Individualized Presentation: A Hallmark Of Parkinsons
If you have met a person with Parkinsons, then you have seen just one patient with Parkinsons. I heard a medical doctor say this at a Parkinsons disease support group meeting and presentation several years ago. After attending four different PD support groups, the truth of individualized presentation was
Whats New In Parkinsons: September 2020
Fall has arrived with cooler temperatures and a wealth of new discoveries about Parkinsons. Weve rounded up some of the most important articles, podcasts, research, and living well stories that hit the news this month for you to check out. Let us know if we missed anything important. Happy reading!
What Can You Do If You Have Pd
- Work with your doctor to create a plan to stay healthy.;This might include the following:
- A referral to a neurologist, a doctor who specializes in the brain
- Care from an occupational therapist, physical therapist or speech therapist
- Meeting with a medical social worker to talk about how Parkinson’s will affect your life
For more information, visit our;Treatment page.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
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General Approach To Management
The primary goal in the management of PD is to treat the symptomatic motor and nonmotor features of the disorder, with the objective of improving the patients overall quality of life. Appropriate management requires an initial evaluation and diagnosis by a multidisciplinary team consisting of neurologists, primary care practitioners, nurses, physical therapists, social workers, and pharmacists., It is also important that the patient and his or her family have input into management decisions.
Effective management should include a combination of nonpharmacological and pharmacological strategies to maximize clinical outcomes. To date, therapies that slow the progression of PD or provide a neuroprotective effect have not been identified., Current research has focused on identifying biomarkers that may be useful in the diagnosis of early disease and on developing future disease-modifying interventions.,
What Are The Latest Approved Treatments For Parkinsons Disease
Several medicines have been approved for the treatment of Parkinsons disease. Here are some of the available medicines for Parkinsons disease:
Nuplazid was approved for the treatment of patients with hallucinations and delusions associated with Parkinsons disease psychosis by the Food and Drugs Administration on April 29, 2016. On December 3, 2020 The approved an update to the prescribing information for Nuplazid that will allow the medication to be taken more easily by Parkinsons patients who have difficulty swallowing.
Ongentys is a medication used for the treatment of Parkinson disease. It is indicated for the treatment of adult patients with Parkinson disease. It is used as an add-on to levodopa/DOPA decarboxylase inhibitors in patients who are having fluctuations in the control of their condition.
Opicapone was approved for treating patients with Parkinsons Disease as an add-on to levodopa/DOPA decarboxylase inhibitors in patients who are having fluctuations in the control of their condition by the European Medicines Agency on June 24, 2016 and by the Food and Drug Administration on April 24, 2020.
Nourianz/Nouriast was approved by the Food and Drug Administration , USA, on August 27, 2019 and by the Pharmaceuticals and Medical Devices Agency , Japan, in June 2013.
How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
Establishing Pd Research Priorities
The NINDS-organized Parkinsons Disease 2014: Advancing Research, Improving Lives conference brought together researchers, clinicians, patients, caregivers, and nonprofit organizations to develop 31 prioritized recommendations for research on PD. These recommendations are being implemented through investigator-initiated grants and several NINDS programs. NINDS and the NIHs National Institute of Environmental Health Sciences held the Parkinsons Disease: Understanding the Environment and Gene Connection workshop to identify priorities for advancing research on environmental contributors to PD.
Research recommendations for Lewy Body Dementia, including Parkinsons disease dementia, were updated during the NIH Alzheimers Disease-Related Dementias Summit 2019 .
Parkinsons Living Well Stories
- In a recent interview with Parkinsons Life, Davis Phinney shares his story and dedication to living well with Parkinsons and helping countless others do the same. I dont spend much time, if any, musing about things like a cure for Parkinsons, he says. I prefer to focus on the areas that I can positively affect here and now.
- Recognizing that many people with Parkinsons experience handwriting challenges, Neurocrine Biosciences recently launched a Cards to Heroes campaign, designed to encourage people whose handwriting has been affected by Parkinsons to write a brief note of appreciation to their hero. You can learn more about the campaign at pdcardstoheroes.com.
- Two leading Parkinsons experts andJournal of Parkinsons DiseaseEditors-in-Chief have guided the development of a special supplement to theJournal of Parkinsons Disease, which focuses on management strategies to help people living with Parkinsons stay positive and well.
Spotlight On Parkinsons Disease: Whats New In Pd Treatment
Parkinsons disease affects the person diagnosed and everyone who is close to that person: family members, friends and co-workers. We invite you to view our latest webcast in the Spotlight series, Spotlight on Parkinsons Disease: Whats New in PD Treatment. While this webcast provides expert perspectives to help you better understand the latest information about the treatment of PD, it is designed to help all people impacted by PD.
