Education

Could this newly discovered protein help treat Parkinson’s?

August 1, 2019 Education, Research
Researchers have found a protein that could help reduce the aggregation of toxic proteins in the brain — a hallmark of Parkinson’s disease. But does their discovery offer fresh hope or just “a Band-Aid?”

Does a new discovery reveal a fresh research pathway for Parkinson’s therapy?

The National Institutes of Health estimate that, in the United States, around 50,000 peoplereceive a Parkinson’s disease diagnosis each year.

This widespread condition is characterized by tremors, slowness of movement, and impaired balance and coordination, among other symptoms.

However, its causes remain unknown and treatments only target the symptoms, helping individuals to manage this condition as best they can.

In the brain, Parkinson’s is characterized by a puzzling feature — the aggregation of alpha-synuclein, a protein that becomes toxic and disrupts the neural pathways when it sticks together in large quantities.

This occurs when alpha-synuclein misfolds, that is, when it folds into an incorrect shape that does not allow it to function correctly, which may cause or facilitate disease.

Alpha-synuclein is typically present at high levels in the brain, and it is also present in other tissue in smaller amounts. Still, researchers have no idea what role this protein usually plays in maintaining neural health or how to prevent it from misfolding.

But a new study, from Purdue University, in West Lafayette, IN, has identified a protein able to reduce the aggregation of misfolded alpha-synuclein. The findings feature in the Journal of Molecular Biology.

How HYPE may reduce aggregation

The new research has focused on the therapeutic potential of a protein called “HYPE,” which, the investigators explain, is the only Fic protein present in humans.

Fic proteins help decide whether a cell survives or dies when it encounters stress, characterized by the misfolding of the cell’s proteins.

“Since HYPE plays such an important role in how cells deal with stress from misfolded proteins, we wondered whether diseases that result from protein misfolding were likely to need HYPE,” explains lead study author Seema Mattoo, Ph.D., an assistant professor of biological sciences at Purdue.

She continues: “We know that in Parkinson’s disease, often the misfolded protein is [alpha-synuclein]. So we asked if HYPE could modify [alpha-synuclein], and if so, what are the consequences?”

In the current study — which the researchers conducted in vitro, using cell cultures in a laboratory setting — they found that HYPE can indeed act on alpha-synuclein, decreasing the amount of aggregation of misfolded proteins. The researchers call this process “AMPylation.”

Then, the team wanted to see if AMPylation actually showed any promise as a potential therapeutic process. In Parkinson’s disease, aggregated, misfolded proteins can puncture the membranes of neurons (brain cells), disrupting their functioning.

Mattoo and colleagues wanted to find out whether AMPylation would also lead to fewer holes in the membranes of cells. To do so, they used a combination of lipids to create a surface simulating that of cell membranes.

They also added dye to the lipids, so if alpha-synuclein aggregates punctured them, the action would become visible through leaked dye.

After doing so, Mattoo notes, “We found that less dye was released with the modified [alpha-synuclein], meaning the membrane stayed more intact.”

“That means HYPE could possibly have a therapeutic effect on Parkinson’s disease,” she adds. Moreover, as Mattoo and colleagues note in their study paper, “This is the first report identifying [alpha-synuclein] as a target for HYPE.”

Going beyond the ‘Band-Aid?’

In a final experiment, Mattoo and the team studied HYPE-modified alpha-synuclein using an electron microscope. This allowed them to observe that, after interacting with HYPE, alpha-synuclein’s structure had changed.

Under regular circumstances, the researchers note, alpha-synuclein twists, which may explain its potential to form aggregates. However, when modified by HYPE, the protein tended to twist less, instead forming parallel strands.

This new modification, the researchers argue, may prevent alpha-synuclein from aggregating as much.

While the current research shows promise in finding new therapies for Parkinson’s disease, the study authors explain that they still have a long way to go.

