Sunday, August 7, 2022

Rush University Medical Center Parkinson Disease

Clinical Trials For Parkinsons Disease

Parkinson’s Disease Research at Rush

At Rush, the longstanding Parkinsons Disease and Movement Disorders Program has a strong commitment to studying new treatments for patients with Parkinsons disease. Because the scientific questions and patient concerns change during the course of this disease, a comprehensive program needs to have multiple programs testing new therapies.

In the early phase of Parkinsons disease, when symptoms are very mild, the primary research focus is to develop interventions that halt or slow the progression of disability. In the midpoint of the disease, improved treatments of the core signs of Parkinsons disease become the focus, because tremor, slowness, stiffness and balance difficulties can be inadequately controlled by currently available medications. In the advanced stages of Parkinsons disease, concerns focus increasingly on non-motor concerns such as cognitive problems, apathy and hallucinations.

Many patients and their families participate in research to gain access to these new treatments and to advance the scientific understanding of Parkinsons disease for the good of all people in the world with this disease. These research studies provide not only the possibility of a new treatment, but research subjects spend more time with staff, receive education, and often meet other research subjects, thereby broadening their understanding and empowerment.

Early Signs Of Parkinson’s Disease

Early signs of Parkinson’s disease can be difficult to notice. However, if you experience the following early signs, speak with your primary care doctor.

The sooner you are diagnosed with Parkinson’s disease, the sooner you can begin treatment to help prevent deterioration.

  • Loss of sense of smell
  • Chronic constipation
  • Physically acting out your dreams at night

Edmond J Safra Interdisciplinary Home Visit Program For Advanced Pd

In 2014, we launched the Edmond J. Safra Interdisciplinary Home Visit Program for Advanced PD at the Marlene and Paolo Fresco Institute for Parkinsons and Movement Disorders at New York University to address the gap in continuity of care for homebound individuals with PD. This philanthropically-supported first iteration of the model is described in detail elsewhere , and summarized briefly here. Movement disorders specialists referred patients to the program if they were diagnosed with PD or a related disorder, met Medicare homebound criteria , lived within New York City, and their neurologist deemed them at high risk of hospitalization or institutionalization.

Patients received quarterly comprehensive visits from a movement disorders specialist, nurse, and social worker. The team identified and addressed motor and non-motor symptoms, medication errors, home safety issues, and unmet psychosocial needs. We implemented a detailed assessment and plan, including referrals to in-home therapies and community resources.

Among a subset of 27 patients followed prospectively for 1 year and who were cognitively intact at baseline, disease severity worsened significantly, as measured by a nearly 12-point increase on the Unified Parkinsons disease Rating Scale . Despite this sharp decline and the typically parallel trajectories of disease severity and quality of life in PD , quality of life did not change in this cohort over 1 year .

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Jori Fleisher Md Msce

Education

MD, Northwestern Univeristy Feinberg School of Medicine

MSCE, University of Pennsylvania School of Medicine

Neurology Residency, University of Pennsylvania School of Medicine, Neurology & Global Health Equities

Movement disorders fellowship, University of Pennsylvania School of Medicine

Research Areas

Parkinsons disease, movement disorders, advanced Parkinsons disease, interdisciplinary home visits, clinical trials, non-pharmacologic interventions, and martial arts

Jori Fleisher, MD, MSCE, is a fellowship-trained, movement disorders neurologist with a special interest in understanding the needs of individuals and families who are living with advanced Parkinsons disease and related disorders. She also has a special interest in designing new models of care to better serve this population. After three years on the faculty at New York University, she joined the Rush University Medical Center Parkinsons disease and Movement Disorders Program in 2017, where she sees patients and conducts research.

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Center of Excellence Series: Rush University Medical ...

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Have You Been A Caregiver For Someone With Parkinsons Disease Psp Msa Cbd Or A Related Disorder

You have learned a lot by caring for your loved one with Parkinsons Disease , PSP, MSA, CBD, or a related disorder. Would you like to help other caregivers on their journey by sharing your experience?

Rush University is studying a new model of caregiver support by pairing an experienced caregiver mentor like you with a caregiver mentee. You will receive training on how to be a mentor, and you will learn about the many resources available for caregivers and people living with Parkinsons Disease, PSP, MSA, CBD, or a related disorder. We anticipate that the results of this study will lead to future mentoring programs for caregivers and people living with PSP and related disorders, too.