This webcast is an archive of the live web education program that was held on September 22, 2020. Please share this invitation with anyone in your support network whom you feel will benefit from participating.
Causes Of Parkinson’s Disease
Parkinson’s disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This;leads to a reduction;in a chemical called dopamine in the brain.
Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson’s disease.
Exactly what causes the loss of nerve cells is unclear. Most experts think that a combination of genetic and environmental factors is responsible.
How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
- Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
- Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
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The Actor Wasn’t Initially Open About His Parkinson’s Diagnosis
Michael J. Fox was diagnosed with Parkinson’s disease in 1991, but he stayed quiet about it for seven years, only telling people who needed to know . Finding new career success with the film “The American President,” Fox returned to television with the sitcom “Spin City.” This, however, meant talking about his diagnosis with the network and production company. “I said it could get very bad or not get bad,” he recalled to People in 1998. “They said, ‘Let’s go!'”; It would be two seasons into the show’s run before Fox told his costars about his condition.
It’s understandable that someone with Parkinson’s would feel anxiety and not want to talk about the disease. The European Parkinson’s Disease Association’s website explains that it is common for someone with this disease to experience mild to severe general social anxiety in which they are worried about being judged. And, unfortunately, that fear can exacerbate some of their symptoms like shaking. But beyond this, research shows that the way Parkinson’s disease can change a person’s brain chemistry may alone bring on feelings of anxiety. In addition, someone with Parkinson’s might develop akathisia, a different condition which mimics anxiety in that the person is uncontrollably restless.
Ultimately, Fox came to an important realization: To properly accept having Parkinson’s, he needed to be open about it. This turning point for Fox, however, meant he had to make significant changes in his life.
A Niche Therapy Emerges
Rapidly acting abortive agents have emerged as a niche therapy for Parkinsons disease, said Thomas L. Davis, MD, Professor of Neurology at Vanderbilt University in Nashville. The purpose of these drugs is to reduce motor fluctuations and unpredictable off periods that sometimes limit patients social activities. The only approved treatment of this kind is an autoinjector that delivers apomorphine subcutaneously. The device allows the patient to adjust the dose and delivers it reliably. Many patients dislike giving themselves injections, however.
Thomas L. Davis, MD
Several other rapidly acting abortive agents under investigation may soon become available. A sublingual formulation of apomorphine is currently in phase III trials. These self-dissolving strips avoid the potential inconvenience of self-injection, but one challenge is the possibility that patients may swallow the strips before they dissolve fully. These formulations also do not permit fine control of the dose. The phase III trials are almost complete, and this drug could be available in the near future, said Dr. Davis.
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Complementary And Supportive Therapies
A wide variety of complementary and supportive therapies may be used for PD, including:
A healthy diet. At this time there are no specific vitamins, minerals, or other nutrients that have any proven therapeutic value in PD. The National Institute of Neurological Disorders and Stroke and other components of the National Institutes of Health are funding research to determine if caffeine, antioxidants, and other dietary factors may be beneficial for preventing or treating PD. A normal, healthy diet can promote overall well-being for people with PD just as it would for anyone else. Eating a fiber-rich diet and drinking plenty of fluids also can help alleviate constipation. A high protein diet, however, may limit levodopas absorption.
Exercise. Exercise can help people with PD improve their mobility, flexibility, and body strength. It also can improve well-being, balance, minimize gait problems, and strengthen certain muscles so that people can speak and swallow better. General physical activity, such as walking, gardening, swimming, calisthenics, and using exercise machines, can have other benefit. People with PD should always check with their doctors before beginning a new exercise program.
Alternative approaches that are used by some individuals with PD include:
New Technology May Boost Efficacy Of Potential Gene Therapies For Parkinsons Others
TWSA gene-associated biological pathways included the mTOR signaling pathway, with alterations being a common hallmark of human neurological disorders. Pathways related to the metabolism of selenium-related compounds also were associated, as was the PPAR signaling pathway, which is activated by naturally occurring fatty acids and plays an essential role in the regulation of numerous biological processes.
Finally, the team identified 166 characteristics linked to genetic changes in the TWAS genes, which were neurological, psychiatric, and cognitive. A further correlation between Parkinsons and 122 identified traits with current GWAS data found a positive correlation with older age at first sexual intercourse and Parkinsons.
Five traits that negatively correlated with Parkinsons included heel bone mineral density, current tobacco smoking, and three measures of leg fat. Importantly, tobacco use disorder and bone mineral density have been identified through GAD disease enrichment analyses, the researchers noted.