“We’re in the early stages [of this research],” Mattoo admits, “but these results are giving us a new angle to look at potential therapeutics.”

“We’re trying to come up with drugs that could be used to manipulate HYPE’s activity. You could give them to patients who are starting to show signs of Parkinson’s or who are prone to having aggregated [alpha-synuclein]. That’s the direction we want to go [in],” the researcher explains.

Article from Medical News Today.

Read more

2019 Parkinson Disease Symposium

August 1, 2019 Caregivers, Community Outreach, Education, Exercise, Facilitators, Support Groups

View photos from the day HERE.

Read more

The Story Changes, While the Message Endures

August 1, 2019 Awareness, Education, Life

Parkinson disease was in the national spotlight recently with the passing of auto industry icon Lee Iacocca, as well as ESPN founder Bill Rasmussen’s recent announcement that he has been living with the disease.

Learn more about these two very different stories, and how Parkinson’s affected each of them.

Auto industry icon Lee Iacocca dies at 94. He helped launch the Ford Mustang and saved Chrysler from bankruptcy.

The Story Changes, While the Message Endures: “I Have Parkinson’s Disease,” ESPN Founder Bill Rasmussen

Read more

Developing a Biomarker for Parkinson Disease

June 1, 2019 Education, Research

Identifying, studying, and verifying a potential biomarker can be a lengthy affair. However, success often means clinicians have a new tool to better diagnose a condition like Parkinson disease and to diagnose the condition earlier in the disease progression.

A biomarker for Parkinson disease might mean that patients can begin receiving treatment before irreversible neurological damage occurs.

Sarah Hamm-Alvarez, PhD, Professor of Ophthalmology at the USC Roski Eye Institute at the Keck School of Medicine of USC, spoke with MD Magazine® about this biomarker research, which she presented at the 2019 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) in Vancouver, BC.

Hamm-Alvarez highlighted the collaborative nature of the project that has included colleagues from the neurology, pharmacy, and preventive medicine departments.

“Part of the passion for the project is driven by the clinical need that I sense from my neurology colleagues and their frustration that they don’t have better ways to diagnose patients at early disease states,” said Hamm-Alvarez.

In part 1 of the interview, Hamm-Alvarez introduced the study and the team’s reasons for investigating tears for a Parkinson biomarker. In part 2, she described the study methods and the differences they found in basal and reflex tears.

What’s the process for developing a biomarker?

First you start by establishing a correlation, which we have done. And right now what we’re doing is that we are actually recruiting patients with Parkinson’s disease that are at different times from disease diagnosis and this, we think, will reflect disease severity. So, what we’re trying to do is to see if the levels of oligomeric α-synuclein are correlated with time from disease diagnosis. So, we’re going to try to get a sense of the disease severity. We also are eventually planning to try to test this in patients without a diagnosis, as well as patients who exhibit symptoms that overlap with Parkinson’s disease, such as patients with atypical parkinsonian syndromes and patients with other neurological disorders, of course, to determine how specific this may be, and also whether this has predictive ability going forward if a patient is at an early stage of Parkinson’s disease.

How have various departments collaborated in this project?

This project is very much a team effort we have a whole team at the University of Southern California including colleagues in neurology and pharmacy and preventive medicine. We work very closely with Mark Liu in neurology, who is a neurologist, and who is very excited about the potential for applying this in his clinic. So, I think that part of the passion for the project is driven by the clinical need that I sense from my neurology colleagues and their frustration that they don’t have better ways to diagnose patients at early disease states.

Article from MD Magazine.

 

Read more

Turn, stop, then sit: A research-based guide for Parkinson’s patients

May 1, 2019 Awareness, Education, Exercise, Research

Tel Aviv University team studies why patients with Parkinson’s disease have difficulty transitioning from walking to sitting, leading to greater instability and falls

People with Parkinson’s disease — a debilitating degenerative disorder that affects the motor system, causing tremors, shaking and rigidity — are known to have difficulty in turning around and then sitting down.

