August 3, 2019 – Parkinson FIT Weekend Update

This Week’s Highlights: Sustainable Exercise for Parkinson’s; inhalable levodopa; Virtual Reality for PD Therapy; When grilled cheese attacks; inspiring people with PD; alpha-synuclein & spontaneous origami; PD Exercise news; Dyskinesia predictors; prescription drugs that might decrease or increase PD risk; dopamine and acetylcholine; basal tears vs. skin tests for biomarkers; blue light therapy glasses; PD constipation; and more

We start this week’s newsletter by exploring the concept of “sustainable exercise”. An article about an exercise research study prompted us to partially rethink our Parkinson’s Disease exercise philosophy. Apparently, the more you exercise, the more likely you are to cut back on exercise. We try to understand what this means and why it happens. Exercise intensity may slow Parkinson’s progression, but in the long run, exercise sustainability is essential for a healthy life.

https://parkinson.fit/sustainable-exercise-for-parkinsons/

In The News

We’ve mentioned before about the danger of anticholinergic drugs, including a drug sometimes prescribed for Parkinson’s – Artane (trihexyphenidyl). Anticholinergic drugs block activity of acetylcholine receptors in the brain (acetylcholine being one of the other neurotransmitters). Studies have shown that long term use of anticholinergic drugs correlates with an increased chance of dementia. (Side note: Acetylcholine is essential to executive function in the brain, and there are studies that suggest gait and balance issues may be improved by boosting acetylcholine, as opposed to blocking it.) CBS News has this report:
https://www.cbsnews.com/news/research-links-widely-used-drugs-to-nearly-50-percent-higher-risk-dementia/

Alison Smith, who blogs as “The Perky Parkie”, offers an insightful look at Inbrija, an inhalable  formulation of levodopa that is designed to bypass the gut and take effect within 10 minutes:
https://www.perkyparkie.com/2019/08/inbrija-a-new-parkinsons-drug/

PHOTO: NAGHMEH ZAMANI/USC

Virtual Reality (VR) technology offers interesting possibilities for Parkinson’s disease therapy. University of Southern California engineers are teaming with researchers and VR game designers to help Parkinson’s patients walk steadily with confidence, creating a VR application called Overcome.

This game, in an immersive virtual reality setting, offers the player an opportunity to attend a rehabilitation session without actually giving him/her the notion of being in one. Patients roam a virtual modern city, complete with roads, pavements, buildings, and cars, and with an option of day/night mode, as they walk on a treadmill.

https://parkinson.fit/usc-develops-virtual-reality-application-for-parkinsons-physiotherapy/

When Grilled Cheese Attacks: Gooey Goodness or Gruesome Grub? There’s a comfort food crisis in Canada, as grilled cheese sandwiches have been implicated in at least 2 deaths. We couldn’t let this story pass without trying to find the lighter side:
https://parkinson.fit/when-grilled-cheese-attacks-gooey-goodness-or-gruesome-grub/

There’s no shortage of bold claims being made about the overwhelming array of conditions that can be treated by stem cell therapy. Search online and you can essentially find a stem cell clinic somewhere in the world that will offer to cure almost anything under the sun.  Here are some things you should know:
https://health.usnews.com/conditions/articles/before-you-undergo-stem-cell-treatment

Inspiring People with PD

Meet former Major League Baseball catcher Ben Petrick, who played for the Colorado Rockies and Detroit Tigers. A Parkinson’s diagnosis cut his big-league career short, but he has remained around the game and enjoys coaching his daughter’s softball team with best friend from high school:
https://www.kptv.com/news/former-mlb-catcher-with-parkinson-s-coaching-daughter-s-softball/article_0a62ed14-b1ae-11e9-a103-4be2fa8978d6.html

Long hailed as one of Britain’s favorite comics, Billy Connolly (a.k.a, Sir William Connolly) will invade U.K. cinema screens this fall for one night only with The Sex Life of Bandages. The event will take place Thursday October 10, 2019 and will feature a taped show from the Australian leg of his last ever stand-up tour, recorded in 2015 as well as a new interview with the comedian.
https://www.forbes.com/sites/jamos/2019/07/31/legendary-comedianactor-billy-connolly-brings-his-final-stand-up-tour-to-cinemas-this-october/

Research News

We normally think of alpha-synuclein as being problematic in Parkinson’s disease, because it misfolds and clumps to form Lewy bodies, which can be toxic to neurons. But not much is understood about what alpha-synuclein’s normal role is when it is not engaging in spontaneous origami. Researchers now believe it may play a crucial role in preventing cell death by repairing damaged DNA.
https://parkinsonsnewstoday.com/2019/07/31/alpha-synuclein-aids-in-dna-damage-repair-study-suggests/

