Tuesday, November 22, 2022

Parkinson’s Disease Slow Progression

Tips For Living Well With Parkinsons Disease In 2022

Can you help slow the progression of Parkinson’s?

This is a self-reported questionnaire, designed for people older than 65, and assesses overall physical activity, including leisure activities such as walking and biking, household activities like gardening, and occupational pursuits, which includes taking care of others. It uses the intensity, frequency, and duration of physical activity over the prior week to calculate the total PASE score, ranging from zero to 793, with higher scores indicating more physical activity.

Motor function was evaluated using part III of the Movement Disorder Society Unified Parkinsons Disease Rating Scale . Each parameter is scored from zero to four, and higher scores indicate more severe impairment. Here, such function was evaluated during patients off times, or periods of time when levodopa medication wears off and motor symptoms re-appear.

Standard cognitive tests were used to assess the participants verbal and memory skills , and the time needed to complete mental tasks .

Participants in the trial were followed for up to six years.

Researchers observed that the Parkinsons patients despite showing significantly greater motor and cognitive impairments compared with the controls at the start of the trial had similar levels of regular physical activity, including of moderate to vigorous exercise, relative to the healthy volunteers.

Best of all, exercise is low cost and has few side effects, he added.

What Tests Will Be Done To Diagnose This Condition

When healthcare providers suspect Parkinsons disease or need to rule out other conditions, various imaging and diagnostic tests are possible. These include:

New lab tests are possible

Researchers have found possible ways to test for possible indicators or Parkinsons disease. Both of these new tests involve the alpha-synuclein protein but test for it in new, unusual ways. While these tests cant tell you what conditions you have because of misfolded alpha-synuclein proteins, that information can still help your provider make a diagnosis.

The two tests use the following methods.

  • Spinal tap. One of these tests looks for misfolded alpha-synuclein proteins in cerebrospinal fluid, which is the fluid that surrounds your brain and spinal cord. This test involves a spinal tap , where a healthcare provider inserts a needle into your spinal canal to collect some cerebrospinal fluid for testing.
  • Skin biopsy. Another possible test involves a biopsy of surface nerve tissue. A biopsy includes collecting a small sample of your skin, including the nerves in the skin. The samples come from a spot on your back and two spots on your leg. Analyzing the samples can help determine if your alpha-synuclein has a certain kind of malfunction that could increase the risk of developing Parkinsons disease.

Symptoms And Warning Signs

Symptoms of Parkinsons fall into two major categories: those related to motor functions, and those related to changes in someones mood. The four most common signs and symptoms of Parkinsons disease include:

  • Trembling: This usually presents itself in the arms, jaw, legs and face.
  • Rigidity: Most patients experience stiffness of the bodys core as well as their arms and legs.
  • Bradykinesia: This is the term for slowness of movement. Some patients pause or freeze when moving without being able to start again, and others begin to shuffle when trying to walk.
  • Postural instability : This results in loss of strength, loss of balance and problems with moving muscles or coordinating body parts.

Other symptoms that can also occur, which often impact someones moods and other behaviors, include:

  • Sexual dysfunction

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Reprogramming For Compound Validation

Since their initial work focused on patients skin cells, the team needed to validate their findings in dopaminergic brain cells, which are lost in Parkinsons. This can be particularly challenging because we cant easily take a brain biopsy from a patient, says Dr Mortiboys. The team therefore used a reprogramming technique utilising the patients skin cells to generate induced neuronal progenitor cells. We used a slightly modified protocol, which doesnt take the cells all the way back to being stem cells, explains Dr Mortiboys. Our method takes them to an intermediate, which can only become brain cell types. Crucially for us, it doesnt take them back to the embryonic state. The reason for this is that age is one of the biggest risk factors for Parkinsons and many other neurodegenerative conditions. We didnt want to wipe all the age-associated changes in the cell so, with this reprogramming technique, we retained the changes that had happened throughout the cells lifetime while still producing a high percentage of dopaminergic cells.

