Does The Tissue Bank Need To Know My Medical History
Since it is essential to relate studies on samples of tissue to the medical history of the tissue donor, we need your permission to access your medical records. You give this permission by signing the ‘Consent for the Procurement of Tissue’ form on our donor registration documents page. Once we have collected your tissues we will contact your general practitioner and neurologist if necessary and ask to consult your medical records. The information will be used to prepare a summary that will be supplied to the researchers who have received samples of your tissue. This medical summary will also help our neuropathologist to interpret his findings on examination of your brain and spinal cord. Your next-of-kin will be informed of the findings in the neuropathology report so that they can discuss the findings and their implications with their GPs if they wish to do so.
Pool Therapy For Multiple Sclerosis Patients
Multiple Sclerosis is a condition that weakens muscles and movements over time. Thus, strength training early and often is one of the key ways to keeping the muscles from weakening. However, this can be understandably difficult for someone who has difficulty walking, picking up a fork to eat or simply waving hello. For Multiple Sclerosis sufferers, the HydroWorx therapy pool can be a place for them to more easily build lean muscle mass than would ever be possible on land. Even if they cannot walk down the street comfortably or safely, they can walk on a treadmill in the water without fear. Not only are they protected by the innate buoyancy of the water, but they are given a psychological boost because they arent afraid to fall.
In a case study that was recently done in Great Britain, a woman with Multiple Sclerosis was treated in the HydroWorx pool. She had complained of progressive weakness in her upper and lower left limbs during a two-year period. She had to walk with a cane, and tended to favor one of her legs over the other. This was causing serious gait problems.
Onset Of Als And Parkinsons
There are several different variants of ALS but it generally affects people between the age of 40 and 70. Juvenile onset ALS, however, can start in childhood or typically before the age of 25, although this form of ALS is particularly rare. The onset of ALS is estimated to be 20% more common in men compared with women and in 10% of cases there is likely to be a genetic component.
Parkinsons disease is usually diagnosed in people over the age of 60, though a small percentage exhibit the symptoms before the age of 50.
Once again, men are more likely to develop Parkinsons than women.
Parkinson’s Disease And Multiple Sclerosis: Conditions And Differences
Its important to note that, while both Parkinsons and multiple sclerosis are diseases of the CNS, they dont originate in the same way. MS is an autoimmune disease, brought on by the immune system attacking myelin, the protective coating over the nerves in the CNS that also speeds up signals. This affects mainly the brain and spinal cord, though it can also affect the optic nerve as well. In Parkinsons disease, the neurons in the brain die off without any known attack, with the lack of dopamine they produce leading to the onset of the disease. This doesnt affect nerves in the spinal cord.
Other notable differences include:
Testing For Parkinsons Disease
There is no lab or imaging test that is recommended or definitive for Parkinsons disease. However, in 2011, the U.S. Food and Drug Administration approved an imaging scan called the DaTscan. This technique allows doctors to see detailed pictures of the brains dopamine system.
A DaTscan involves an injection of a small amount of a radioactive drug and a machine called a single-photon emission computed tomography scanner, similar to an MRI.
The drug binds to dopamine transmitters in the brain, showing where in the brain dopaminergic neurons are.
The results of a DaTscan cant show that you have Parkinsons, but they can help your doctor confirm a diagnosis or rule out a Parkinsons mimic.
Who Funds And Oversees The Work Of The Tissue Bank
The Tissue Bank is jointly funded by the Multiple Sclerosis Society of Great Britain and Northern Ireland and Parkinsons UK. The charities have put in place a system of governance that ensures that the work of the Tissue Bank is regularly reviewed by an independent panel that includes experts on both conditions, in tissue banking and in research; persons with MS and Parkinsons are also members of the panel. In addition, the literature, consent forms and procedures that are used by the Tissue Bank have all gained approval from the appropriate national ethics committee. Tissue Bank is fully licensed by the Human Tissue Authority, a government regulatory body that oversees the use of human samples in research and we are regularly to ensure compliance. Tissue donated to the Tissue Bank is a gift and therefore the Tissue Bank does not charge any of the researchers for the tissue that they have received.
Thank you again for reading through these pages and for finding out about making a very special contribution to discovering a treatment for multiple sclerosis. For more condition-specific information please download or request the appropriate information sheet from our donor registration documents page.