You may be eligible to participate if you meet the following criteria:

  • Have 2 or more years of unpaid experience as a caregiver to someone with someone with Parkinsons Disease, PSP, MSA, CBD, or a related disorder
  • Are 30 years of age or older
  • Are primarily English-speaking
  • Live in the Chicago area

Your involvement includes:

  • One five-hour mentor training session at Rush
  • 32 weekly in-person or phone/video chats with the mentee using a study-provided iPad
  • 8 monthly supervision group meetings with other mentors over a one-year period.

You will receive roundtrip CTA passes for study-related travel. If you are interested in participating or learning more about this study, please contact:

Principal Investigator:

Contact: Ellen Wallace

Parkinsons Disease Care And Research At Rush

The Rush Parkinsons Disease and Movement Disorders Program is one of the largest and oldest such centers in the country, treating more than 2,000 patients annually. The programs staff includes eight movement disorder specialists, a psychiatrist and neuropsychologists focused on movement disorders and expert nursing staff.

These clinicians understand that a comprehensive and holistic approach is important for providing the best care for our patients. In addition to treating motor symptoms, the center focuses on the cognitive, behavioral and emotional aspects of movement disorders that can significantly affect patients quality of life. Using this holistic approach to care, the team addresses both the motor and non-motor symptoms through the following interventions:

  • Medication management
  • Psychological support for patients and caregivers
  • Education and support groups
  • Surgical management, including deep brain stimulation
  • Research studies The center is a major Parkinsons disease research program, with a dozen clinical trials of treatments for the disease currently underway. According to the Parkinsons Foundation, Rush offers tremendous innovation in clinical research.

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Movement Disorders Research: How You Can Help

Volunteering for clinical trials and donating to our research supports our mission to better understand and treat movement disorders.

Volunteering for clinical trials and donating to our research supports our mission to better understand and treat movement disorders.

Research is a vital part of the mission of Parkinson’s Disease and Movement Disorders Care at Rush. Our research program is dedicated to finding new ways to treat Parkinson’s disease, slow its progression and find a cure.

Center Of Excellence Series: Rush University Medical Center Provides Critically Needed Parkinsons Mental Health Program

Motor Fluctuations and Dyskinesia in Parkinson’s Disease

Most people associate Parkinsons disease with tremors, a motor symptom. However, non-motor symptoms are common and can be more troublesome and disabling than motor symptoms. They can include cognitive changes, mood and sleep disorders, autonomic symptoms or weight loss. Rush University Medical Center, a Parkinsons Foundation Center of Excellence, is not only on the front lines of PD-related cognitive research, but is actively hosting life-changing programs targeting these non-motor, and in particular, cognitive and behavioral symptoms.

Jennifer G. Goldman, MD, MS, is unique in the Parkinsons field. She is a fellowship-trained movement disorder specialist with additional background in behavioral neurology and neuropsychiatry an uncommon combination that provides her with a unique skillset to treat Parkinsons non-motor symptoms.

In between seeing patients, Dr. Goldman conducts research studies to better understand what causes a person with PD to experience neuropsychiatric symptoms . She utilizes MRI brain scans and clinical assessments to evaluate cognitive and behavioral effects. More broadly, Dr. Goldmans research tries to find the mechanisms of the brain and biomarkers that contribute to Parkinsons-related non-motor symptoms.

It is a well-known problem that many doctors do not have enough time during an appointment to truly explain and talk through mental health issues, said Dr. Goldman.

A Day at the Integrated Cognitive Behavioral Movement Disorder Clinic

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Addressing Parkinson’s Disease Symptoms

  • Our providers connect you to experts in exercise, physical therapy and occupational therapy for Parkinson’s disease these therapies can help improve gait, balance, tremor, flexibility, grip strength, motor coordination and your ability to perform daily activities.
  • We connect you to speech therapists who specialize in Lee Silverman Voice Treatment . LSVT can help you speak more loudly and clearly.
  • We have psychiatrists and neuropsychologists who specialize in Parkinson’s disease to help you cope with depression and other mental health issues.
  • We have experts to help with autonomic dysfunction these include urinary problems , dizziness or blood pressure changes.
  • Providers at Rush University Medical Center work closely with gastroenterologists and dietitians there to address gastrointestinal issues, such as constipation and bloating, that are common in people with Parkinson’s disease.

