Thursday, September 22, 2022

Slowing The Progression Of Parkinson’s Disease

What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms

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

Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinsons disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didnt exercise or didnt start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.

Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinsons, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.

Preventing falls and maintaining balance: Falls are a frequent complication of Parkinsons. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments whether medicines or deep brain stimulation are optimal and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.

Ways Physical Therapists Help Slow The Progression Of Parkinson Disease

It is well-known that exercise of any kind is good for each persons health, both body and mind. But did you know that it is even more important for those living with Parkinson disease? Physical therapy is key to slowing down the disease. And it helps those affected to stay as independent as possible.

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Can The Symptoms Of Parkinsons Disease Remain Mild

The main symptoms of Parkinsons disease tremors, stiff muscles, slow movements and difficulties with balance may be mild at first, but will gradually become more intense and debilitating. Symptoms of Parkinsons disease can worsen over a period of 20 years or even longer.

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How long does it take for the symptoms of Parkinsons disease to change?

Often within 3-7 years you will see more changes. At first, you might have a little trouble with something like buttoning up a shirt. At this point, you may not be able to do this at all. You may also find that the medication you are taking begins to wear off between doses. Advanced stage. Some people never reach this stage.

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Parkinson’s Disease Symptoms: Life Expectancy

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
  • Pneumonia
  • Choking

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.

Pilot Study Suggests Parkinsons Disease Progression Can Be Slowed

Parkinson

A pair of ultra-thin electrodes surgically implanted deep into the brain might slow the progression of Parkinsons disease, according to five-year outcomes from a 30-patient randomized clinical trial conducted by investigators at Vanderbilt University Medical Center.

Their report, published in the July 2020, issue of Neurology, presents the latest findings from the worlds first study of deep brain stimulation, or DBS, for early stage Parkinsons, defined as within four years of disease onset.

Parkinsons is a long-term neurodegenerative disorder most obviously characterized by tremor, rigidity, slow movement and difficulty with balance and walking. As of 2016, some 6.2 million people worldwide were living with Parkinsons. According to the Parkinsons Foundation, as many as 60,000 Americans are diagnosed each year with the disease.

From 2006 to 2009, the investigators enrolled 30 patients, all of whom received optimum drug therapy, with a random half additionally receiving DBS, which is often characterized as a pacemaker for the brain. In the DBS group, electrodes were positioned through two surgical openings in the cranium to deliver electric pulses to the subthalamic nucleus, a small cluster of neurons located deep within the brain on both sides. As with a heart pacemaker, the electric pulses are supplied by a battery implanted under the skin near the collarbone.

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Sidebar: Advances In Circuitry Research

The brain contains numerous connections among neurons known as neural circuits.

Research on such connections and networks within the brain have advanced rapidly in the past few years. A wide spectrum of tools and techniques can now map connections between neural circuits. Using animal models, scientists have shown how circuits in the brain can be turned on and off. For example, researchers can see correlations between the firing patterns of neurons in a zebrafishs brain and precise behavioral responses such as seeking and capturing food.

Potential opportunities to influence the brains circuitry are starting to emerge. Optogenetics is an experimental technique that involves the delivery of light-sensitive proteins to specific populations of brain cells. Once in place, these light-sensitive proteins can be inhibited or stimulated by exposure to light delivered via fiber optics. Optogenetics has never been used in people, however the success of the approach in animal models demonstrates a proof of principal: A neural network can be precisely targeted.

Thanks in part to the BRAIN Initiative, research on neural circuitry is gaining momentum. The Brain Research through Advancing Innovative Neurotechnologies Initiative is accelerating the development and application of new technologies that enable researchers to produce dynamic pictures of the brain that show how individual brain cells and complex neural circuits interact at the speed of thought.

NIH Publication No. 15-5595

Can Parkinson’s Disease Be Cured

No, Parkinson’s 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

Parkinson’s disease is a very common condition, and it is more likely to happen to people as they get older. While Parkinson’s isn’t 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 Is It Diagnosed

Diagnosing Parkinson’s disease is mostly a clinical process, meaning it relies heavily on a healthcare provider examining your symptoms, asking you questions and reviewing your medical history. Some diagnostic and lab tests are possible, but these are usually needed to rule out other conditions or certain causes. However, most lab tests aren’t necessary unless you don’t respond to treatment for Parkinson’s disease, which can indicate you have another condition.

