660-raccoon

This little critter was pointed out to me by a gentleman in a parking lot. Apparently It had been looking for tasty morsels in the large garbage bins, and was unable to get out on its own. Hopefully, someone gave him or her a ramp  to get out of the bin before the next garbage pickup.

2022-01-17-003640

I believe that this was a Yaupon Holly, or a cultivated variation thereof, as it was in the same parking lot as the raccoon. Could have been Ilex decidua, and just not dropped its leaves yet, due to a shorter Fall and Winter in Florida (if there is one). As a cultivated/planted plant, I didn’t bother to check it in iNaturalist.org.

2022-01-17-003643

Spanish Moss

I suppose there is Spanish Moss in abundance in South and Gulf Coast Texas, but what we see here is mostly Ball Moss. So this was a distinctive and omnipresent reminder that we weren’t in the Greater Austin Metro Area anymore. (Of course, there were lots of Southern Oaks present, from which the Spanish Moss was hanging. We have them here, though other oak species are more common in Central TX.

A new one to me was this interesting little reddish plant. common name Tassel Plant. After encountering this one in the motel parking lot, I began to notice them all over Gainesville. An exotic or introduced plant.

Found in many places in the Gainesville area. An exotic or introduced plant

Tassel Plant

Finally, a fern which I had not yet known the name of A fern with the aptly descriptive common name of “Fishbone Fern.” This was shot in the jungle-like surroundings of Bivens Arm Nature Park on the South side of Gainesville, just north of Paynes Prairie. This photo  (below) was chosen because it demonstrates the leaf pattern that gives the fern its name.

2022-01-18-003708-fishbonefern

Though it was nice to go “home”again, it was also nice to get back “home” again.

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#nativeplants #Texas #Florida #GainesvilleFlorida

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

Keep on moving to (and making) music

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The evidence that rhythm, movement, and making music continues to accumulate as a therapeutic approach to address the symptoms and Quality of Life issues related to Parkinson’s Disease (PD).

Today we look at an article just out in Frontiers of Human Neuroscience, titled

Rhythm and Music-Based Interventions in Motor Rehabilitation: Current Evidence and Future Perspectives  

Over the last quarter of a century, increasing research results point to rhythm and music as effective and useful tools for treatment and rehabilitation of people with neurological disorders. This article reviews the evidence for four different approaches, what the consensus is at the present time, and, of course, suggests future directions.

The authors look at four different approaches:

  1. Rhythmic Auditory Stimulation (RAS)
  2. Music-Supported Therapy (MST)
  3. Therapeutic Instrumental Music Performance therapy (TIMP) and
  4. Patterned Sensory Enhancement (PSE)

The consensus of recent meta-analyses and systematic reviews is that, for Parkinson’s Disease (PD), is that RAS is an effective tool for improving gait, stride, and speed – folks walk faster and with longer steps with RAS. Additionally, evidence is showing that it also reduces freezing of gait (FOG), improves balance and reduces the occurrence of falls.

Neither MST nor TIMP have been studied much beyond the rehabilitation of stroke patients. They involve practicing on a keyboard or drums, beginning with the patient’s comfort level and increasing in difficulty. Some studies have begun to be used to investigate effectiveness as treatments for PD.  Some have shown improvements in motor dexterity. More research is needed, but in the meantime, learning to play drums or keyboards can’t hurt, and may enrich one’s quality of life (QOL).

Growing evidence in neurological and brain imaging have shown increased activity in the auditory and motor areas of the brain, indicating that brain plasticity might be achieved through music and rhythmic interventions. The authors note that RAS has been well studied with stroke and PD populations, but not with other movement disorders and Alzheimer’s populations. In addition MST and TIMP have only begun to be investigated as a means of restoring fine motor coordination.

The authors also call for neuroimaging use in studies, to better understand the physiological basis of the rehabilitation process. They point out the gaps in research and hope to provide a framework for future research – not so much a roadmap, I would think, but a laying out of what we know and what we don’t know, and what kinds of studies are needed to answer the questions about what we don’t know..  They state that “musical rhythm is a powerful tool” for therapy, and our understanding and exploration of how it modulates brain networks is in the initial stages.

 In other words, “We’ve only just begun.”

Meanwhile: Don’t stop moving to the music.

 

Citation:
Braun Janzen T, Koshimori Y, Richard NM and Thaut MH (2022) Rhythm and Music-Based Interventions in Motor Rehabilitation: Current Evidence and Future Perspectives. Front. Hum. Neurosci. 15:789467. doi: 10.3389/fnhum.2021.78946

 

biodiversity,, Drought resistant, gardening, insects, pollinators, shrubs , , Leave a comment

What’s in bloom in December?