Received Parkinson’s Foundation Funding From 1957 Present

Columbia University Medical Center researchers and doctors are leaders in Parkinsons science and training. They have developed scales to assess the severity of Parkinson’s, tested new drugs to treat the disease and are leaders in uncovering the pathogenesis of the disease. Recent grants have supported research in neuroinflammation, genetics, the development of dopamine neurons, neuropsychology, behavioral effects and clinical trials.

Highlight: Finding Potential Targets for Preventing or Treating ParkinsonsThe most common Parkinsons-associated gene mutations occur in the LRRK2 gene. Researchers at the Parkinsons Foundation Research Center at Columbia University Medical Center showed for the first time why the faulty LRRK2 protein is harmful, and how it can block the normal cell recycling process. This study, published in Nature Neuroscience, 2013, builds upon earlier Parkinsons Foundation-funded work. The study showed that chaperone-mediated autophagy was capable of recycling healthy LRRK2 proteins, but it was not as successful in breaking down those LRRK2 proteins that had the mutation found in people with Parkinsons. These faulty LRRK2 proteins also prevent other proteins, such as alpha-synuclein , from breaking down and getting recycled.

This study shows the need for developing therapies that can help restart or speed up cellular recycling therapies that could potentially help people whose PD has no known genetic cause as well as those who have LRRK2 mutations.

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Icipate In Clinical Trials

If you are interested in participating in clinical trials for Parkinson’s disease and other movement disorders, see the ongoing trials available at Rush. For more information about our research programs, call 563-2900 and press 4.

Benefits of Participating in Clinical Trials

  • Physical improvements: You will have access to new treatments that are not yet available to the public. These new treatments may help improve your symptoms, function and quality of life.
  • Emotional fulfillment: Being involved in studies can give you a sense of control and empowerment over your disease.
  • Contributing to the greater good: You will be actively involved in making a difference in the future of Parkinson’s disease and other movement disorders by playing a role in getting closer to a cure.

What We Study

  • Epidemiology: Studying who gets Parkinson’s and other movement disorders in the hope of identifying factors that may prevent the disease.
  • Features of the disease: Studying characteristics of the disease to increase our understanding of the disease itself or its affect on physical and emotional health.
  • Protective therapies: Studying new drugs or surgical approaches to help slow or stop the degenerative brain processes.
  • Studying new drugs or procedures that help control the symptoms of degenerative brain processes, while not directly treating the degenerative process itself.

Participating in a Study

  • Consent: If selected, you will sign consent forms agreeing to comply with the study requirements.
  • Karate May Increase Mobility Balance Well

    Protein linked to Parkinson

    Karate may be an appropriate and effective strategy for improving functional mobility in people who are living with brain disorders such as Parkinsons disease, said Dr. Jori Fleisher, principal investigator of the study and neurologist at Rush.

    Parkinsons disease is a progressive neurological disorder that causes tremors, rigidity, a slowing of movement and difficulty with balance. The movement problems of Parkinsons disease are caused by loss of the brain chemical messenger dopamine as a result of dysfunction or death of brain cells that manufacture this essential chemical.

    We all know that martial arts can change lives, said Fleisher. It can improve your health, confidence and discipline.

    The Kick Out PD classes are an opportunity for those with Parkinsons disease to derive both physical and emotional benefits from participating in a karate class, Fleisher said. Our initial pilot study showed that martial arts may be beneficial for individuals with Parkinsons disease by increasing mobility, balance coordination and overall well-being.

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    Cinnamon May Be Used To Halt The Progression Of Parkinson’s Disease

    Study results published in the Journal of Neuroimmune Pharmacology

    Rush University Medical Center

    Neurological scientists at Rush University Medical Center have found that using cinnamon, a common food spice and flavoring material, can reverse the biomechanical, cellular and anatomical changes that occur in the brains of mice with Parkinson’s disease . The results of the study were recently published in the June 20 issue of the Journal of Neuroimmune Pharmacology.

    “Cinnamon has been used widely as a spice throughout the world for centuries,” said Kalipada Pahan, PhD, study lead researcher and the Floyd A. Davis professor of neurology at Rush. “This could potentially be one of the safest approaches to halt disease progression in Parkinson’s patients.”

    “Cinnamon is metabolized in the liver to sodium benzoate, which is an FDA-approved drug used in the treatment for hepatic metabolic defects associated with hyperammonemia,” said Pahan. It is also widely used as a food preservative due to its microbiocidal effect.