The link between contact sports and dementia extends beyond chronic traumatic encephalopathy (CTE) to a much wider range of neurological diseases, including Alzheimer’s disease and Parkinson’s disease, according to new studies of the brains of former football and rugby players.
https://www.telegraph.co.uk/sport/2019/07/31/dementias-beyond-cte-including-alzheimers-parkinsons-linked/

Why are they sending brain cells from people with Parkinson’s into space, launching them on a SpaceX CRS-18 cargo flight bound for the International Space Station?
https://phys.org/news/2019-07-space-station-cell-major-diseases.html

Shuo Chen is the 2019 grand prize winner of the Science & PINS Prize for Neuromodulation, for developing a less invasive technique to precisely control the activity of neurons nestled deep in the brain. The findings, described in his prize-winning essay, “Optical modulation goes deep in the brain,” could help usher in the next-generation of noninvasive deep brain stimulation technologies. In search of a more precise and minimally invasive solution, Chen, currently a postdoctoral fellow at the University of California Berkeley, turned to optogenetics – the use of light to control neurons. He shifted the existing optogenetic technology into the near-infrared (NIR) wavelength, which is recognized for its tissue-penetrating capability, in contrast to the highly scattered and absorbed blue-green wavelengths.
https://www.aaas.org/news/shuo-chen-awarded-science-pins-prize-neuromodulation

Case Western Reserve School of Medicine scientist receives $150,000 grant for developing diagnostic tools for Alzheimer’s disease, Parkinson’s disease, and other related brain-based degenerative disorders via an innovative skin test that uses ultrasensitive technology. The new test is much less invasive than evaluating brain tissue, which is the only approach for making a definitive diagnosis today.
https://case.edu/medicine/about/newsroom/our-latest-news/case-western-reserve-school-medicine-scientist-receives-major-grant-diagnosis-alzheimers-parkinsons-new-skin-test

Parkinson’s Foundation grants $8 million in research funding to design and launch Parkinson’s-specific research studies over the next four years. The four institutions receiving grants for these studies are:

  • Columbia University Irving Medical Center
  • University of Florida in collaboration with Emory University
  • University of Michigan in collaboration with The University of Texas Southwestern Medical Center
  • Yale School of Medicine

https://www.prnewswire.com/news-releases/parkinsons-foundation-grants-8-million-to-further-parkinsons-research-300892672.html

An article on the Parkinson’s Foundation website reports on a gene therapy study that reversed dyskinesia in mice, and looks at how calcium channels are involved:
https://www.parkinson.org/blog/science-news/Levodopa-Induced-Dyskinesias-Reversed

Parkinson’s Exercise & Fitness News

The University of Arkansas for Medical Sciences (UAMS) has received two grants totaling almost $29,000 to launch a free exercise program for people with Parkinson’s disease in Little Rock. The Parkinson’s Foundation provided $13,924.59 to train, staff and support the program, and the Philip R. Jonsson Foundation of Little Rock provided $15,000 for the equipment.
https://www.fox16.com/news/two-grants-allow-uams-to-start-free-exercise-program-for-people-with-parkinsons/

A local Edmonton TV news station visits a Parkinson’s Boxing program at Shadowbox Gym in Lacombe, Alberta (Canada).
https://edmonton.ctvnews.ca/it-s-made-me-stronger-central-albertans-living-with-parkinson-s-fighting-back-1.4530279

A local newspaper visits a Rock Steady Boxing affiliate in Richmond, Virginia, and interviews PD boxer Bob Scudder, and his wife/cornerperson Dougie. (There’s a video at the bottom of the article).
https://www.richmond.com/life/health/strapping-on-boxing-gloves-to-fight-parkinson-s/article_22ddd251-c8fb-5a5d-8e14-0159e589b65d.html

A local Worcester, Massachusetts newspaper visits Chad Moir’s DopaFit exercise program:
https://www.telegram.com/news/20190729/boxing-class-aims-to-put-parkinsons-on-ropes

A local TV station visits a Rock Steady Boxing affiliate in Huntington, West Virginia:
https://www.wowktv.com/news/boxing-class-helps-fight-symptoms-of-parkinsons-disease/

More Research News & ScienceOfParkinsons.com

At the end of every month, Dr. Simon Stott publishes a summary of science and research news relating to Parkinson’s disease on his excellent Science of Parkinson’s disease website. If you like to read about PD research, he posts links to enough material to keep you busy until the end of the next month, when he’ll post another summary, and you can start all over again:
https://scienceofparkinsons.com/2019/08/01/july-2019/

In between these monthly reviews, his blog articles provide the most thorough and understandable explanations of PD research advancement.

Here are a few things that we found interesting while reading the monthly review for July 2019:

The research study where mice infected with bacteria that cause mild intestinal infections exhibited Parkinson’s like symptoms later in life was definitely he most interesting research of the month. (We discussed this last week in our article “Food for Thought: Parkinson’s and the Gut-Brain Connection“.)

