Johns Hopkins Medicine Scientists Create Nanobody That Can Punch Through Tough Brain Cells And Potentially Treat Parkinsons Disease
What is a nanobody? Click on the download at right to see an infographic that explains the tiny antibody derivative.
Proteins called antibodies help the immune system find and attack foreign pathogens. Mini versions of antibodies, called nanobodies natural compounds in the blood of animals such as llamas and sharks are being studied to treat autoimmune diseases and cancer. Now, Johns Hopkins Medicine researchers have helped develop a nanobody capable of getting through the tough exterior of brain cells and untangling misshapen proteins that lead to Parkinsons disease, Lewy body dementia, and other neurocognitive disorders caused by the damaging protein.
The research, published July 19 in Nature Communications, was a collaboration between Johns Hopkins Medicine researchers, led by Xiaobo Mao, Ph.D., and scientists at the University of Michigan, Ann Arbor. Their aim was to find a new type of treatment that could specifically target the misshapen proteins, called alpha-synuclein, which tend to clump together and gum up the inner workings of brain cells. Emerging evidence has shown that the alpha-synuclein clumps can spread from the gut or nose to the brain, driving the disease progression.
Additional tests in mice showed that the PFFNB2 nanobody cannot prevent alpha-synuclein from collecting into clumps, but it can disrupt and destabilize the structure of existing clumps.
Parkinsons Biomarkers And Early Diagnosis
There are currently no robust biomarkers for Parkinsons disease diagnosis. Dr. Dexter, who was not involved in the current study, believes that better biomarkers could help improve the accuracy of Parkinsons diagnosisgreatly impacting the lives of people who have this disease.
Biomarkers could also be used to identify individuals who are on the pathway to developing Parkinsons in the future. If this can be achieved, novel drug therapies to prevent the loss of dopamine-producing brain cells may be more effective in the earlier stages of the condition, he said.
Dr. de Souza echoed his views, noting that, f they detect the disease early, they could help to start treatment early and improve outcome.
Discussing the future potential and advances that biomarkers for Parkinsons disease could bring, Dr. Dexter noted that Parkinsons affects people in different ways, with some people having a faster rate of progression than others. The structural changes seen in the proteins may have the potential to help us better understand why there is considerable variation in how the condition progresses between individuals.
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Location: Baltimore Mdunited States
Stephen Grill is co-founder of the Parkinsons and Movement Disorders Center of Maryland, a freestanding clinic affiliated with Johns Hopkins University. His research interests concern how use of sensory information and feedback may improve motor functioning in persons with Parkinsons disease and other movement disorders.
He received his PhD in Neuroscience from Northwestern University, Evanston, Illinois, and his MD also from Northwestern University at the Chicago campus. He completed his Neurology Residency at Washington University in St. Louis, Missouri, and a fellowship in Movement Disorders at the Human Motor Control Section of the National Institute of Neurological Disorders and Stroke of the National Institutes of Health, Bethesda, Maryland. Dr. Grill was the recipient of the Dystonia Doctors of Excellence Award in 2003.
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Myth : Deep Brain Stimulation Is Experimental Therapy
Fact: Deep brain stimulation, or DBS, is a procedure in which doctors place electrodes in the brain at the point when medications are less effective in masking motor symptoms, such as tremor, stiffness and slowness of movement.
While it may sound frightening and futuristic, its been around and successfully used for decades. DBS works very similarly to a pacemaker, except the wire is in the brain, not in the heart. Its been a standard procedure for the past two decades.
Coping With Parkinsons Hallucinations
Living with hallucinations is difficult. It can make you question whats real and whats not. It can also cause you to develop mental health conditions such as depression and anxiety. While your healthcare provider is in the best place to provide effective treatment, here are ways you can cope with the pressures of living with Parkinsons hallucinations:
- Talk to your family and friends: Letting the people who are closest to you know whats going on can relieve some of the pressure. When the people around you know whats happening, they are more equipped to support you through hallucination episodes.
- Speak to your healthcare provider often: Keep your healthcare provider updated about changes and developments in your condition. If you have a hallucinatory episode even once, dont dismiss it. Contact your doctor about it immediately. The earlier they are aware, the quicker they can get on top of the situation and provide you with efficient and adequate care.
Hallucinations can also be difficult for a person with Parkinsons carer to manage. Knowing how to manage a hallucinatory episode is crucial as a caretaker of a person with Parkinsons disease.
Invalidating the experience of a person having hallucinations or telling them that what they are experiencing isnt real does very little to help them.
Instead, provide support. If they become stressed, try out calming techniques such as deep breathing exercises to help alleviate their stress.
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Is Parkinsons Disease Exclusion Diagnosis
There is currently no cure for Parkinsons disease, and the cause of the condition is unknown. There is no definitive test for Parkinsons disease, and the diagnosis is typically made based on a review of the persons medical history and symptoms. There is no exclusion diagnosis for Parkinsons disease.