A new Tel Aviv University study provides an understanding as to why these patients may have difficulty transitioning from walking though turning around to sitting. The results suggest new ways to help improve the rehabilitation of these kind of patients.

“Parkinson’s patients can be challenged when they try to turn as they walk,” said Prof. Jeffrey Hausdorff of Tel Aviv University’s Sackler Faculty of Medicine and the Center for the Study of Movement, Cognition, and Mobility at Tel Aviv Sourasky Medical Center.

While most healthy older adults turn and then sit in a precise sequence that clearly distinguishes the two components of the task, in contrast “we found that most Parkinson’s patients start to sit while they are still turning,” he said.

“We originally speculated that, when transitioning from a walking or standing position to a sitting position, people with Parkinson’s would first turn and then start the process of sitting,” Hausdorff said. “But we found that this wasn’t true.”

The research was led by Hausdorff in collaboration with Prof. Anat Mirelman and Prof. Nir Giladi, also of the university and the Tel Aviv Medical Center, and colleagues at Rush University in Chicago. It was published in January in the journal Gait & Posture.

According to the study, when healthy older adults turn to sit, about 80 percent of them complete the turn before starting to sit, in what the researchers called a “distinct strategy.” But in about 20% of the subjects, part of the turning and sitting take place at the same time, in what the researchers called an “overlapping strategy.”

The researchers evaluated the strategies employed by people with Parkinson’s as they transitioned from standing through turning to sitting. In one experiment, 96 participants with Parkinson’s, assessed both on medication and after its effects wore off, were asked to turn to sit while wearing a body-fixed sensor. The researchers then quantified the turning-to-sitting transition and determined whether the distinct or the overlapping strategy had been employed. The use of the sensor revealed subtle but important distinctions that were previously overlooked based on visual observation alone.

The scientists then stratified the cases, using models adjusted for age, gender, height and weight, to identify the associations with their sitting strategies and with the Parkinsonian characteristics and cognition.

“Interestingly, we found that the individuals who employed the overlapping strategy experienced more severe postural instability compared to those who used the distinct strategy,” Hausdorff said.

They also found that anti-Parkinsonian medications did not affect the strategy choice, “suggesting that the decision may be regulated by networks and brain areas that are less directly affected” by the drugs.

Hausdorff said that it is important for people who suffer from Parkinson’s disease and their physical therapists and others to be aware of this issue.

Based on the study, he said in an emailed comment to The Times of Israel, “one can speculate that some of the rehabilitation and continuous care process should be devoted to teaching people with Parkinson’s that when they are turning to sit down, they should break the process into two separate pieces: first turn, briefly stop, and then sit down.”

“This is the way that healthy young and healthy older adults generally carry out this common task,” and they are much less prone to falls than people with Parkinson’s disease, he said.

Stopping along the turn “may, therefore, be safer and less prone to problems than doing this movement all at once,” he said.

Even so, he added, “it remains to be seen” if interventions designed to make this change in the turning process are indeed effective.

Article from Times of Israel.

 

Read more

Digital Management of Parkinson Disease: Is Technology the Future?

May 1, 2019 Education, Life, Research

With the ever-increasing integration of technology into nearly every aspect of modern life, its applications in medicine continue to expand, including in the area of Parkinson disease (PD).

A recent randomized controlled trial of 195 patients with PD, for example, found that physician care delivered via telemedicine into patients’ homes was as effective as in-person care.1 Additional emerging research supports the benefits of other digital tools in this patient population.