If you are interested in a more thorough scientific exploration of the gut-brain connection, the following older articles from SoPD are recommended:

Back to July 2019 Research News…

  • Dyskinesias are involuntary movements, which are primarily associated with the long term use of levodopa. An Oxford study followed 734 patients with PD for up to 10 years to identify clinical predictors for which patients were more likely to develop motor complications (dyskinesia and motor fluctuations) from levodopa. Low mood and anxiety were found to be significant risk factors for motor complications.
    https://onlinelibrary.wiley.com/doi/full/10.1002/mds.27783
  • A review study of 4 large US claims databases analyzed prescription drugs that might be associated with an increased or decreased chance of Parkinson’s. Reduced risk was associated with Armodafinil (56% reduction), Modafinil (54%), Methylphenidate (39%) & the β-agonist Albuterol (17%). The β-blocker propranolol was associated with a 32% increased risk. While experts analyze this further, I think I have an explanation for why propranolol shows an increased risk. Propranolol is widely prescribed as a treatment for essential tremor. It is likely that essential tremor is an initial suspect in a significant number of PD cases, where physicians may try prescribing propranolol before eventually referring a patient to a neurologist. 
    https://link.springer.com/article/10.1007%2Fs40261-019-00830-4
  • A Yale study challenges a long held assumption about Parkinson’s effect on neurotransmitters other than dopamine. Scientists had previously believed that when dopamine levels dropped, acetylcholine levels increased. However, this relationship had never been thoroughly investigated, despite acetylcholine’s likely role in creating a movement disorder called dyskinesia, which develops in most patients after several years of dopamine treatment for Parkinson’s. The research argues that dopamine deficiency reduces acetylcholine rather than increases it, and suggests that treating Parkinson’s may require targeted therapies that restore the balance between these two chemicals, instead of focusing solely on dopamine.
    Yale News: https://news.yale.edu/2019/07/16/parkinsons-disease-study-identifies-possible-new-treatment-target
    Study: https://www.cell.com/neuron/fulltext/S0896-6273(19)30563-X
    [Editor’s note: Time for researchers to take another look at CDP Choline?]
  • Recently, the large LEAP study showed that L-DOPA has no disease-modifying effect on Parkinson’s. But, remember that disease progression is judged by clinical observation, not pathologically. In a mouse study, researchers report that L-DOPA has a suppressive effect on the propagation of pathological α-synuclein,  suggesting it may have disease progression benefits, even if we can’t measure it observationally. The debate will continue.
    https://www.frontiersin.org/articles/10.3389/fnins.2019.00595/full
  • Basal tears from 93 people with Parkinson’s & 82 matched controls suggest that oligomeric alpha synuclein levels are significantly raised in PD in this easily accessed bodily fluid – a novel, noninvasive, inexpensive biomarker?
    https://www.futuremedicine.com/doi/10.2217/bmm-2019-0167
    [Editor’s note: Refer back to our May 4, 2019 Newsletter for more.]
  • Researchers report that blue light therapy glasses appear to have a positive effects on sleep, mood, & motor symptoms in Parkinson’s in an open label study based on subjective patient feedback:
    https://www.hindawi.com/journals/pd/2019/1906271/
  • Prevail Therapeutics has announced that they have received FDA Fast Track Designation for their gene therapy candidate PR001 for the treatment of GBA-associated Parkinson’s:
    https://ir.prevailtherapeutics.com/news-releases/news-release-details/prevail-therapeutics-receives-us-fda-fast-track-designation
  • An interesting look at severe constipation in Parkinson’s. Did you know that researchers have defined a “Constipation Scoring System” (CSS)? Highlights: Data confirm the high prevalence of constipation among patients with PD. The reduction of motor performance seems to be the primary cause for developing severe constipation in PD patients. These data suggest that maintain a good quality of gait and endurance may be helpful to reduce the risk of constipation. Keep moving to keep things moving!
    https://doi.org/10.3389/fneur.2019.00621

That’s just a small sampling of last month’s research. If this is the type of news that captures your interest, there is so much more at: https://scienceofparkinsons.com/2019/08/01/july-2019/

Motivation for the Upcoming Week

Diagnosed with PD in 2003, at the young age of 27, Jimmy Choi spent 8 years in a combination of denial and self-pity, until he found the strength and resolve to regain control of his life.

Jimmy’s story is best told by the videos included below.

We all can’t become elite athletes like him…but that’s not what makes his story special. As he says in one of the videos below, his American Ninja Warrior experience gave him his 15 minutes of fame, and presented an opportunity for people to hear his message. His advice to others is simple and succinct: “Find something that moves you, and move!”

For more of Jimmy Choi’s story, here is a video from the Michael J. Fox Foundation:

And here is Jimmy telling his story with 100 pounds of weights in his backpack:

More on Jimmy Choi:

 

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