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Just a look at the most recent shots:

Dalea greggii – Gregg’s Dalea – click image for larger size
Sonchus sp. – Sow Thistle – click image for detail
Horsemint – click image for detail
Opuntia engelmannii – Prickly Pear (click for detail)

Taken on December 1, 2021. Since March 27, I have seen and photographed at least one Monarch Butterfly in each of the following months in 2021. And that just doesn’t seem right…

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

RBD and other things PD-related

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Diagnosis of PD is often not made until a person is in their 60s. With all the attention that has been focused on the disease(s) in the last 20 years or so, I suspect that more people are getting diagnosed at an earlier age, although most cases of young onset PD are likely to be genetic in origin.

However, an “early” diagnosis may not be a timely diagnosis, as  the title of one opinion piece I read some time ago said (see link below).

It is now becoming apparent that “Parkinson’s”includes several categories of symptoms, not just rigidity, tremors, and gait, as shown in the table below::

Source for the following table, accessed 11/28/2021:  URL=https://www.frontiersin.org/article/10.3389/fneur.2020.00686

The problem is that treatment and diagnosis are often delayed until PD has already reduced Quality of Life for many folks.

Good evidence for the quality-of-life benefits of existing symptomatic treatment supports the argument for earlier diagnosis at a time when symptoms are already present (emphasis added). This argument would be significantly bolstered by the development of disease-modifying treatments. Benefits of early diagnosis and treatment would affect not only the individual (and their families) but also the wider society and the research community. Ultimately, however, shared decision-making and the principles of autonomy, beneficence, and non-maleficence will need to be applied on an individual basis when considering a “timely” diagnosis.

Therefore, the earlier one can predict the probability or inevitability of PD the sooner one can use treatments – whether pharmacological, surgical, nutritional, or lifestyle in nature – that can either reduce, delay, or defer (and possibly reverse?) the symptoms of PD.

Of all the symptoms associated with PD: tremors, bradykinesia, depression & anxiety, posture, gait issues (difficulties walking), REM Sleep Behavior Disorder (RBD), anosmia (loss of ability to smell), cognitive issues, facial masking, and micrographia (small handwriting) – RBD is the one which is most highly predictive of a later PD diagnosis.

The predictive ‘specificity’ is so strong that if someone has RBD, the chance of being diagnosed with Parkinson’s or related conditions over the next 15 years or more is over 80%

If an 18-21 year old person walked into a physician’s office with RBD, essential tremors, and depression as main symptoms, what would happen? In 1970, probably nothing – one might get treated for depression, but essential tremors are also called “benign”tremors, and were ignored, even if the patient reported being able to feel the tremors while resting, though invisible to the external observer. As for RBD, it would probably also be ignored.

By “a physician,” we are talking about a General Practitioner, or “family doctor,” and not s specialist like a  Movement Disorders Specialist who would be trained to identify varied symptoms, including those that are prodromal. And, of course, the identification of prodromal symptoms has only been investigated within the last decade or so, and are identified as for “research only” purposes – not for clinical diagnosis. A recent survey article (not referenced below) indicated that a majority of general practitioners were either unaware of the Movement Disorders Society’s list of prodromal symptoms, or were not using them to make referrals to Movement Disorders Specialists.

But thanks to the dedication and generosity of folks like Michael J. Fox and others, PD has become a respectable disease for which the person who has it has no reason to be apologetic or ashamed, and can hold their head up (and they ought to, since one symptom is to walk with shoulders stooped down) and proudly proclaim that they have Parkinson’s, which is why they walk funny. And so it goes.

Articles that were quoted above or which contributed to this article are found in the links below.

But first:

I See The Signs of PD

Perspective: Current Pitfalls in the Search for Future Treatments and Prevention of Parkinson’s Disease

An early diagnosis is not the same as a timely diagnosis of Parkinson’s disease

Prodromal REM Sleep Behavior Disorder and PD

10 Early Signs of Parkinson’s Disease / Parkinson’s Foundation

REM Sleep Behavior and Motor Findings in Parkinson’s Disease: A Cross-sectional Analysis

Current Update on Clinically Relevant Sleep Issues in Parkinson’s Disease: A Narrative Review

The prodromes of Parkinson’s disease

Exercise-Induced Neuroprotection of the Nigrostriatal Dopamine System in Parkinson’s Disease

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Agalinis species found on my way to cast my ballot . . .

