It Doesn’t Matter What Exercise as Long as You’re Exercising

By Sherri Woodbridge

Several years ago, when I was diagnosed with young onset PD, it seemed the rage in beneficial exercise for people with Parkinson’s disease was bicycling. A few years later, the craze seemed to turn to dance. Now it seems as though boxing could be the in thing. As the others appear to come and go in cycles, one form of exercise that appears to remain consistent and advantageous is tai chi.

The question is, what exercise is best? I think the simple answer is whatever feels best and whatever you enjoy. None of it is bad for you and the most important thing is just to be doing something.

A real prospect exists that the physical movement involved in riding a bicycle, and in certain other forms of exercise, may alleviate the symptoms of the neurodegenerative condition we know more intimately as Parkinson’s disease.

The observation made by a research scientist from the Cleveland Clinic, in Ohio, that the physical symptoms associated with Parkinson’s appeared to improve in a personal friend who had ridden a tandem cycle. It seemed that there was a connection between forcing patients to move their legs faster than they would have otherwise been able to on their own, and because of this, there was a significant improvement in relieving symptoms.

In fact, further research from the Cleveland Clinic showed that forced exercise appeared to be more effective than drug treatment at improving symptoms in those with PD. They even went so far to suggest that forced exercise can also decrease some of the cognitive problems that can be associated with PD.

Studies have also shown that dance may be an effective alternative to traditional exercise for those with Parkinson’s disease. Staying active is crucial for those of us who have PD and dancing has been shown to lessen tremors and improve flexibility, as well as lifting mood.

“The positive effect that dancing has on us is quite magical,” says Alison Underwood, diagnosed with PD 10 years ago and now in her 60s. I don’t know about you, but I could use a little magic while living with this little monster we call Parkinson’s disease.

Boxing is definitely on the list of exercise popular among PD patients of late. Of course, it may not be the exercise of choice for everyone, but it has definitely become trendy. One such program is called Rock Steady Boxing. It is a non-contact program specifically designed for those with Parkinson’s to help strengthen motor skills, balance, speech, and sensory function.

A side benefit of getting out and getting some exercise is being around other people like us, those who struggle day-to-day with symptoms pertaining to PD. We can encourage each other to keep on keeping on.

 

Source:: Parkinson’s Today

Sniff Test for Parkinson’s Disease

By Michael J. Fox Foundation

Lack of objective tests to diagnose Parkinson’s disease (PD) challenges drug development and patient care. While scientists are looking to pinpoint PD earlier through skin and spinal fluid, there is also promising research on some less invasive methods. In this podcast, host Dave Iverson talks with two researchers on the significance of these non-invasive tests.

“What we’re doing now is to really try and identify whether there’s a particular secretion in the skin of Parkinson’s patients and what it smells like and then how can we detect it,” says Samantha Hutten, PhD, senior associate director at The Michael J. Fox Foundation, which is funding projects to sniff out Parkinson’s disease.

Another MJFF-funded study led by Mark Baron, MD, professor of neurology at Virginia Commonwealth University, breaks down what eye movement means in relation to PD.

“If you look at a target — assuming we aren’t going to have Parkinson’s disease — and we stare at a dot on a screen, our eye is not moving. People with Parkinson’s disease — it’s moving in all directions, so it’s not staying perfectly still,” says Dr. Baron.

Tune into to the live discussion in our next webinar this Thursday, October 19, at 12 p.m., where we discuss how these screening methods and others could lead to earlier PD diagnosis. Register today.

Like what you hear? Subscribe to The Michael J. Fox Foundation Parkinson’s Podcast in iTunes or your podcast mobile app. Please consider leaving us a rating on iTunes and sharing the series with your network.

Learn more about the search for a test for Parkinson’s disease in our guide.

View a text transcript of this podcast.

Source:: MJFF Podcasts

Ask the MD: Parkinson’s Disease Psychosis

By Rachel Dolhun, MD

Parkinson’s disease (PD) psychosis has been in the news as pimavanserin (Nuplazid) — a novel medication to treat this non-motor symptom — nears possible Food and Drug Administration approval. (A final decision will be made no later than May 1, 2016.) Pimavanserin would be the first drug indicated for PD psychosis and could be an important step in the evolution of therapies for non-motor symptoms of Parkinson’s.