Multiple Sclerosis Vs Parkinsons Disease: Us Prevalence And Economic Impact
Anyone can develop multiple sclerosis, but it mostly affects 20- to 40-year-olds. Prevalence of multiple sclerosis in the U.S. is estimated at over 400,000 cases, and nearly 200 new cases are diagnosed each week. Rates of multiple sclerosis are highest in areas furthest away from the equator, so the rates are higher in the Northern U.S.
Direct and indirect costs resulting from multiple sclerosis can range from $8,528 to $54,244.
One million Americans live with Parkinsons disease. The average cost of Parkinsons disease including treatment, lost work wages, and social security payments is $25 billion annually in the U.S.
Scales Used To Measure Depression In Parkinsons Disease
As mentioned above, symptoms of idiopathic PD have considerable overlap with those of depression. This means that standard rating scales for depression may not be valid in this situation. Rating scales for depression may be loaded with somatic or vegetative symptoms, which reduce their validity.
Three rating scales have been tested using a clinical interview with operationalised diagnosis as a gold standard. Using receiver operating curves, the sensitivity and specificity at a given cut off point can be calculated. From this methodology, it is clear that the Beck depression inventory is not a useful rating scale in PD. The Montgomery and Asberg depression rating scale and the Hamilton depression scale have performed better. In summary, diagnosis of depression should be made clinically, using appropriate diagnostic criteria, with severity or response to treatment being measured using MADRS or HAM-D.
Slowing The Development Of Multiple Sclerosis
This table depicts the results of four major studies showing that beginning treatment at the “pre-MS” stage of the disease, after the first clinically isolated syndrome , extended the time until the MS diagnosis compared to people who were not treated after a CIS.
Multiple Sclerosis: The Basics
Multiple sclerosis is thought to be an autoimmune disease in which immune system cells and inflammatory chemicals damage the myelin sheath that covers nerve cells in the brain and spinal cord. This, in turn, leaves the neurons open to further damage and impairs their ability to communicate, leading to problems with vision, movement, balance, and thinking. Most people are diagnosed in their twenties and thirties. Although studies suggest that about half of people with MS use a cane for walking and 15 percent require a wheelchair 10 years after diagnosis, the disease-modifying drugs used in treatment today can significantly slow the progression of the disease and the development of disability.
Between 250,000 and 350,000 people in the United States, primarily women, have been diagnosed with MS. The disease is likely related to a combination of genetic and environmental causes. People with a family history of the disease have a much higher risk of developing MS themselves.
Diagnosis Of Depression In Parkinsons Disease
Diagnosing depression in PD can be particularly difficult because of the clinical overlap between the two syndromes.
Symptoms that are common to both depression and idiopathic Parkinsons disease include motor slowing, bradyphrenia, sleep and appetite disturbance, weight loss, loss of interest and concentration, and reduced libido. The body language of depression looks similar to that of PD at first glance. The patient often appears hunched with a lack of an obvious affective response and spontaneity .
Symptoms that may help in the diagnosis of depression in people with PD include;
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pervasive low mood with diurnal variation
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early morning wakening
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pessimistic thoughts about the world, themselves, and the future
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suicidal ideation.
Table 1 lists the Diagnostic and statistical manual, 4th revision criteria for major depressive episode.
Table 1
?DSM-IV criteria for major depressive episode
Depression should be considered in any patient whose function deteriorates notably over a few days or weeks.
Table 2
?Differential diagnosis of depression in Parkinsons disease
A variety of mood disorders have been described in the setting of neurosurgery for PD. These include transient dysphoria during surgery . More chronic changes in mood have also been described following pallidotomy and deep brain stimulation although definitive studies have not been performed in this area.
Which Is Worse Als Or Ms
Multiple sclerosis is an autoimmune disease, while ALS is hereditary in 1 out of 10 people due to a mutated protein. MS has more mental impairment and ALS has more physical impairment. Late stage MS rarely is debilitating or fatal, while ALS is completely debilitating leading to paralysis and death.
Key Difference Ms Vs Parkinsons
MS and Parkinsons disease are two diseases affecting the central nervous system. Multiple Sclerosis is a chronic autoimmune, mediated inflammatory disease affecting the central nervous system. On the other hand, Parkinsons disease is a movement disorder characterized by a decline in the level of the brain.Although MS is an autoimmune disorder, there is no immune component in the pathogenesis of Parkinsons disease.This is the key difference between MS and Parkinsons.