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Agalinis strictifolia

November 2nd, 2021, was a primary election day where I live. I decided to carry my camera in order to get some better photos of the first species shown below. Good enough for positive identification, if nothing else. On the other side of the draw, along the actual hike and dog walk bathroom trail, found a different set of Agalinis species. Plus other stuff, which I might post later. The Agalinis species are also known by the common name of “False Foxgloves” due to their resemblance to the “True” Foxgloves, one might suppose.

Agalinis in bloom and gone to seed on Election day:

Agalinis heterophylla

Agalinis heterophylla

and, not so far away,  Agalinis strictifolia:

Agalinis strictifolia

Agalinis sstrictifolia

I had a difficult time making the correct identification,  but thanks to the good-hearted folks on iNaturalist.org. I was able to get through my confusion and agree to the IDs they made from my numerous photos. Next year, I won’t wait until November to look for these. And hopefully, will be able to identify which Agalinis is which, using the field guides and other materials available.

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Old man’s beard

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Last September, the bulldozers came and razed a 19 acre plot of land that was for sale. Along with it went any number of wildflowers, including a healthy stand of Old Man’s Beard, aka Texas Virgin’s Bower, and other native and a few invasive plants.

recently I came upon a female C. drummondii wending its way through some planted holly (most likely a non-native variety), catching the November sun in feathery achenes. 

birds, exotics, gardening, native plants, pollinators , , Leave a comment

A possible explanation to Monarchs’ dallying around Texas this year

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This article came up in my newsfeed recently,.

It suggests  why some Monarch butterflies seem to be hanging around Texas this year – the popularity of Tropical milkweed (Asclepias curassavica). The article further goes on to explain that

” Tropical milkweed becomes a problem when planted in temperate areas where it does not die back in winter. A protozoan parasite of monarch butterflies, Ophryocystis elektroscirrha or OE for short, can travel with monarchs visiting the plants and become deposited on leaves. When caterpillars hatch and start eating the plant, they ingest the OE. High OE levels in adult monarchs have been linked to lower migration success in the eastern monarch population, as well as reductions in body mass, lifespan, mating success, and flight ability.”

Milkweeds native to the region die back after blooming, and with them, the OE. Thus each new flight of Monarchs gets to lay their eggs on new, uninfected milkweeds.

Interestingly, the article was written over three years ago…

Tropical Milkweed is a No-Grow – by the Xerxes Society

On the other hand, I have now seen and photographed Monarchs in my backyard from late March through November . I went to vote  on Tuesday, November ,2, and  observed more than a few Monarch butterflies, both in the greenbelt and in the demonstration garden. Sadly,  many of the flowers being used didn’t appear to be natives.  I also noticed that the milkweeds at the community center garden appear to be Tropical milkweed. (They have yellow flowers instead of orange flowers).

Some plants and wildlife in October:

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Can Parkinson’s be predicted using Artificial Intelligence (AI)??

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Today we take a look at a review of other papers (a way to get a paper published without having to do any actual research yourself, and the drudge work can be delegated to grad students, someone once told me), but nevertheless, there’s much to be learned from looking at the big picture instead of focusing on individual studies, so we’ll forge ahead. Next article will be on rehabilitation therapies that address motor and cognitive issues in PD.

Interestingly enough, this article comes from Indonesian Journal of Electrical Engineering and Computer Science – not the first place you’d probably look for information n Parkinson’s (PD). And, unless you’re a computer science major or are developing applications using AI, I wouldn’t recommend looking this one up.

Most of the studies reviewed used various techniques to analyze datasets of speech recordings, and tried to differentiate between “healthy”people and people with PD. Some of the approaches were fairly accurate (in the 90% plus range) while others were not that much better than reliance on the four cardinal symptoms to be observed clinically (resting tremor, rigidity, bradykinesia and postural instability). 

This one will either be good reading before going to sleep (unless you’re into neural networks and Bayesian prediction) or a good way to induce a headache. The authors do call for more research (naturally) in this area, especially in regard to developing biomarkers using either neuro-imaging or biofluids. And they note that fine-tuning of biomarkers must be  done, so that there is an acceptable balance between false positives and false negatives in predicting whether a person will likely get PD in the near or distant future.

Citation for this is:

A comparative and comprehensive study of prediction of Parkinson’s Disease, (2021) Pandi, V., et al., Indonesian Journal of Electrical Engineering and Computer Systems, vol. 23, No. 2, September 21, pp. 1748-1760.

It’s an open access article, so if you are interested in computer systems. go ahead and search for it.