Once these cells had been cultured, the team studied their mitochondrial function and observed that they were far more defective in the patients brain cells than in their skin cells. This showed us that it did matter which cells we were looking at it really was a problem with the mitochondria in the dopaminergic brain cells, explained Dr Mortiboys.

What You Can Do

Parkinsons Disease

As of 2021, there is no definite cure for Parkinsons disease. There is also no definite known cause. Its likely due to a combination of an individuals susceptibility and environmental factors. Most cases of Parkinsons disease happen without a genetic link.

According to research published in 2012, only report having a family member with the disease. Many toxins are suspected and have been studied, but no single substance can be reliably linked to Parkinsons.

However, research is ongoing. Its estimated that

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How Do Symptoms Progress

The most common symptoms of Parkinson’s are tremor, rigidity and slowness of movement.

Not everyone with Parkinson’s experiences the same combination of symptoms they vary from person to person.

Also, how Parkinson’s affects someone can change from day to day, and even from hour to hour. Symptoms that may be noticeable one day may not be a problem the next.

Many of the symptoms can be treated or managed with medication and therapies.

Many people with Parkinson’s lead active and fulfilling lives. An important part of coping with Parkinson’s is understanding how it affects you and how to work around it.

It may not always be easy to maintain a positive outlook, especially immediately after diagnosis. But we can give you help and support.

What Is The New Breakthrough For Parkinson’s Disease

Scientists have made a breakthrough in the development of a nasal spray for Parkinson’s disease treatment. Researchers from the University of York have developed a new gel that can adhere to tissue inside the nose alongside the drug levodopa, helping deliver Parkinson’s disease treatment directly to the brain.

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Theory Of Pd Progression: Braaks Hypothesis

Researchers believe a combination of genetic and environmental factors cause Parkinsons. In 2003, Heiko Braak, MD, hypothesized that an unknown pathogen in the gut could be the cause of PD.

This was followed by a more extensive hypothesis, stating that PD starts in two places: the neurons of the nasal cavity and the neurons in the gut. This is now known as Braaks hypothesis. In this theory, the pathogen enters the body via the nose and/or gets swallowed and reaches the gut. The pathogenic products thus come into contact with the olfactory and/or enteric neurons, triggering the aggregation of an abnormal protein called -Synuclein. The aggregated -Synuclein then spreads toward the central nervous system , and eventually arriving in and causing the degeneration of the dopaminergic neurons in the area of the brain called the substantia nigra.

This theory is supported by evidence that non-movement symptoms, such as a loss of sense of smell, sleep disorders and constipation, may appear several years ahead of movement symptoms. For this reason, researchers focus on these non-motor symptoms to detect PD as early as possible and to look for ways to stop its progression.

Page reviewed by Dr. Jun Yu, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.

Parkinson’s Disease Symptoms: Life Expectancy

Slowing the Progression of Parkinson’s Disease (PD): The Hype and the Hope

Even though Parkinson’s disease is a serious, progressive condition, it is not considered a fatal illness. People who have Parkinson’s disease usually have the same average life expectancy as people without the disease.

But when the disease is in its advanced stages, Parkinson’s symptoms can lead to life-threatening complications, including:

  • Falls that lead to fractured bones

Thinking about the progression of Parkinson’s disease can be frightening. But proper treatments can help you live a full, productive life for years to come. And researchers hope to one day find ways to halt the progression of Parkinson’s and restore lost functioning.

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More Important To Maintain Exercise Than To Be Active Before Disease Starts Study Shows

byJudy George, Senior Staff Writer, MedPage Today January 13, 2022

People with early Parkinson’s disease who exercised regularly over 5 years performed better on cognitive testing and had slower disease progression in several domains, an observational cohort study showed.

Regular overall physical activity levels over time were significantly associated with slower deterioration of postural instability and gait scores , activities of daily living scores , and processing speed scores , reported Kazuto Tsukita, MD, of Kyoto University in Japan, and colleagues.