Rating Scales For Depression Post
Rating scales for depression have two main uses after strokeas a screening instrument, and as a way of measuring change in symptoms over time. There are very few studies validating the use of rating scales for measuring change, but a number of studies have looked at validation of screening instruments.
On the whole there tends to be poor agreement between a variety of screening rating scales and clinical diagnosis based on operationalised criteria. For most of the scales that have been studied using receiver operating curves, sensitivity to depression is only gained by significant losses in specificity. A recent review of screening instruments produced for the Stroke Association recommended the following screening measures:
Risk Factors For Depression In Ms
There appears to be a complex relation between disability, pain, fatigue, perception about prognosis, location of lesion, and depression in MS. Most of the magnetic resonance imaging studies have not located a depressogenic MS lesion except for a possible relation between severity of depression and right temporal lesions.
Multiple Sclerosis Vs Parkinsons Disease: Treatment And Therapies
Treatment for multiple sclerosis is lifelong, and although it cannot cure the condition, it aims to minimize symptoms and allow the patients to live as normal of a life as possible. Some treatment methods include corticosteroids and plasma exchange, beta interferons, Glatiramer acetate, Dimethyl fumarate, Fingolimod, Teriflunomide, Natalizumab, Alemtuzumab, and Mitoxantrone, which all help to reduce the likelihood of relapses.
Other treatment methods include physical therapy to improve mobility, muscle relaxants, medications to reduce fatigue, and other medications like antidepressants, medications to control the bowels and bladder, and medications to improve sexual function.
Exercise, meditation, yoga, and acupuncture are also recommended as a means to reduce stress and improve overall mental and physical well-being.
There is no cure for Parkinsons disease as well, but treatments are available to manage the symptoms and slow down the disease progression as much as possible. Alongside traditional treatments, supportive therapies are also used to improve different aspects of a persons health.
Common medications prescribed in Parkinsons disease include dopamine replacement therapy, dopamine agonists, anticholinergics, amantadine, monomine oxidase type B inhibitors, and catechol-o-methyl transferase inhibitors.
You can work closely with your doctor to create a specific treatment plan for you.
Will My Personal Details Be Kept Confidential
All consent forms and related paperwork are stored in secure filing cabinets. Personal details of our tissue donors are never divulged to researchers receiving tissue or anyone outside the Tissue Bank. The databases that store details of individuals that have requested information, those registered as donors and those that have donated tissues, are on a secure computer that is only accessed by Tissue Bank staff.
Pool Therapy For Parkinsons Patients
Like Alzheimers, Parkinsons disease tends to be progressive in nature. Disturbing the neurons in the brain, Parkinsons slowly robs patients of balance, muscle control and motor functions. As has been noted by the Parkinsons Center for Disease, there is a two to four percent increased risk for Parkinsons disease among people over the age of 60. Therefore, senior living facilities often have a large number of people in various stages of the disease.
Although no one is quite certain why Parkinsons occurs, genetic links are suspected. Other factors that can lead to the condition appear to be repeated head trauma, and long-term exposure to environmentally-hazardous materials like pesticides, heavy metals and cleaning solvents. If patients with Parkinsons live long enough, they may reach the point where they are bedridden or wheelchair-bound.
To combat the symptoms of Parkinsons without adding more pharmaceuticals to a patients treatment, numerous physical therapists and exercise experts are introducing seniors with the disease to water-based exercises and rehabilitation plans. In a HydroWorx pool with variable-depth floor, a patient who cannot safely move freely on land can enjoy some independence, security and control in the pool. Best of all, regular exercise provides improved balance, delayed progression and improved dopamine release/uptake.
Epidemiology Of Depression Post
Epidemiological studies of depression post-stroke are fraught with a variety of methodological problems related to ascertainment bias, rating of depression, and the heterogeneity of cerebrovascular disease. The peak incidence of depression is between six months and two years post-stroke and point prevalence for depression varies between 1034% according to studies. In one large, US based, community epidemiological study, patients with depression post-stroke were more likely to be younger, more often white and less likely to be alive three years post-cerebrovascular accident than those who were not depressed post-stroke.