In a review published online in the Journal of Parkinson’s Disease, Clint Hansen, PhD, of the Department of Neurology at Christian-Albrechts-Universität Kiel and the University Hospital Schleswig-Holstein, Campus Kiel in Kiel, Germany, and colleagues explored current and future directions regarding the use of technologies such as the electronic health record (EHR) and wearable sensors in PD management.2

Although many institutions and private practices have replaced paper-based medical records with EHRs, there are often limitations on how these are used in clinical decision making. This is likely to change significantly within the next decade, as most “countries with established health structures will then have nationwide provision of innovative EHRs with cloud storage solutions, and most of these EHRs will be patient-controlled,” Dr Hansen and colleagues noted.

In addition, they wrote, EHRs will “communicate with clinical data warehouses that consolidate hospital- and practice-derived data, with population health analytics databases that will provide information about disease risk and prevention, and with digital technology that is used by… the patient.”2 They also expect that moving forward, data protection laws will become more stringent, thus reducing the risk for privacy violations and increasing patient acceptance of EHRs.

With the growing use of digital devices to provide personalized feedback on measures of health, including those worn on the wrist or contained in shoes, it is conceivable that similar tools could be designed to facilitate the continuous monitoring of disease manifestations in patients with PD. These systems “will most probably be easily and widely used and not [require] an active interaction with the user, will be approved by regulatory authorities and the costs will be covered by health insurances,” noted Dr Hansen and colleauges.2

As a template for such devices intended for application in PD, the authors pointed to continuous subcutaneous glucose monitors that are used in patients with diabetes. Other possibilities include integrated detection systems in hearing aids, glasses, and earphones to allow patient interaction with the environment; analysis of mobility data such as reaction times and multitasking ability; insertable cardiac monitors; use of a smartphone as an accelerometer platform to gauge the treatment efficacy of deep brain stimulation; and remote assessment of autonomic features and gut motility. Many of these systems should be easily individualized to each patient.

In another review published in the same journal issue, the authors propose the use of a sensor-based system to analyze gait and detect falls in patients with PD, which would include decision support based on big data sources.3 One benefit of this type of approach is the “standardization of real-life medical data derived from individual patients into longitudinal multimodal disease trajectories…[which] will allow matching and clustering of different patient trajectories for individualized prediction about the expected treatment efficacy of particular interventions,” wrote Jochen Klucken, MD, of the Department of Molecular Neurology at Friedrich-Alexander University, and colleagues, in the Journal of Parkinson’s Disease. “Ultimately, the growing amount of medical data derived from individualized real-life treatment contexts will enable academic and industrial research to further improve objective outcomes and better tailor individual care.”

To glean further insights pertaining to the use of digital health technology in the realm of PD, Neurology Advisor spoke briefly with Alberto J. Espay, MD, MSc, professor of neurology and director and endowed chair of the James J. and Joan A. Gardner Center for Parkinson’s Disease and Movement Disorders at the University of Cincinnati Academic Health Center. Dr Espay is also chair of the Movement Disorders Society Task Force on Technology, which promotes the development of digital health systems that will achieve the goals mentioned above.4

Neurology Advisor: What is a key example of how digital health technologies could be used to improve PD care?

Dr Espay: Digital health technologies have the capacity of capturing intraday fluctuations with the kind of granularity that no scales, diaries, or questionnaires can.

Neurology Advisor: How can clinicians support these developments?

Dr Espay: Clinicians can stimulate their patients’ participation in a variety of technology-integration projects through many organizations. This is a great time to participate and contribute.

There will be a variety of ongoing studies aimed at developing a new version of the diary in electronic format for the digital age, integrated with mobile health technologies (“e-diary/tracker”). This is being coordinated through the Task Force on Technology of the International Parkinson’s and Movement Disorders Society. Efforts such as these are ongoing or will soon occur in many countries in the world.

Neurology Advisor: What should be next steps in terms of research or development in this area?

Dr Espay: The future development of a unifying platform for integrating and synchronizing the data from multiple technologies, one of the goals of the Movement Disorders Society Technology Task Force, could provide the most comprehensive picture of patients’ function than anything we currently have.

Neurology Advisor: Would you like to note any additional takeaways on the topic?