A large number of Parkinsons disease patients are diagnosed with the disease and then have an incorrect diagnosis confirmed through necropsy. Some 15% of patients who have Parkinsons disease do not meet the strict clinical criteria that are required for the condition. A little over 20% of people who have received medical attention for this condition have not been diagnosed with it. Patients diagnosed with Parkinsons disease have a different diagnosis in up to 5% of cases, according to pathological findings. Using strict published criteria and follow-up, we aimed to identify as many patients as possible from an unselected primary care population and compare their existing diagnosis to that of an expert. A patient with tremor who began before the age of 50 was excluded if he or she had benign essential tremor. Patients with Parkinsonism who only have tremor and no other neurological symptoms are thought to have very low chances of being lost.
Myth : Parkinsons Disease Is Fatal
Fact: Although a diagnosis of Parkinsons is devastating, it is not as some people may still believe a death sentence. Parkinsons disease is not a direct killer, like stroke or heart attack. That said, much depends on the quality of your care, both from your medical team and yourself.
As the disease progresses, you may become more vulnerable to falls, which can be dangerous. Thats why exercise and physical therapy are so important.
Infection is another problem. In later stages of Parkinsons, people often miss those signals and may not notice somethings up until its too late. That can be, literally, a killer so be sure to stay up to date with checkups.
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A Multidisciplinary Approach To Care
Parkinsons disease is a condition that can affect different aspects of your life, including mobility, mood, and sleep. We work with a highly trained and dedicated team of specialists that are all focused on helping you live better with Parkinsons disease.
- A Nurse can help your physician provide you the best care and address concerns about medications and other Parkinsons-related symptoms.
- A Physical Therapist can evaluate and treat you to optimize your mobility, physical activity, and safety.
- An Occupational Therapist can help you stay active and independent in your daily activities.
- A Speech Therapist can evaluate you and provide recommendations and treatment if Parkinsons is affecting your speech or swallowing.
- A Social Worker can answer your questions and provide counseling about life transitions, options if you need help with your care, and financial and work-related issues.
- A Spiritual Care Provider can offer support and facilitate positive spiritual coping if you are struggling with your illness.
You have changed my life. I started using the MGH PD Exercise videos on New Year’s Day and have exercised every day since then even when I got my first COVID vaccine jab and had a very sore arm. Now, I actually look forward to my exercise sessions with you… I am stronger, more flexible, have better stamina and am healthier both physically and emotionally because of your work.
- Medication-induced movement disorders
Myth : Parkinsons Medications Cause Symptoms
Fact: Even though the myth that Parkinsons disease medicines are toxic and make the condition progress faster was completely debunked, it persists. Levodopa is the main drug therapy for Parkinsons disease. Its a potent drug that helps patients with motor symptoms. But many people got the idea that over time, it makes the disease progress faster. The myth was that levodopa is somehow toxic and is somehow making the Parkinsons progression faster, hurting patients.
This misconception was debunked decades ago with a large clinical trial, where it was found that people exposed to levodopa versus a placebo werent worse. In fact, they were better at the end of the .
Its true that levodopa isnt a cure as yet, there is no cure for Parkinsons disease but its not toxic.
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What My Sister And I Looked For In A Top Parkinsons Center
How do I know that my family members are receiving the best care for their Parkinsons disease ? What criteria should I consider when choosing a disease management strategy?
Given my nursing background, I asked myself these questions when my sister, Bev, was diagnosed with PD in 2017. Fortunately, Bev, who was also a nurse, lived near Cleveland, Ohio, and I had grown up in that same suburb.
We were aware of the two medical center giants in Cleveland healthcare: the Cleveland Clinic and the University Hospitals Cleveland Medical Center. Before my move to sunny Arizona, I worked at both organizations cancer centers as the director of cancer communications and community outreach.
Neurology Clinical And Academic Programs
Parkinson’s disease is the second most common brain degenerative disorder in the United States after Alzheimer’s disease. It is no respecter of persons, young or old, various races, genders, occupations, or other factors that distinguish us as individuals. It has impacted the lives of famous people such as baseball star Kirk Gibson, singer and songwriter Neil Diamond, former Attorney General Janet Reno, actor Michael J. Fox, boxer Muhammed Ali, singer and songwriter Linda Ronstadt, and actor Alan Alda. It is estimated that over 1 million people are living with Parkinson’s disease in the United States now and that number is expected to double in the next 10 to 15 years.
THE PARKINSON’S DISEASE AND MOVEMENT DISORDER PROGRAM
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Nikki Artiaga, BSW, LSW
Lisa Kosier, RN, Clinical Nurse
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The PDMDP works in close affiliation with the Parkinson Foundation of Northwest Ohio. Website: WWW.PFNWO.ORG
Research and Education
The annual PD educational conference, now in its 22nd year has featured national speakers such as the former attorney general, Janet Reno, and Rasheda Ali, daughter of Muhammad Ali. This conference is held in collaboration with the Parkinson Foundation of Northwest Ohio.
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Myth : Aside From Medication There Isnt Much You Can Do
Fact: This it is what it is theres nothing I can do to help myself myth is counterproductive. There is a lot you can do chiefly, keeping as active as you can. A recent study found that patients with Parkinsons who took part in weekly, hourlong exercise sessions were able to do more in their daily lives than those who did not.