Other risk factors for depression include functional and cognitive impairment, a past history of depression, and a lack of social support
What Makes Them Different
MS and Parkinsons have different causes. They usually start to affect you at different ages, too.
MS often affects people between ages 20 and 50, but children get it, too. Parkinsons usually starts at age 60 or older, but some younger adults get it.
MS is an autoimmune disease. That means your bodys immune system goes haywire for some reason. It attacks and destroys myelin. As myelin breaks down, your nerves and nerve fibers get frayed.
In Parkinsons, certain cells start to die off. Your makes less and less of a chemical called dopamine that helps control your movement. As your levels dip, you lose more of this control.
Some genes may put you at risk for Parkinsons, especially as you age. Theres a small chance that people who are exposed to toxic chemicals like pesticides or weed killers can get it, too.
These symptoms are more common if you have MS. They not usually found in Parkinsons:
- or , where you feel like the room spins around and you lose your balance
How Long Will My Tissues Be Stored And How Will They Be Disposed Of
Your tissues will be immersed in formaldehyde or stored frozen at 85oC. These preservation techniques ensure that tissues will remain usable in research for many years to come. Some research studies can be carried out on tissue that has been stored in this way for ten years or more. If we have to dispose of your tissues because they are no longer suitable for research, we will do so only after consulting the funding charities and other appropriate organisations to make sure that it is done in an ethical and respectful manner. Samples of tissue that have been used in research are usually archived and after a suitable length of time respectfully disposed of by the researcher.
Common Misdiagnosis: Multiple Sclerosis
One of the most common answers to the question was multiple sclerosis . Both diagnoses have an effect on the central nervous system. These diagnoses also frequently cause muscle spasms, balance changes, tremor, and impaired memory. However, these are two separate diagnoses.
One difference is that MS is often diagnosed when someone is in their 20s, while most people receive a PD diagnosis in their 60s. Also, MS is an autoimmune disease that over time causes nerve damage. Parkinsons affects the brain. The brain starts producing less and less dopamine, which is responsible for controlling movement.
Yes, with MS which I was worried about for years, but right now I do not know which one is worse. However, my meds are helping a lot. My new saying is It is what it is, aka just live on. My neurologist says that I have stage one mild Parkinson’s disease.
My husband was diagnosed with MS back in 1993 when he had a mini stroke. He was diagnosed with Parkinsons in 2014.
What Do I Need To Do Now
If, after having read all the information and discussed it with your family, you have decided to bequeath your tissues to research and none of your family has raised objections, then you and your next-of-kin will need to complete and return the three forms enclosed in the pack. We will keep your original registration forms and send you photocopies for your records. We will also send you your Tissue Bank Donor Card. Always carry your card so that in an emergency staff at a hospital will know immediately of your bequest to the Tissue Bank.
The Diseases And Your Nerve Cells
“Sclerosis? comes from the Greek word for scar.? Both ALS and MS cause scarring of the covering of nerve fibers. But the process of how that happens is different for each.
Nerve cells in your body are wrapped in thin coverings called myelin sheaths. They protect these cells, similar to how insulation protects electrical wires.
When you have MS, your body attacks the myelin sheaths in your brain and spinal cord.
When myelin sheaths are damaged, signals from your brain to other parts of your body get short-circuited.
ALS breaks down the actual nerve cells in your brain and spinal cord. These cells, called motor neurons, are in charge of the voluntary muscles in your arms, legs, face, and diaphragm for breathing.
You lose control of your motor functions, and as the motor neurons break down, the myelin sheaths harden.
Symptoms Of Depression In Ms
Like Parkinsons disease, vegetative or somatic symptoms do not tend to be good diagnostic discriminators for depression in MS. Some vegetative symptoms may be specifically related to fatigue rather than depression, but this area is fraught with methodological and conceptual difficulties. One study has indicated that disinterest in sex was uniquely related to depression in MS . Important clues to depression in MS are illustrated in table 4.
?Important clues to depression in multiple sclerosis
Treating Depression In Ms
There is only one double blind RCT of treatment of depression in MS. This trial compared desipramine plus psychotherapy to placebo plus psychotherapy. Half the patients in the drug treatment arm did not reach the specified dose because of adverse effects. However there was a significant, if modest, effect in favour of desipramine.