Dr Espay: Technology offers us the means to improving the ends of health care delivery. In the future it will weave seamlessly into patients’ lives to enhance the capture of data, help anticipate periods in which changes are needed, and empower patients to apply strategies to enhance their quality of life.

References

1. Beck CA, Beran DB, Biglan KM, et al. National randomized controlled trial of virtual house calls for Parkinson disease. Neurology. 2017;89(11):1152-1161.

2. Hansen C, Sanchez-Ferro A, Maetzler W. How mobile health technology and electronic health records will change care of patients with Parkinson’s disease. J Parkinsons Dis. 2018;8(Suppl 1):S41-S45.

3. Klucken J, Krüger R, Schmidt P, Bloem BR. Management of Parkinson’s disease 20 years from now: towards digital health pathways. J Parkinsons Dis. 2018;8(Suppl 1):S85-S94.

4. Espay AJ, Bonato P, Nahab FB, et al. Technology in Parkinson’s disease: challenges and opportunities.Mov Disord. 2016;31(9):1272-1282.

Article from NeurologyAdvisor.

Read more

WPA on The Morning Blend!

April 5, 2019 Awareness, Community Outreach, Education, Life

Jeremy Otte, director of outreach & education, and Dale Luedtke, a musician with Parkinson disease, were featured on The Morning Blend, a morning talk show on TMJ4 Milwaukee. Check it out!

Read more

Educating the Educated About Parkinson’s Disease

April 1, 2019 Community Outreach, Education, Life

This column appeared in Parkinson’s News Today.

I went to the dermatologist yesterday for a skin check. Those of us who have Parkinson’s disease (PD) should make a habit of getting a yearly check because our condition increases the odds of getting skin cancer. The Mayo Clinic reported that patients with Parkinson’s “were roughly four times likelier to have had a history of melanoma than those without Parkinson’s, and people with melanoma had a fourfold higher risk of developing Parkinson’s.”

So, I had an appointment with the dermatologist. After a thorough body check and five biopsies, I was free to leave. The nurse stayed back with me after the doctor left because I struggled to move. She asked when I was diagnosed with Parkinson’s. After I answered “2004,” she replied, “Isn’t that young for Parkinson’s?” Not as young as when the symptoms began 10 years before that, I wanted to answer.

She followed that question with another: “Did it run in my family?”
No.
“Not even one relative?”
No.
“Are you sure?”
Yes.

While I dressed and walked out to where my husband waited in the car, I shook terribly. That’s something I hadn’t done in quite a while. I was sure it was the combination of numbing five different areas with an intrusive needle and the anxious feeling that came over me with the news that spots could be cancerous. However, what caught me almost more off guard was the nurse’s questioning.

I guess what surprised me is how uninformed so many still are.

I have spoken to groups about my 20-year journey with Parkinson’s disease. I write about it on my blog. I am open about it with others. I have written articles for several different publications. I am a PD advocate. I know a lot about the disease. I just figure others do, too. What surprised me most about her questions was that she worked for a dermatologist who should be very familiar with PD since the disease can highly affect the skin.

As patients, our job is far from finished.

As long as we live with PD, we are responsible for getting information about this disease out to everyone we can, as best we can. Not just to newbies in the patient club, but also those in the medical fields. Perhaps the patients and caregivers should hold a conference for medical professionals instead of the opposite. After all, we are living PD day to day, feeling it moment by moment. As my movement disability specialist once told me, “You patients are the experts. The doctors take their cue from you.”

If that is true then we need to be proactive with the hand we’re dealt. We must educate those around us, whether they’re a patient, nurse, caregiver, doctor, dental hygienist, or medical transporter. It’s going to take a whole lot more than answering the question of whether Parkinson’s disease is hereditary — it was obvious to me the nurse wasn’t buying my answers.