PD Psychosis Comes in Varied Forms
Estimates vary — maybe because symptoms are underreported — but psychosis can eventually affect more than half of people with PD. This symptom is more common in people with a longer duration (and increased severity) of disease, cognitive impairment or dementia, and older age. Other risk factors include mood, sleep and visual (e.g., need for corrective lenses, cataracts, glaucoma) disturbances. Psychosis can appear in a variety of ways, including:

  • Hallucinations: seeing things that aren’t there
  • Delusions: holding false, typically paranoid, beliefs
  • Illusions: misinterpreting things that are there
  • False sense of presence: feeling that someone is nearby when no one is present

Hallucinations and delusions occur most often in those with Parkinson’s. Visual hallucinations usually consist of people (e.g., small children or deceased relatives) or animals; they happen in the evening (or periods of lower stimulation) and last seconds to minutes. Delusions typically center on themes of spousal infidelity or financial concerns and — despite evidence pointing otherwise — a person cannot be convinced of their falsehood. An illusion is mistaking one object for another (i.e., thinking a garden hose is a snake).

In some cases, psychosis is mild and a person knows that these experiences are not real. In others, symptoms are more severe and can considerably disrupt the lives of the person with PD, his or her caregiver, and family. PD psychosis may even contribute to the need for an alternative living situation, such as a nursing home.

Parkinson’s Disease and Drugs Can Cause Psychosis
Parkinson’s psychosis can be caused by the underlying disease and/or the medications used to treat it. As the brain chemical dopamine diminishes in Parkinson’s, many PD drugs work to temporarily replenish it. While the increased dopamine can lessen motor symptoms, it can also stimulate brain areas that lead to psychosis.

Management of Psychosis Requires a Stepwise Approach
When psychosis occurs, doctors first look for other medical illnesses — such as infections or electrolyte imbalances — that could be causing symptoms. If these aren’t present or psychosis persists after treatment, the next step is to reduce and/or remove Parkinson’s drugs. The goal of medication adjustment is to decrease psychosis without significantly worsening motor symptoms. If this cannot be done, an atypical antipsychotic agent may be added. These drugs are used for mood and thought disorders, such as schizophrenia, but they are prescribed off-label for PD psychosis. They generally work by blocking dopamine effects, though, so as they ease psychosis, they may make motor symptoms worse. Clozapine (Clozaril) is the least likely to do the latter, but low doses of quetiapine (Seroquel) are well tolerated too, so doctors typically prescribe one of these medications. Potential risks with these medications include sleepiness and, for clozapine, a decrease of infection-fighting white blood cells (which necessitates regular blood monitoring). In some situations, rivastigmine (Exelon) — which is indicated for PD dementia — is prescribed off-label for psychosis instead.

Pimavanserin Represents a Potential New Therapy for Psychosis
The approval of pimavanserin would potentially expand the somewhat limited treatment options for psychosis in Parkinson’s. Pimavanserin works on the serotonin (rather than dopamine) brain chemical system. Since this is a different mechanism than that of the presently available antipsychotic medications, it might help psychosis without aggravating motor symptoms. In short-term studies, the medication also seemed to improve nighttime sleep and daytime wakefulness while lessening the burden of psychosis on caregivers.

If pimavanserin is approved, it’s important to remember that (like every medication) it can have side effects and it isn’t right for everyone. A person who is doing well on his or her current drug regimen doesn’t necessarily have to change simply because a newer therapy comes on the market. But, for those with uncontrolled psychosis and/or intolerable side effects on current treatment, trying a different drug may be beneficial. No matter which therapy is chosen, communication about medication benefits and side effects, as well as regular assessment of the challenges psychosis poses for both the person with PD and the caregiver, must be maintained. Optimal management of each Parkinson’s symptom always requires input from every person on the care team: patient, caregiver, family members and physician.

about pimavanserin.

 

The “Ask the MD” series is supported by Acorda Therapeutics. While our generous sponsors make the “Ask the MD” program possible, their support does not influence MJFF’s content or perspective.

Source:: Fox Feed Blog