We recently launched a Podcast/Online Radio Show!
We will create a new episode every other week, and we’ll interview doctors, people with Parkinson’s, caregivers, therapists and more!
WPA in the Community
Assisted living communities are prepared to care for older adults, but they aren’t always familiar with Parkinson disease. When a new resident has Parkinson’s, they turn to WPA for help. Jeremy Otte, WPA’s director of outreach & education, is happy to connect with these facilities and spend time training their staff to recognize some of the unique challenges presented by Parkinson’s.
“We are a RCAC assisted living facility,” said Bonnie Cohn, RN, campus administrator for ProHealth Care Regency Senior Communities. “We see many residents that move in with very minimal effects of Parkinson’s and see how quickly their disease can progress.”
Regency Senior Communities recently invited Jeremy to help educate their staff. He visited their campuses in New Berlin, Muskego, and Brookfield, and gave five presentations for employees on different shifts.
“It was wonderful for him to be here to explain the different stages and what to watch for. It helped them to understand the reasons that a resident may have ‘freezing’ episodes, difficulty getting their thoughts across, or slow mobility,” Bonnie told us.
Jeremy also discussed the importance of administering medication at a certain time, helping staff to understand the impact medication can have on a resident’s quality of life. She was grateful that he helped the staff understand how to assist a resident who is have these issues.
If you are interested in having Jeremy speak at your community or agency, call our office at 414-312-6990.
How gut bacteria affect PD treatment
Patients with Parkinson’s disease are treated with levodopa, which is converted into dopamine, a neurotransmitter in the brain. In a study published on 18 January in the journal Nature Communications, scientists from the University of Groningen show that gut bacteria can metabolize levodopa into dopamine. As dopamine cannot cross the blood-brain barrier, this makes the medication less effective – even in the presence of inhibitors that should prevent the conversion of levodopa.
‘It is well established that gut bacteria can affect the brain’, explains Assistant Professor in Microbiology Sahar El Aidy, lead investigator of the study. ‘There is a continuous chemical dialogue between gut bacteria and the brain, the so called gut-brain axis.’ El Aidy and her team investigated the ability of gut microbiota to influence the bioavailability of levodopa, a drug used in the treatment of Parkinson’s disease.
The drug is usually taken orally, and the levodopa is absorbed in the small intestine and then transported through the blood stream to the brain. However, decarboxylase enzymes can convert levodopa into dopamine. In contrast to levodopa, dopamine cannot cross the blood-brain barrier, so patients are also given a decarboxylase inhibitor. ‘But the levels of levodopa that will reach the brain vary strongly among Parkinson’s disease patients, and we questioned whether gut microbiota were playing a role in this difference’, says El Aidy.
In bacterial samples from the small intestines of rats, Aidy’s PhD student Sebastiaan van Kessel found activity of the bacterial tyrosine decarboxylase enzyme, which normally converts tyrosine into tyramine, but was found to also convert levodopa into dopamine. ‘We then determined that the source of this decarboxylase was Enterococcus bacteria.’ The researchers also showed that the conversion of levodopa was not inhibited by a high concentration of the amino acid tyrosine, the main substrate of the bacterial tyrosine decarboxylase enzyme.
As Parkinson’s patients are given a decarboxylase inhibitor, the next step was to test the effect of several human decarboxylase inhibitors on the bacterial enzyme. ‘It turned out that, for example, the inhibitor Carbidopa is over 10,000 times more potent in inhibiting the human decarboxylase’, says El Aidy.
These findings led the team to the hypothesis that the presence of bacterial tyrosine decarboxylase would reduce the bioavailability of levodopa in Parkinson’s patients. To confirm this, they tested stool samples from patients who were on a normal or high dose of levodopa. The relative abundance of the bacterial gene encoding for tyrosine decarboxylase correlated with the need for a higher dose of the drug. ‘As these were stool samples, and the levodopa is absorbed in the small intestine, this was not yet solid proof. However, we confirmed our observation by showing that the higher abundance of bacterial enzyme in the small intestines of rats reduced levels of levodopa in the blood stream’, explains El Aidy.
Another important finding in the study is the positive correlation between disease duration and levels of bacterial tyrosine decarboxylase. Some Parkinson’s disease patients develop an overgrowth of small intestinal bacteria including Enterococci due to frequent uptake of proton pump inhibitors, which they use to treat gastrointestinal symptoms associated with the disease. Altogether, these factors result in a vicious circle leading to an increased levodopa/decarboxylase inhibitor dosage requirement in a subset of patients.
El Aidy concludes that the presence of the bacterial tyrosine decarboxylase enzyme can explain why some patients need more frequent dosages of levodopa to treat their motor fluctuations. ‘This is considered to be a problem for Parkinson’s disease patients, because a higher dose will result in dyskinesia, one of the major side effects of levodopa treatment.’