Surgery For People With Parkinsons Disease
Deep brain stimulation surgery is an option to treat Parkinsons disease symptoms, but it is not suitable for everyone. There are strict criteria and guidelines on who can be a candidate for surgery, and this is something that only your doctor and you can decide. Surgery may be considered early or late in the progression of Parkinsons.
When performing deep-brain stimulation surgery, the surgeon places an electrode in the part of the brain most effected by Parkinsons disease. Electrical impulses are introduced to the brain, which has the effect of normalising the brains electrical activity reducing the symptoms of Parkinsons disease. The electrical impulse is introduced using a pacemaker-like device called a stimulator.
Thalamotomy and pallidotomy are operations where the surgeon makes an incision on part of the brain. These surgeries aim to alleviate some forms of tremor or unusual movement, but they are rarely performed now.
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Research & Clinical Trials
Our team of physicians is actively involved in research to better understand the causes of Parkinsons disease and to identify new treatments. Since 2013, MGH has been the home to the Parkinson Study Group, the largest not-for-profit network of Parkinsons centers in North America. As a patient, you may have the opportunity to participate in:
- Clinical trials for new investigational drugs
- Research studies to find new and better ways to diagnose and monitor Parkinsons disease
- Studies that improve delivery and quality of care for Parkinsons patients
If you are interested in volunteering for research, please ask to speak with a research coordinator or browse our list of movement disorders clinical trials.
Are You Living With A Neurological Condition Physical Therapy Can Help
The goal of physical therapy for neurological disorders is to restore as much function as possible, in order to help you regain independence and move freely.
The physical therapists at NY Physical Therapy & Wellness are specialized in the treatment of patients who suffer from movement difficulties, either due to an injury or ailment surrounding the nervous system.
We can help you find comfort in the fact that you will be receiving treatment from experts in the field. Our specialists will assess your situation and develop the best plan of care for your needs. For more information on how our physical therapy services can benefit you and help you reclaim your life from Neurological Disorders, request an appointment today!
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Testing For Parkinsons Disease
There is no lab or imaging test that is recommended or definitive for Parkinsons disease. However, in 2011, the U.S. Food and Drug Administration approved an imaging scan called the DaTscan. This technique allows doctors to see detailed pictures of the brains dopamine system.
A DaTscan involves an injection of a small amount of a radioactive drug and a machine called a single-photon emission computed tomography scanner, similar to an MRI.
The drug binds to dopamine transmitters in the brain, showing where in the brain dopaminergic neurons are.
The results of a DaTscan cant show that you have Parkinsons, but they can help your doctor confirm a diagnosis or rule out a Parkinsons mimic.
Treatment For Parkinsons Hallucinations
Treatment for Parkinsons hallucinations depends on what is causing the hallucinations. Here are treatment approaches considered for the management of Parkinsons hallucinations.
- Hallucinations induced by medication: For people who experience Parkinsons hallucinations as a result of medication, your doctor may tweak your dose in hopes that it can stop the side effect. High dosages of certain medications can cause Parkinsons hallucinations.
- Other co-occurring conditions: If you begin to experience hallucinations in the early stages of Parkinsons disease, your doctor will put you through a series of tests to rule out other co-occurring conditions. Dementia which commonly co-occurs with Parkinsons disease can cause hallucinations.
- Medical intervention: In severe cases where hallucinations inhibit a persons quality of life, medication may be prescribed to help reduce their severity and occurrence. Antipsychotic drugs are most commonly used to manage symptoms of hallucinations. However, they have bothersome side effects such as cognitive and motor decline. Your doctor will make the call on whether living with these side effects outweighs your need for the medication. In 2016, the FDA approved a medication called Nuplazid , specifically formulated to treat symptoms of hallucinations and delusions in people with Parkinsons disease.
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Myth : Parkinsons Research Is Stalled
Fact: It may feel as though theres nothing dramatic going on in the Parkinsons disease field, but there are several recent and very exciting breakthroughs regarding our understanding of the underlying pathology and disease mechanism. This will translate into actual clinical results in the next few years.
Q& a With Parkinsons Foundation Ceo And President John L Lehr
Gratefully, Bev was referred by her excellent primary care physician to the Cleveland Clinics Center for Neurological Restoration, which is dedicated to the medical and surgical management of movement disorders, including essential tremor, PD, and other neurological disorders. It is also designated as a Parkinsons Foundation Center of Excellence.
This designation means that the medical center has a specialized team of neurologists, movement disorder specialists, physical and occupational therapists, mental health professionals, and others who are current on the latest PD medications, treatments, and research to provide the best possible care for individuals with PD.
Bev and I both knew that her diagnosis would require a team of skilled healthcare professionals working with Bev and her caregivers. We wanted to make sure that the team specialized in PD and other movement disorders versus general therapies for all diseases.
The Johns Hopkins Parkinsons Disease and Movement Disorders Center recommends that a persons PD healthcare team include a neurologist, occupational therapist, physical therapist, speech therapist, mental health provider, case manager/social worker, and others who will play a role when needed. Bevs team at the Cleveland Clinic included all of these healthcare professionals.
After dealing with Bevs PD over the past four years, she and I can offer the following tips on what to look for in a top medical center:
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