Moderate-to-vigorous exercise was linked with slower decline in postural and gait stability, while work-related physical activity was tied to slower deterioration in processing speed, they wrote in Neurology. Baseline activity level, however, was not tied to Parkinson’s progression.

“We found that to slow progression of the disease, it was more important for people with Parkinson’s to maintain an exercise program than it was to be active at the beginning of the disease,” Tsukita said in a statement.

“Although medications can provide people with Parkinson’s some symptom relief, they haven’t been shown to slow the progression of the disease,” Tsukita added. “We found that regular physical activity, including household tasks and moderate exercise, may actually improve the course of the disease over the long run.”

Disclosures

Primary Source

Neurology

The Two Best Ways To Prevent Parkinsons Disease

For Immediate Release May 13, 2021

Parkinsons disease is a brain disorder that affects the body and how it moves.

It begins with tremors, stiffness and balance problems that get worse with time. In addition, many people with Parkinsons disease feel tired, depressed, constipated, have trouble sleeping and can lose the sense of smell. They may also have trouble remembering, concentrating, learning new things, as well as have trouble talking or making decisions that affect their everyday life. Many people with Parkinsons disease also have difficulty walking which can put them at increased risk of falls.

Both men and women can get Parkinsons disease, but it is 50% more common in men. Most often, the disease first shows signs around age 60, but some people develop early-onset Parkinsons, which begins around age 50. Prevalence rates in the United States rise from 1% of the population at age 60 to 3% at age 80.

Although the exact cause for Parkinsons Disease is not known, environmental factors and genetics are thought to play a significant role. Research is underway to learn more. Researchers have also been trying to discover ways to prevent Parkinsons disease or slow it down. So far, only two theories have shown to be helpful: exercise and diet.

Kiranmayi Adimoolam, MD, FAAFP is a family and senior care physician at UM Baltimore Washington Medical Group Adult and Senior Care at Pasadena. She can be reached at 410-553-2900.

In This Section:

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Study Strengths And Limitations

This study is the largest to document gait change in PD over the longest period from diagnosis, in a relatively homogeneous cohort of incident PD participants. The main strength was that gait changes due to aging and disease progression could be parsed, as a well-matched control cohort was assessed alongside people with PD. Relatively precise modeling of gait change in early PD was achieved as PD participants were recruited close to diagnosis, enabling monitoring over the first 6 years of the disease. Inter-individual variation was accounted for through the random effect term included in all models. The inclusion of LEDD in analyses enabled the investigation of gait changes that were related and, arguably, more importantly, not related to changes in dopaminergic medication, to identify potential therapeutic targets for non-dopaminergic interventions. The effects of dopamine on gait progression could be further explored by comparing gait progression for characteristics measured on and off medication. Specifically, testing participants both on and off medication will allow us to better understand the progression of the underlying disease as well as explore the complex relationship between step width variability and dopaminergic medication.

Lets Talk Parkinsons Disease

Parkinson

Parkinsons is a slowly progressive disorder that affects movement, muscle control, and balance.

Our understanding of PD pathophysiology has vastly improved compared to what we knew 20 years ago, explained the study authors.

We believe we can be optimistic that the next 20 years will see major breakthroughs towards the discovery of therapies that may slow, stop, or reverse PD.

The authors summarise recent advances, including identification of the major genetic risks for Parkinsons disease, development of more representative animal models of the disease, early successes using Antisense Oligonucleotide and vaccination approaches in other neurodegenerative diseases, along with a translational pipeline of a broad range of repurposed drugs showing the first signals of potential efficacy, which are being driven forward through the various clinical trial stages.

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Parkinsons Disease Symptoms Of Dementia

Up to one-third of people living with Parkinson’s disease experience dementia, according to the Parkinson’s Disease Foundation. Problems with dementia may include trouble with memory, attention span, and what is called executive function the process of making decisions, organizing, managing time, and setting priorities.