Top Senior Scams to be on the Lookout For
Eras Senior Network of Waukesha County coordinates S.T.O.P. – an awareness program focusing on frauds and scams aimed at older adults.
In 2014, the Federal Trade Commission created the Pass it ON campaign aimed at encouraging people to share vital information about scams. The FTC encourages you to not only share gifts and food during the holidays, but also tips about scams targeting older adults.
Since 2016, Eras Senior Network has given 47 presentations to over 1,250 seniors and their caregivers about common scams targeting the senior population. Through our research and conversations with seniors who have experienced interactions with scam artists, we’ve collected a list of popular senior scams that we hope you’ll share with those you love.
Grandparent Scam: A scam artist calls a senior and says “Hi Grandma, it’s me!” Oftentimes the senior assumes they’re speaking to their grandchild and won’t even ask for a name. Sometimes, the scam artist pretends to be crying, which distorts their voice, making it easier for the senior to believe it could be their grandchild. The scammer will then tell the senior they are in some sort of trouble and will need money wired to them – and begs their “grandparent” not to tell their “parents”. To avoid this scam, ask the caller specific questions like their name, address, or something only your true grandchild would know – and never wire money or send gift cards through the internet!
Telemarketing “Yes” Scam: Telemarketing scam artists use a simple response to steal from you. In this scam, a senior will receive a call and be asked if they can hear the caller. The natural response is to say “yes”. Unfortunately, scam artists can record this response and use it to fraudulently authorize charges via the telephone, according to the Federal Communications Commission. The best way to avoid this is by screening your calls and only answering numbers you recognize, or finding another way to answer their question without saying the word “yes.”
Medicare Card Scams: As you may know, new Medicare cards without the individual’s social security number began being mailed in April 2018. With this comes the risk for Medicare related scams as predicted by the Better Business Bureau. Scam artists may ask you for your social security number or a payment in order to receive your card. Your new Medicare card will be sent to you automatically at no charge – you DO NOT need to do anything or pay anything for your new Medicare card to be mailed to you.
Spear Phishing: Spear phishing is an email or electronic communications scam targeted towards a specific individual, organization or business. Emails that look like they are from a friend or family member can actually be attempts to steal data. Before clicking on the message, hover your mouse (without clicking) above the sender’s email address to see if it is from the person you know. Phone calls may showing caller identification from a known person can also be spear phishing attempts. Once you realize the caller isn’t your friend or family member, hang up without saying anything!
Sharing what you know about frauds and scams may be the best gift you can give someone. If you feel like you have been a victim of a fraud or scam, contact your local police department by calling their non-emergency number.
Kathy Gale is Executive Director, Eras Senior Network, Inc. and a member of the Wisconsin Attorney General’s Task Force on Elder Abuse. S.T.O.P. Senior Frauds and Scams is brought to you by Eras through a grant from the Wisconsin Consumer Antifraud Fund at the Greater Milwaukee Foundation and the United Way of Greater Milwaukee and Waukesha County. More information about Eras Senior Network, Inc. can be found at www.ErasWaukesha.org.
Experimental cancer drug repurposed for Parkinson’s
As promising as a drug candidate may be, the unfortunate truth is that not all of them end up performing as hoped – but that doesn’t mean they’re completely useless. Researchers at Oxford University have managed to give second life to an experimental cancer drug known as tasquinimod, which has now shown promise for Parkinson’s.
Tasquinimod emerged as a promising drug in fighting solid tumors, with most research focusing on using it to treat prostate cancer. The drug made it through to phase three clinical trials, but unfortunately it didn’t seem to extend overall survival rates in patients, and after those disappointing results development was discontinued for prostate cancer treatment.
But the work wasn’t for nothing – the clinical trials so far have shown that tasquinimod is well tolerated by the body, and it could still potentially help treat other illnesses, such as Parkinson’s disease.
To investigate the drug, the Oxford team first took skin cells from patients with a rare genetic form of Parkinson’s, and turned them into a type of stem cell known as induced pluripotent stem cells (iPS). From these the researchers grew brain cells in vitro, allowing them to observe progression of the disease in the lab.
The team found that the key may be an error with a protein known as HDAC4. When that happens, this protein begins to repress certain genes, which in turn messes with the brain cells’ ability to regulate the natural cycle of proteins. That means those proteins build up in the cells, which has long been known to contribute to Parkinson’s and related neurodegenerative diseases like Alzheimer’s.
Tasquinimod comes to the rescue by blocking HDAC4, meaning those key genes aren’t “switched off,” and effectively halting progression of the disease.
“We think that switching off these genes in brain cells may play a vital role in the cell damage and death that occurs in Parkinson’s,” says Richard Wade-Martins, co-lead author of the study. “Finding a way to ‘turn them back on’ with a drug could be a promising, unexplored way to develop new treatments.”