The team pointed out that studies show smoking is associated with a lower incidence of , and nicotine stimulates nerve cells that are damaged in Parkinsons and protects against nerve cell damage in animal models.
These findings are expected to further research into the effects of these specific genes in possibly causing Parkinsons.
How Much Does Parkinsons Disease Change Someones Personality
Many Parkinsons caregivers report seeing changes to their loved ones as the disease progresses. Some people experience more irritability. Others might see apathy. Maybe its just that theres been a subtle adaptation to how they experience the world. Since my dads diagnosis in 2013, Ive definitely seen changes in
Alpha Synuclein Receives Renewed Attention
The past year has witnessed a renewed interest in alpha synuclein, said Dr. Davis. In Parkinsons disease, the protein forms abnormal polymers and accumulates in Lewy bodies. Removing abnormal or dysfunctional alpha synuclein might reduce symptoms or modify the disease course. One way to effect this removal is to increase autophagy, the bodys mechanism for clearing dysfunctional proteins.
Nilotinib, a tyrosine kinase inhibitor approved for the treatment of Philadelphia-positive chronic myelocytic leukemia, increases autophagy clearance of alpha synuclein in rodent models. In 2016, researchers randomized 12 patients with either Parkinsons disease dementia or dementia with Lewy bodies to 150 mg/day or 300 mg/day of nilotinib for 24 weeks. The drug appeared to be safe and well tolerated, and the results suggested possible motor and cognitive benefits of treatment. CSF levels of homovanillic acid, the end metabolite of dopamine, were significantly increased at week 24, compared with baseline, suggesting an increase in dopamine production. The trial was open label.
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Michael J Fox Stepped Away From Television And Created A Foundation
After going public in 1998 with his Parkinson’s disease diagnosis, Michael J. Fox found support from Meredith Baxter, the actress who played his mother on “Family Ties.” She said in a statement provided to;The Washington Post, “The fact that Michael is passing along his experience and truth is a very courageous and loving thing to do.”;After telling the world about his condition, Fox continued his role on “Spin City” as the Deputy Mayor of New York City Mike Flaherty for another two years.
“One of the reasons I left ‘Spin City’ was that I felt my face hardening,” Fox explained to;The New York Times. “My movements were constricted. If you watch episodes from the last couple of seasons, you’ll see I would anchor myself against a desk or the wall. Eventually it was too burdensome.”
As it turned out, Fox’s final performance as Mike Flaherty before retiring from “Spin City” was on the 100th episode of the popular sitcom, per the;Michael J. Fox Foundation. It wasn’t long after this curtain call that he opened his foundation with the mission to cure what’d long been considered an incurable disease.
Michael J Fox Is Hopeful About New Treatments
Since the cause of Parkinson’s disease is still not clear, treating it can be challenging. And even when a medicine is effective, that doesn’t mean there aren’t any side effects. As Michael J. Fox told The New York Times, although carbidopa-levodopa medication had been the “gold standard” for Parkinson’s patients, it can cause dyskinesias, in which a part of the body moves involuntarily. Fox himself has this side effect from his medications and so some nights, he will sleep on the floor rather than in his bed to both provide some resistance to his movements and avoid disturbing his wife’s rest, according to;Men’s Health.
A number of medications used to treat Parkinson’s focus on the effects of dopamine on the mind and body . This is because this chemical produced by our brains allows us to coordinate our muscle movements. Not surprisingly, a common aspect of Parkinson’s is having lower levels of dopamine. So, when taking carbidopa-levodopa, levodopa helps to replenish dopamine, and carbidopa slows the breakdown of levodopa.
In addition, Amantadine can help with levodopa-related involuntary movements. Nevertheless, during his interview with The New York Times, Fox talked about the importance of finding better treatment options, “like a rescue inhaler for when you freeze,” he said, referring to how sometimes Parkinson’s patients are unable to move. “Treatments for that can make a huge difference in people’s lives,” he continued.
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Can Parkinsons Disease Be Prevented
Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.
Advanced And Future Treatments For Parkinsons
While theres no cure for Parkinsons disease, recent research has led to improved treatments.
Scientists and doctors are working together to find a treatment or prevention technique. Research is also seeking to understand who is more likely to develop the disease. In addition, scientists are studying the genetic and environmental factors that increase the chance of a diagnosis.
Here are the latest treatments for this progressive neurological disorder.
In 2002, the FDA approved deep brain stimulation as a treatment for Parkinsons disease. But advances in DBS were limited because only one company was approved to make the device used for the treatment.
In June 2015, the FDA approved the
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