December in July

The title refers to the fact that this post was drafted back in December 2016 as an email InfoShare for the Capitol Area Parkinson’s Support (CAPS) group, which is meeting today (July 15 2017) at 2 PM. Never did send it out. So here it is, a few months late, but the news is still timely. Especially the value of early treatment and diagnosis of PD.  So, here it is:
The London School of Economics and Political Science recently released a report on the “Value of Early Diagnosis and Treatment in Parkinson’s Disease”, a literature review of recent studies with recommendations for action. It can be downloaded at http://www.braincouncil.eu/wp-content/uploads/2016/11/Parkinson-report-2016-1.pdf 
On a broader view of PD,  here’s a link to a page that has links to just about everything Parkinson’s – The National Institutes of Health (NIH) U.S. National Library of Medicine (NLM) Medline Plus topic page on Parkinson’s Disease.
OK – you can spend a week going through all of that information. 
So here are the items mentioned in the subject headline:
First, evidence that DBS is helpful in early stages of PDS, not just in later stages. Benefits extend for at least 5 years.
The PDF copy of the research paper referenced in the above news article can be found at this link:
A less drastic approach than brain surgery might be helpful for motor symptoms:
Next, contradictory evidence regarding whether statins used to lower cholesterol levels offer a protective effect for PD – previous analyses said yes, but further massage of the data reveals that the answer is not as simple as it seemed at first.
Here are links to related articles, papers, and abstracts:
Earlier this year, an analysis of ten reports that yielded different conclusions after adjusting for cholesterol levels.
In 2012, the JAMA Neurology journal published a prospective analysis that indicated statins reduced the risk of PD. (PDF of full article is available for free download):
Several years ago, an analysis found publication bias in favor of positive results, and both a protective effect for statin use and no protective effect for long term statin use:
And last year, an analysis of published reports that found that use of statins was not protective for PD, in contrast to the hypothesis that statins are protective.

Contributing to Research via DNA sharing

I had my DNA analyzed by 23AndMe and in addition to getting some somewhat innocuous reports on my genetic makeup (including the revelation that there is about .5% match each with Askenazi and African groups somewhere in my ancestry, plus some Neanderthal genes) my data has been anonymously included in nine published articles/studies so far, including:

  1.   23and Me blog article on Depression and genes:  https://blog.23andme.com/23andme-research/new-genetic-findings-on-depression/     The original (abstract of) the article on genes associated with depression:  http://www.nature.com/ng/journal/v48/n9/full/ng.3623.html 
  2.  On genes related to risks of basal cell carcinoma:  https://blog.23andme.com/23andme-research/new-study-on-genetics-of-common-type-of-skin-cancer/   Original article in Nature Communications:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992160/  
  3.  AND OTHERS which can be found at 23AndMe Blog – Research category

    Live long and Prosper!

I’ve got a (gut) feeling…

Here’s a sample of links to Gut Microbiota For Health’s website and some of the research articles they’ve published, mostly in the last year. One talks about the linkage between certain bacteria and motor system disorders, another about relief for constipation for Parkinson’s patients, Another is a compilation of several articles, and finally, an article that explores the gut to brain relation regarding Parkinson’s, and to top it all off, the relationship of the bacteria in your stomach to the chemicals in your brain, and how the various microbial communities communicate. Life goes on within you and without you, it would seem.

Standing up can reveal cognitive difficulties.

Unmasking cognitive deficits by standing up

Published at the end of November 2016, the linked article found that folks with orthostatic hypotension revealed more cognitive deficits on standing up than when measured sitting down or lying down.

Since most cognitive tests are administered while the subject is sitting or lying down,  cognitive difficulties faced in day to day living might be underestimated.

Participants with PD and OH were far more susceptible to posture-related impairment on several tests, including those that measured math skills, the ability to produce words easily, keeping information in mind while working on it, paying sufficient attention so that later memory is efficient and searching for items quickly and accurately.

Will Parkinson’s be diagnosed by a simple sample of blood in the near future?

A step towards more accurate diagnoses of Parkinson’s and other similar neurological diseases was recently reported in Nature. And by CNN which picked up the story: Parkinsons disease blood test study

Up until now, many diseases have been diagnosed based on symptoms, with patients asking, “How do you know I have this?” Meanwhile, doctors are not always correct, Wright said. This is true even of Parkinson’s, which is diagnosed based on symptoms, a patient’s history, neurological exams, a patient’s response to medicine and, in some cases, brain imaging tests.

As a person with Parkinson’s among other conditions, related or unrelated, this would be a big deal. When a diagnosis is based on having a specific array of symptoms, some of which might not be present in all cases (tremors, for instance), one wonders whether medications for reducing certain symptoms might not prevent the presentation of all the symptoms required for a diagnosis of Parkinson’s.

It does me little good to play “what if” since one doesn’t know how one would have reacted to an earlier diagnosis at an earlier age. One can only refer to Victor Frankl’s work on the search for meaning in our lives, and approach the present as though one has already been at this decision point and are being given a second chance to make a decision just as wrong as the original decision. At least that’s how I remember that particular quote.  Here’s another quote from Frankl:

the meaning of life always changes, but that it never ceases to be. According to logotherapy, we can discover this meaning in life in three different
ways: (1) by creating a work or doing a deed; (2) by experiencing something or
encountering someone; and (3) by the attitude we take toward unavoidable
suffering. The first, the way of achievement or accomplishment, is quite obvious.

Contributing data for scientific research

Got my genome sequenced by the folks at 23andMe, and consented to having my data used in research studies. As a result, some new genetic sites have been identified through the sifting of the aggregate data of other folks like or unlike me.

We humans are pattern identifying organisms. So if you have Parkinson’s but not one of the gene mutations/variations known to “cause” the disease, it is only natural that we would look for correlations and associations that might also result in Parkinsonism.  So scientists mine the DNA data of thousands of people with Parkinson’s and find some additional markers

DNA and Parkinson’s – discovery by association

A related article

Not having been trained in the field, I think in broader terms – for instance, if 50% of depression diagnoses eventually become PD cases, and 25% of essential tremor cases result in Parkinson’s cases, doesn’t it stand to reason that a person with depression and essential tremors will have a greater than 50% chance of developing Parkinson’s, assuming their lifetime is long enough?  Or would it be greater than 75%? It would be interesting to see a Venn diagram of overlapping diagnoses…

One more cup of coffee for the road

It seems that caffeine and therefore coffee can have a neuro-protective effect for Parkinson’s people.
CDC site article on Parkinson’s, Genomics and Coffee:

Here’s a guy who probably won’t be getting PD, if coffee and nicotine protect one against Parkinson’s. (I drank a lot of coffee in my day, but quit smoking early, after getting strep throat and then bronchitis within the course of a few months. Figured my body was trying to tell me something.)

A Good ole Boy a’Dancin an’ a’Prancin’ Again

This just came in: A physiotherapist in Oklahoma has discovered gait training with the use of favorite music and posted the anecdotal results as a video on Facebook. I remember my first experience with Dance for Parkinson’s  and how it got me swinging my arms to the rhythm. Recently found that Walk Like A Man reminds me to get my shoulders back and my head up, instead of stooping over like Quasimodo. (YouTube of WLAM below).

Someone needs to put together a playlist on YouTube of Gait Training For Parkinson’s videos and songs. Who will beat me to it? Bueller? Bueller?

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