The researchers then repeated the study using iPS cells gathered from people with the more common non-genetic form of Parkinson’s, and found that the same pattern of inactive genes seems to be at play. That indicates that these people might also benefit from the treatment, although the team also acknowledges that some people don’t seem to respond to it.
“The study also highlights the growing number of drugs which can be repurposed from their original medical use to treat Parkinson’s,” says David Dexter, Deputy Director of Research at Parkinson’s UK, which funded the study. “Developing a drug from scratch is a long, slow and expensive process. By finding existing drugs and moving them rapidly into clinical trials, we can make them available for people with Parkinson’s much more quickly, easily and cheaply.”
Although that process may be streamlined, it is still early days for tasquinimod. The study has only been conducted on a total of 10 patients so far, so more testing will need to be done before it could become a viable treatment option.
The research was published in the journal Cell Stem Cell.
Did George HW Bush have Parkinson’s?
The recent death of former president George HW Bush from vascular parkinsonism led many to question the difference between the condition and Parkinson’s disease.
Parkinsonism is the umbrella term for conditions that mimic symptoms similar to those experienced by people living with Parkinson’s. Vascular parkinsonism can occur in people who have experienced a mild stroke, or have restricted blood supply to the brain. The condition causes symptoms similar to Parkinson’s – including rigidity, difficulties walking and problems with speech and memory.
While the symptoms of the two conditions are similar, vascular parkinsonism is not considered a progressive neurodegenerative disease.
Dr Michael Okun, professor of neurology at the University of Florida, said: “It can be tricky to differentiate Parkinson’s disease from vascular parkinsonism (due to stroke(s)). Many experts refer to stroke induced parkinsonism as lower body parkinsonism because it tends to affect the legs more than the arms. In practice the differentiation can be tricky and sometimes both entities actually coexist.”
Study examines links of age, smoking, and physical activity with Parkinson’s
A new study published in the European Journal of Preventive Cardiology examines the links of age, smoking and physical activity as factors associated with Parkinson’s.
Previous studies have examined the link between physical activity and Parkinson’s, but the findings were inconclusive because of difficulties interpreting the results.
Researchers from the Technical University of Munich, Germany, and the Stanford University School of Medicine, US, assessed how physical activity and lifestyle factors impact the development of Parkinson’s.
They invited 7347 male veterans from the Veterans Exercise Testing Study (VETS) – an ongoing physical evaluation program – to take part in the study. The average age of those who took part was 59.
During the period of the study – which was 12 years on average – 94 participants or 1.3% of those studied had developed Parkinson’s.
Researchers found that high physical fitness, current smoking and younger age were associated with a lower incidence of Parkinson’s disease.
Commenting on the study, researchers said: “These findings parallel those of several epidemiological studies focusing on physical activity and the onset of Parkinson’s disease. Together, these observations provide strong support for recommending physical activity to diminish the risk of Parkinson’s disease.”
View the full study from the European Journal of Preventive Cardiology here.
Study Reveals Mechanisms Underlying Pain Processing in PD
Parkinson’s disease is a condition affecting the human brain that becomes worse over time. The most common symptoms are tremors, muscle spasms and movements that are much slower than normal; all of which decrease an individual’s quality of life. Although there is currently no cure, the brain structures involved in Parkinson’s disease are known. These are collectively termed the basal ganglia, and are often targeted to treat the symptoms of Parkinson’s disease. For example, electrically stimulating the subthalamic nucleus (STN), one part of the basal ganglia, reduces muscle tremors and stiffness.
Pain is another common symptom in Parkinson’s disease. Patients often report strange burning or stabbing sensations with no obvious physical cause. They are also likely to be more sensitive to painful stimuli and have a lower pain threshold than normal. This suggested that the brain circuits that allow us to perceive and process pain could be somehow involved in Parkinson’s disease. Indeed, stimulating the STN is known to relieve pain in Parkinson’s disease, as well as the muscle symptoms, but exactly how the STN might link up with the brain’s ‘pain network’ remains poorly understood. Pautrat et al. therefore set out to explore the connection between pain networks and the STN, and determine its potential role in Parkinson’s disease.
First, the electrical activity of nerve cells in the STN of rats was measured, which revealed that these cells do respond to mildly painful sensations. Experiments using dyes to label cells in both the STN and brain structures known to transmit painful signals showed that the STN was indeed directly linked to the brain’s pain network. Moreover, rats with a STN that did not work properly also responded abnormally to painful stimuli, confirming that the STN did indeed influence their perception of pain. Finally, Pautrat et al. repeated their measurements of electrical activity in the STN, this time using rats that lacked the same group of nerve cells affected in the basal ganglia of patients with Parkinson’s disease. Such rats are commonly used to model the disease in laboratory experiments. In these rats, the STN cells responded very strongly to painful stimuli, suggesting that problems with the STN could be causing some of the pain symptoms in Parkinson’s disease.