How To Slow Parkinsons Disease

Exercise therapy helping slow the progression of Parkinson’s Disease

It begins with trembling or shaking, usually in the fingers of one hand. Over time the tremor worsens, and other symptoms such as slow movements, muscle rigidity, and difficulty walking appear. Patients with Parkinsons disease are eventually given prescriptions for l-dopa and other drugs, and they may be offered deep brain electrical stimulation, stem-cell or gene therapy somewhere down the road. But the one thing they want most, hope for improvement, they do not get.

Until now. Researchers have discovered that coenzyme Q10 and creatine, nutritional supplements that are sold in health food stores, offer something rare to those who suffer with Parkinsons disease: hope.

Parkinsons Disease and Free Radical Damage

Parkinsons disease is characterized by a sharp decline in dopamine, a key neurotransmitter that stimulates the brain and affects movement. This decline is caused by the destruction of neurons, or brain cells, that produce dopamine. As dopamine levels fall, other neurons compensate and become overactive, which further contributes to the symptoms of the disease.

Nobody knows why the dopamine-producing neurons die. A genetic predisposition has been identified, as has a link to certain environmental toxins. Another suspect, which is a factor in many degenerative diseases, is free radical damage. Levels of some free radical fighting antioxidants are known to be low in patients with Parkinsons, especially in the dopamine-generating neurons.

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References

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Surgical Treatment For Parkinsons

This is advised when the disease progresses and the medications are no longer controlling the symptoms of PD adequately.

  • As the disease progresses, Levodopa still works, but the brains response to the medication becomes less predictable. Levodopa may take longer to kick in and may wear off earlier, requiring patients to take medication more frequently during the day. Higher doses of levodopa are associated with abnormal involuntary movements, known as dyskinesias . Unpredictable medication effect results in OFF time when patients feel stiff, rigid, stuck, frozen, slow, or fatigued, compared to ON time when movements are smooth and closer to normal.
  • Treatment options as the disease progresses include taking levodopa more frequently making the medication last longer by adding medications to reduce the metabolism of levodopa, or dopamine adding or changing to long-acting forms of levodopa , or adding or changing to long-acting forms of dopamine agonist . Amantadine can be added to reduce dyskinesia. As these options are being considered and implemented, its time to consider deep brain stimulation surgery .
  • Deep brain stimulation surgery is FDA-approved for the treatment of motor complications in Parkinsons disease and is not experimental. DBS is not a last-resort treatment. It has been shown that DBS is more beneficial when performed earlier in the course of the disease compared to waiting for disability.

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Can Progression Of Parkinson Disease Be Slowed

Deep brain stimulation implanted in early-stage Parkinson disease was found to decrease the risk of disease progression. If findings are replicated in a larger trial recently approved by the FDA, DBS would be the first therapy proven to slow the progression of any element in PD.

Deep brain stimulation implanted in early stage Parkinson disease was found to decrease the risk of disease progression and lessen the need for multiple, simultaneous prescription drugs, according to study findings published in Neurology.

PD serves as the fastest growing neurological disorder worldwide, with as many as 60,000 US cases diagnosed each year. Innovations within the treatment of PD have led to better, noninvasive outcomes for common symptoms such as tremor and OFF periods. However, as the disease progresses, these therapies may not prove as effective and can contribute to significant economic burden for both patients and caregivers.

When it comes to managing PD, senior author David Charles, MD, professor and vice chair of neurology at Vanderbilt University Medical Center , noted the relentless nature of the disease, which currently has no therapies approved to slow its progression.

After the 5-year follow-up, the study found that those with early-stage PD who received early DBS with ODT had a more than 5 times lesser odds of of experiencing worsening of their rest tremor compared with those given only ODT .

Reference

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When Should I See My Healthcare Provider Or When Should I Seek Care

You should see your healthcare provider as recommended, or if you notice changes in your symptoms or the effectiveness of your medication. Adjustments to medications and dosages can make a huge difference in how Parkinsons affects your life.

When should I go to ER?

Your healthcare provider can give you guidance and information on signs or symptoms that mean you should go to the hospital or seek medical care. In general, you should seek care if you fall, especially when you lose consciousness or might have an injury to your head, neck, chest, back or abdomen.

How Much Should I Exercise For Pd

Exercise may slow progression of Parkinson

At the recent World Parkinson Congress 2016, the main theme that I noticed is that exercise is the best medicine for PD. It may not be as effective at treating PD symptoms as l-dopa, but all the research and anecdotal evidence clearly shows that collectively, those who exercise regularly enjoy a far better quality of life with PD, for a longer period of time, as compared to those who do not. While medical research continues to be important, the best thing that can be done for the growing number of People with Parkinsons today is to encourage exercise.

