New approach – direct brain infusions to regrow dopaminergic neural cells

This approach might help, but apparently it will take about 18 months to get results in moderately advanced cases. (emphasis added to abstract below).

One wonders whether complementary therapeutic treatments (exercise, dance (movement + rhythm), singing, or music instrument training were being used by any of the participants, or whether this was the only treatment these subjects were using during this time. Certainly worth trying this in combination with other, non-invasive treatments (says the cyborg with electrodes stimulating the subthalamus nigra substantia).

Journal of Parkinson’s Disease research pre-press

Abstract.
Background: Intraputamenal glial cell line-derived neurotrophic factor (GDNF), administered every 4 weeks to patients with moderately advanced Parkinson’s disease, did not show significant clinical improvements against placebo at 40 weeks,
although it significantly increased [18F]DOPA uptake throughout the entire putamen.
Objective: This open-label extension study explored the effects of continued (prior GDNF patients) or new (prior placebo patients) exposure to GDNF for another 40 weeks.
Methods: Using the infusion protocol of the parent study, all patients received GDNF without disclosing prior treatment allocations (GDNF or placebo). The primary outcome was the percentage change from baseline to Week 80 in the OFF state
Unified Parkinson’s Disease Rating Scale (UPDRS) motor score.
Results: All 41 parent study participants were enrolled. The primary outcome decreased by 26.7 ± 20.7% in patients on GDNF for 80 weeks (GDNF/GDNF; N = 21) and 27.6 ± 23.6% in patients on placebo for 40 weeks followed by GDNF for 40 weeks
(placebo/GDNF, N = 20; least squares mean difference: 0.4%, 95% CI: –13.9, 14.6, p = 0.96). Secondary endpoints did not show significant differences between the groups at Week 80 either. Prespecified comparisons between GDNF/GDNF at Week 80 and placebo/GDNF at Week 40 showed significant differences for mean OFF state UPDRS motor (–9.6 ± 6.7 vs. –3.8 ± 4.2 points, p = 0.0108) and activities of daily living score (–6.9 ± 5.5 vs. –1.0 ± 3.7 points, p = 0.0003). No treatment-emergent safety concerns were identified.

Conclusions: The aggregate study results, from the parent and open-label extension suggest that future testing with GDNF will likely require an 80- rather than a 40-week randomized treatment period and/or a higher dose.

Might mitophagy be enlisted in the fight against Parkinson’s?

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.

 

Exergame based therapy and other stuff

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

 

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

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.

Management of sleep disturbances in PD – review and consensus recommendations

Just in: a review of sleep disturbances and treatments for PD patients.

I’ve been having trouble getting a full night’s sleep the last few days. Could be due to any number of reasons.

Early this morning, received this review on sleep disturbances in patients with PD, It covers Insomnia, Restless legs, REM Sleep Disorder and obstructive sleep apnea types of sleep disturbances, Could be useful to print out and share with your physician to make sure you are on the most effective regimen: Note the 4 tables that accompany the article.

http://www.cmj.org/article.asp?issn=0366-6999;year=2018;volume=131;issue=24;spage=2976;epage=2985;aulast=Liu

Amyloid-Beta and Parkinson’s Disease

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.