This work reveals a new role for the STN in controlling responses to pain, both in health and disease. Pautrat et al. hope that their results will inspire research into more effective treatments of nerve pain in both Parkinson’s disease and other neurodegenerative conditions.
Characterization of Parkinson Disease With Restlessness
Highlights
- A study was conducted of restless leg syndrome, leg motor restlessness, and their variants in Parkinson disease and related disorders.
- A total of 49.2% of PD patients had any restlessness, including RLS and LMR.
- LMR variants and RLS variants are rare in PD and related disorders.
- PD with restlessness was related to autonomic, sleep and depressive symptoms.
Objective
The objective of this study was to investigate the prevalence of restless leg syndrome (RLS), leg motor restlessness (LMR) and RLS/LMR variants and their relationship with clinical factors in patients with Parkinson’s disease (PD) and related disorders.
Methods
Sixty-three PD patients, 17 multiple system atrophy (MSA) patients and 11 progressive supranuclear palsy (PSP) patients were included in this study. Through face-to-face interviews, the patients were diagnosed with RLS/LMR, or with RLS/LMR variants in which the symptoms occur predominantly in body parts other than the legs.
Results
The frequency of RLS, LMR, RLS variants and LMR variants was as follows: PD (12.7%, 11.1%, 0% and 1.6%); MSA (5.9%, 11.8%, 0% and 0%); and PSP (0%, 9.1%, 0% and 0%). Restlessness without the urge to move was observed in 25.4% of the PD patients, 11.8% of the MSA patients and 0% of the PSP patients. The PD patients with restlessness exhibited higher Hoehn and Yahr stages and higher scores on the Scales for Outcomes in PD-Autonomic, PD sleep scale-2 and Beck Depression Inventory-II. The olfactory functioning, 123I-MIBG myocardial scintigraphy uptake and dopamine transporter single photon emission computed tomography findings did not differ between the PD patients with restlessness and those without. The severity of RLS was correlated with the autonomic symptoms among the PD patients with restlessness.
Conclusion
PD with restlessness was characterized by increased autonomic, sleep and depressive symptoms. Further studies including a large sample are warranted to characterize restlessness in PD and related disorders.
Brian Grant Foundation launches free PD exercise program
The Brian Grant Foundation (BGF) has launched an online training program for physical therapists, personal trainers and group fitness instructors to develop safe and effective exercise classes for people living with Parkinson disease. The program is based on research from Oregon Health & Science University’s Balance Disorders Laboratory, which shows how to slow down the mobility problems associated with Parkinson’s using a variety of physical and cognitive activities.
Parkinson’s is a degenerative, neurological disorder that affects the cells in the brain that produce dopamine, a chemical that helps initiate and control movement. Although there is no cure for Parkinson’s, studies suggest a consistent, vigorous fitness routine may improve motor symptoms common in people with Parkinson’s, such as rigidity, slow and small movements, and impaired balance and coordination, along with non-motor symptoms such as depression, anxiety and sleep difficulties.
“After being diagnosed with Parkinson’s, I looked for ways to combat the symptoms that I was experiencing while keeping my physical abilities as long as possible,” said Brian Grant, former NBA player and BGF founder. “I learned the importance of staying flexible, keeping good posture and practicing specific movements to address symptoms of the disease.”
Getting people into Parkinson’s-specific exercise programs in the early stages of diagnosis is fundamental because the sooner a person with the disease starts a workout routine, the better their chances of slowing the progression of symptoms. Any exercise is better than none, but ideally, workouts should be higher intensity and include a variety of activities that have been shown to help target the common symptoms of Parkinson’s. For example, lunges are helpful for improving small movements while yoga increases flexibility and coordination.
That’s why the Exercise for Parkinson’s Training for Professionals program is such a game-changer. Instructors will learn how to safely and effectively train people with Parkinson’s using activities that offer the greatest benefits for symptoms. And most importantly, they’ll empower their clients to stay motivated, healthy and social by giving them the chance to work out with others who have Parkinson’s disease.
BGF is recognized by the National Academy of Sports Medicine (NASM) and Athletics and Fitness Association of America (AFAA) as an approved continuing education provider. Exercise professionals certified through NASM or AFAA will receive continuing education credit for completing the online Exercise for Parkinson’s Training.
Brian Grant Foundation: Founded in 2010 by former NBA player Brian Grant, who is living with Parkinson’s, the Brian Grant Foundation provides tools to improve the well-being of people with the disease. BGF’s programs focus on exercise and nutrition to help people with Parkinson’s manage their symptoms, improve their overall health and prevent other serious illnesses.
Recent Comments