Read more

Exercise can improve non-motor symptoms of Parkinson’s disease

April 1, 2019 Education, Exercise

Exercise has potential to improve non-motor as well as motor symptoms of Parkinson’s disease (PD), including cognitive function, report investigators in a review published in the Journal of Parkinson’s Disease.

PD is a slowly progressive disorder that affects movement, muscle control, and balance. While traditionally regarded as a movement disorder, it is now known to be a heterogeneous multisystem disorder — in recognition of the significant impact that non-motor symptoms have on the quality of life of individuals affected by PD. It is widely acknowledged that physical exercise improves motor symptoms such as tremor, gait disturbances, and postural instability. However, the effect of exercise on non-motor symptoms in PD, especially cognitive function, is less clear.

The number of older people with and without PD that experience cognitive impairment is steadily increasing worldwide. It is associated not only with a substantial rise in healthcare costs, but also affects the quality of life of both patients and relatives or carers. Up to 57% of patients suffering from PD develop mild cognitive impairment within five years of their initial diagnosis, and if they survive more than ten years, the majority will eventually develop dementia. The underlying neurophysiological mechanisms for cognitive decline in PD are not completely understood, but an accumulation of amyloid plaques, mitochondrial dysfunction, and neurotransmitter changes are all suggested to contribute.

A comprehensive literature review was conducted by investigators from the Institute of Movement and Neurosciences, German Sport University, Cologne, Germany, and the VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia. The studies reviewed included investigations of the effects of coordination exercise, resistance exercise, and aerobic exercise on domain-specific cognitive function in patients with PD. “Physical exercise is generally associated with increased cognitive function in older adults, but the effects in individuals suffering from PD are not known,” explained lead investigator Tim Stuckenschneider, MA.

The researchers identified relevant studies published before March 2018. There were 11 studies included with a combined total of over five hundred patients with PD with a disease severity from stages 1 to 4 on the Hoehn & Yahr scale, which is used to describe the symptom progression of PD. In four studies, positive effects of exercise on cognition (memory, executive function, and global cognitive function) were shown with no negative effect of exercise on any cognitive domain. Furthermore, disease severity was generally improved by exercise interventions.

The investigators concluded that all modes of exercise are associated with improved cognitive function in individuals with PD, however, no clear picture of which exercise mode is most effective emerged as they may influence cognitive function differently. Aerobic exercise tended to improve memory best, but different forms of exercises such as treadmill training or stationary bike training may have different effects, although both are considered aerobic exercise. Future studies are needed that directly compare the effects of different exercise modes, as the number of high-quality research projects is still limited.

“The potential of exercise to improve motor and non-motor symptoms is promising and may help to decelerate disease progression in individuals affected by PD,” observed Stuckenschneider. “Exercise therapy needs to be, and often already is, an essential part of therapy in individuals with PD. However, it is mostly used to treat motor symptoms. As part of a holistic therapy, the potential of exercise to maintain or improve non-motor symptoms such as cognitive function in individuals with PD needs to be acknowledged, and the most effective treatment options need to be defined. This will not only help practitioners to recommend specific exercise programs, but also ultimately improve the quality of life of the individual. Our work shows that ‘exercise is medicine’ and should routinely be recommended for people with PD to help combat both the physical and cognitive challenges of the disease.”

Article from ScienceDaily.com.

Read more

WPA on the Radio!

April 1, 2019 Education, Life

WPA Executive Director Gary Garland was interviewed by Milwaukee Radio Group host Andrea Williams last week. Listen here!

Read more

Wisconsin Parkinson Association Mission

Our mission is to provide hope, community, support, and resources for people with Parkinson’s and their loved ones.

Contact

13400 Bishops Lane
Suite 120
Brookfield, WI 53005
414.312.6990
[email protected]
Follow Us On Facebook

View Our Annual Report

Click here to view Wisconsin Parkinson Association’s 2021-2022 Annual Report.

Search Our Site

Copyright Wisconsin Parkinson Association 2023