There is a growing consensus that more exercise is better, and there is concern that many PwP are being given outdated or incomplete exercise recommendations.

Results from the Bastyr University Patient-Reported Outcomes in PD survey were shared at WPC 2016. The survey asks PwP about their diet, exercise and supplement regimens, and correlates this information with a self-assessment of PD progression.

The survey results indicate that the more days per week that a person exercises , for at least 30 minutes, the slower the PD progression.

Before you start a 6 or 7 day per week program, please dont do the same exercise routine every day. Focus on different muscle groups so that you are not overworking particular muscles, and not neglecting any muscle groups.

It is very important to stress that the CDC and other organizations consider these to be minimum recommendations to receive health benefits from exercise.

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Take Control Of Your Health

As more people live longer, the incidence of chronic conditions is increasing, including Parkinsons disease.

However, as in the case of other chronic conditions, evidence is building that keeping your body and mind healthy might prevent or slow down the progression of Parkinsons.

Exercise regularly, eat a healthy diet and manage your stress to maintain the best possible quality of life.

Lets Talk Parkinsons Disease

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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Slowing Down The Progression Of Parkinsons Disease

We have all heard that keeping active is good for you and has immediate benefits for your health both short-term and long-term. Regular activity reduces the risk of developing some cancers, cardiovascular disease, as well as obesity and the health issues associated with this. What you may not have heard is regular exercise has also shown to slow the progression of Parkinsons disease.

Parkinsons disease is a neurodegenerative disease which targets and progressively damages nerve cells in a particular area of the brain over a long period of time. These nerve cells are very important for their role in producing a chemical called Dopamine. Without this chemical, the brain is not able to control normal bodily movement and the typical presentation of Parkinsons beings to show in the individual. This can range from balance issues, difficulty with memory and smell, as well as the well-known involuntary shaking. The cause of Parkinsons is still unclear, however, there is thought to be a combination of both genetic and environmental factors.

The link between exercise and reducing Parkinsons progression is believed to be focused on a particular protein known as the DJ-1 gene. As we all become more and more sedentary in our day-to-day lives, scientists have noticed an increase of a normal neural protein alpha-synuclein, which is important for relaying messages and normal brain function. However, in excessive clumps this could potentially be an issue.

Enhancing Neuronal Survival Processes

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

An alternative to stopping the spread of pathology, is to try and help neurons continue to function despite the presence of pathological alpha synuclein, i.e., to provide some form of trophic support. There are several classes of drugs being repurposed , which may achieve this.

There has been a lot of publicity surrounding the potential of Glucagon-like peptide 1 receptor agonists in PD . These drugs are licensed for the treatment of Type 2 diabetes and have neuroprotective properties across the whole range of animal models of PD, including 2 alpha synuclein models. There is some evidence that this action may relate to an improvement in brain insulin signaling which enhances Akt activity while additional data indicate these drugs may also act in parallel through a positive effect on neuroinflammation . Indeed, the increased risk of developing PD among T2DM patients may be ameliorated according to the choice of anti-diabetic agent used .

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Cinpanemab Fails To Slow Disease Progression In Patients With Early Parkinson’s Disease: Nejm

Toronto: In the phase 2 SPARK study trial, cinpanemab did not show any beneficial effect concerning clinical, imaging, or quality-of-life measures as compared to placebo in patients with early Parkinson’s disease. The study article was published in the New England Journal of Medicine.

Globally, Parkinson’s disease is the numerically fastest growing and the second most common neurodegenerative disorder. In Parkinson’s disease, dopamine replacement has a substantial benefit concerning symptoms, but it does not slow disease progression. Also, there is a risk of developing levodopa-resistant symptoms over time, thus disease-modifying therapies beyond currently existing ones are needed. Aggregated -synuclein plays an important role in Parkinson’s disease pathogenesis. Cinpanemab, a human-derived monoclonal antibody targeting aggregated -synuclein, is being evaluated as a disease-modifying treatment for Parkinson’s disease.

The primary endpoints were the changes from baseline in the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale total score at weeks 52 and 72. Secondary endpoints included MDS-UPDRS subscale scores and striatal binding as assessed on dopamine transporter single-photon-emission computed tomography .

Key findings of the trial,

The change in the MDS-UPDRS score at 52 weeks was 10.8 points in the control group, 10.5 points in the 250-mg group, 11.3 points in the 1250-mg group, and 10.9 points in the 3500-mg group .

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