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Who Does It Affect

The risk of developing Parkinsons disease naturally increases with age, and the average age at which it starts is 60 years old. Its slightly more common in men or people designated male at birth than in women or people designated female at birth .

While Parkinsons disease is usually age-related, it can happen in adults as young as 20 .

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What Is Parkinsons Disease

Parkinsons disease is a condition where a part of your brain deteriorates, causing more severe symptoms over time. While this condition is best known for how it affects muscle control, balance and movement, it can also cause a wide range of other effects on your senses, thinking ability, mental health and more.

Can Parkinsons Disease Be Cured

Expert Briefing: Can We Put the Brakes on Parkinson’s Disease Progression?

No, Parkinsons disease is not curable. However, it is treatable, and many treatments are highly effective. It might also be possible to delay the progress and more severe symptoms of the disease.

A note from Cleveland Clinic

Parkinsons disease is a very common condition, and it is more likely to happen to people as they get older. While Parkinsons isnt curable, there are many different ways to treat this condition. They include several different classes of medications, surgery to implant brain-stimulation devices and more. Thanks to advances in treatment and care, many can live for years or even decades with this condition and can adapt to or receive treatment for the effects and symptoms.

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How Does Parkinsons Progress

Parkinsons is a chronic and slowly progressive disorder. This means that symptoms normally appear slowly and develop gradually over time. The stage at which symptoms appear, speed at which they progress and the severity of those symptoms will vary from person to person. The most important point is that Parkinsons affects everyone differently.

There are a wide range of symptoms, but it is highly unlikely that you will experience every possible symptom. Some of the early symptoms of Parkinsons include handwriting changes, reduced sense of smell, tiredness and constipation. As Parkinsons progresses symptoms will change over time, and new symptoms will emerge. It can take many years for symptoms to progress to a point where they cause problems.

Ultimately symptoms will begin to impact on your day-to-day life. Many symptoms are related to physical movement, so you may find that walking becomes difficult. You may also experience non-movement symptoms such as mood changes, disrupted sleep or difficulty communicating. As these symptoms worsen it may become difficult to manage all of your daily activities.

Currently, there is no known way to slow the progression of Parkinsons. However, medications and other treatments can help to effectively manage your symptoms. To ensure the effectiveness of medications, they will need to be reviewed regularly by your specialist or doctor.

Sidebar: Morris K Udall Centers Of Excellence For Parkinson’s Disease Research

The Morris K. Udall Parkinsons Disease Research Act of 1997 authorized the NIH to greatly accelerate and expand PD research efforts by launching the NINDS Udall Centers of Excellence, a network of research centers that provide a collaborative, interdisciplinary framework for PD research. Udall Center investigators, along with many other researchers funded by the NIH, have made substantial progress in understanding PD, including identifying disease-associated genes investigating the neurobiological mechanisms that contribute to PD, developing and improving PD research models, and discovering and testing potential therapeutic targets for developing novel treatment strategies.

The Udall Centers continue to conduct critical basic, translational, and clinical research on PD including: 1) identifying and characterizing candidate and disease-associated genes, 2) examining neurobiological mechanisms underlying the disease, and 3) developing and testing potential therapies. As part of the program, Udall Center investigators work with local communities of patients and caregivers to identify the challenges of living with PD and to translate scientific discoveries into patient care. The Centers also train the next generation of physicians and scientists who will advance our knowledge of and treatments for PD. See the full list of Udall Centers.

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How Is It Treated And Is There A Cure

For now, Parkinsons disease is not curable, but there are multiple ways to manage its symptoms. The treatments can also vary from person to person, depending on their specific symptoms and how well certain treatments work. Medications are the primary way to treat this condition.

A secondary treatment option is a surgery to implant a device that will deliver a mild electrical current to part of your brain . There are also some experimental options, such as stem cell-based treatments, but their availability often varies, and many arent an option for people with Parkinsons disease.

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