    Chinese cinnamon and original Ceylon cinnamon are two major types of cinnamon that are available in the US.

    “Although both types of cinnamon are metabolized into sodium benzoate, by mass spectrometric analysis, we have seen that Ceylon cinnamon is much more pure than Chinese cinnamon as the latter contains coumarin, a hepatotoxic molecule,” said Pahan.

    This research was supported by grants from National Institutes of Health.

    Journal

    Interdisciplinary Palliative Care For People With Advanced Parkinsons Disease: A View From The Home

    Jori E. Fleisher1, Ellen C. Klostermann1, Serena P. Hess1, Jeanette Lee1, Erica Myrick1, Joshua Chodosh2,3

    1Department of Neurological Sciences, New York University School of Medicine , 3Medicine Service, VA New York Harbor Healthcare System, New York, NY , USA

    Contributions: Conception and design: JE Fleisher, J Chodosh Administrative support: EC Klostermann, SP Hess, J Lee, E Myrick Provision of study materials or patients: JE Fleisher Collection and assembly of data: JE Fleisher, EC Klostermann, SP Hess, J Lee, E Myrick Data analysis and interpretation: JE Fleisher, SP Hess, J Lee, EC Klostermann, J Chodosh Manuscript writing: All authors Final approval of manuscript: All authors.

    Correspondence to:

    Background: Advanced Parkinsons disease is a multidimensional neurodegenerative condition with motor and non-motor symptoms contributing to increasing disability and decreasing quality of life. As the disease progresses, patients may become homebound and estranged from neurological care, with dire consequences. We describe the increasing epidemiologic burden of and individual risks faced by patients with palliative-stage PD and their caregivers.

    As our population ages, therapies increase, and the number of individuals living with advanced PD and related disorders grows, so too does the imperative to recognize and address the palliative care needs of such patients and families. For many, home may be a viable, and perhaps optimal, site for this care.

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    Received Parkinson’s Foundation Funding From 2001

    Weill Cornell Medicines Parkinsons Disease and Movement Disorders Institute specializes in the management and diagnosis of Parkinsons. The institute manages PD research studies and clinical pharmacotherapy trials.

    Highlight: New Tool Will Improve Testing of New TreatmentsWith Foundation funding, labs at Weill Cornell Medical Center and Columbia University Medical Center have made progress finding a new and powerful tool for testing new Parkinsons therapies and studying the underlying causes of the disease.

    Working with Columbia University, the Weill Cornell team created a unique mouse model that expresses a mutated form of the LRRK2 gene. Published in Nature Neuroscience, this model will help scientists create and test new Parkinsons treatments in the lab. Prior to this development, PD research was hampered, as scientists did not have a model that accurately mimicked the natural course of Parkinsons in humans.

    Movement Disorders Patient Education Resources

    Jessica Karl, PA-C – Rush University Medical Center

    The Rush Parkinsons Disease and Movement Disorders Program team is committed to helping people with movement disorders live their best lives. This includes providing comprehensive education to empower patients, families and caregivers to navigate the challenges of a movement disorder diagnosis.

    Were pleased to offer the following expert resources, created by or featuring our internationally recognized providers. These videos can help you learn about symptom management, exciting new treatment options, promising research, and strategies for improving your overall health and well-being.

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    Translating Research Advances Into Patient Care

    Along with Rush, the Parkinsons Foundation named Columbia University Medical Center in New York City a Center of Excellence.

    At Parkinsons Foundation, we are proud that our longtime investment in Columbia and Rush has played a pivotal role in all significant Parkinsons research advances, said John L. Lehr, chief executive officer of Parkinsons Foundation. This newest designation recognizes that both institutions are successfully translating those research advancements into improvements in patient care exactly what our community so urgently needs.

    The Parkinsons Foundation designates Centers of Excellence following a rigorous application and peer-review process. Currently, there is a worldwide network of 42 leading academic medical centers that leverage the interplay between cutting-edge research and exemplary patient-focused, multidisciplinary care. This network serves more than 100,000 individuals diagnosed with Parkinsons disease.

    To participate in the competitive designation process, centers must first meet strict criteria for research, comprehensive care, patient outreach services and professional education. The network is widely credited with developing and promoting the modern Parkinsons team model of care and ensuring patients the highest standards of care.

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