There have been open label trials of a number of drug treatments including SSRIs . In general, SSRIs are easier to tolerate and are likely to be equally effective compared to tricyclic drugs.
Clinical experience would suggest that the best strategy would be to start low, go slow when initiating antidepressant treatment . If side effects are encountered, judicious reduction in dose may be the best strategy.
Mild to moderate forms of depression may be managed with cognitive behavioural therapy . CBT can also work well in a group setting, enhancing its cost effectiveness. For more severe forms of depression and in those with cognitive impairment, drug treatments are probably the best first line treatment.
Other models of psychotherapeutic treatment have been used in people with MS . In general, experience has been favourable but there is very little evidence for or against effectiveness.
How Therapy Helps Ms And Parkinsons
While there are differences in Parkinsons and MS, physical, occupational and speech therapy can help both MS and PD patients improve their independence and safety, as well as achieve and maintain optimal function and cognition. Therapy can help prevent complications such as de-conditioning, muscle weakness from lack of mobility and muscle contractures related to spasticity. Training in energy conservation techniques and the use of adaptive tools and devices can help simplify everyday tasks. Therapists can even recommend strategic modifications to your home to ensure accessibility and safety even as the disease progresses.
Clinicians certified in LSVT and PWR! therapeutic programs can provide Parkinsons-specific exercises to target weight shifting, posture, trunk rotation and stepping strategies to overcome rigidity and slowness of movement. Education on specific exercises and strategies helps increase safety and slow the progression of the disease.
Benefits Of Inpatient Rehabilitation
Inpatient rehabilitation hospitals are required to provide an interdisciplinary approach to patient caremeaning specialists from many disciplines are involved in creating and implementing a patients care plan. Interdisciplinary team members include physical, speech and occupational therapists, rehabilitation physicians, nurses, case managers, dietitians and pharmacists. Patients participate in three hours of therapy each day for a total of 15 hours per week, and an individualized plan of care is created for each patient to meet their needs while providing necessary intervention to make functional gains. Inpatient rehabilitation can be beneficial for both MS and Parkinsons disease.
Educational sessions with the patient and family members can also improve understanding for all involved in the patients care about the progression of each disease and ways to combat symptoms.
Bethany Moss is a physical therapist at Encompass Health Rehabilitation Hospital of Jonesboro. She is a PWR! certified therapist and a LVST BIG certified clinician.
Common Misdiagnosis: Peripheral Neuropathy
Peripheral neuropathy occurs when the nerves outside of the brain and spinal cord are damaged. Muscle contractions are a common physical symptom. In contrast, PD has a variety of physical, mental, and emotional symptoms.
My husband started tremors 14 years ago but was only diagnosed last year. The doctor had previously said it was peripheral neuropathy.
My old neurologist for 11 years said peripheral neuropathy! VA then said 50/50 Parkinsons and sent me to the CU Movement Disorder Center. My new neurologist watched me walk along with other tests and said Parkinsons.
How Effective Is Early Treatment Of Ms And Parkinsons
Though not a cure, nipping neurologic disorders in the bud may help slow their progression. But proper diagnosis is necessaryand thats not easy.
Arlie Barber knew something was wrong when, in the spring of 2008, she found herself running to the bathroom all the time. Her gynecologist diagnosed her with overactive bladder. But Barber, then 35, was an avid runner who had never had children. The diagnosis didn’t seem to fit.
ILLUSTRATION BY BRIAN STAUFFER
A few months later, she woke up with half her face numb. Her doctor blamed it on the Botox injection Barber had received a few days earlier, but the numbness spread over the next few weeks to her hands and feet. Along with balance problems and a sense of just not “feeling right,” Barber knew something was amiss. But it wasn’t until she described her symptoms to a second doctor in October 2008 that she started to get answers that made sense. “When a woman your age describes symptoms like these,” the doctor told her, “the medical community thinks .”
Given Barber’s symptoms and lesions, the doctor strongly suspected Barber would eventually be diagnosed with MS, so he offered to start her on treatment. But many of the drugs used to treat the condition require injections and can have significant side effects. “He told me that it was really serious stuff and to be really sure that’s what I wanted to do,” she says.
Early Treatment in Multiple Sclerosis
Early Treatment for Parkinson’s Disease