BrainBlog

Odor identification deficits identify Parkinson's disease patients with poor cognitive performance Movement Disorders. 2011 Sep;26(11):2045-50 Damholdt MF, Borghammer P, Larsen L, Ostergaard K Abstract Olfactory dysfunction is a prodromal and prevalent nonmotor symptom of Parkinson's disease. Unlike olfactory dysfunction in Alzheimer's disease, it is believed to be unrelated to cognitive impairment. However, recent research has implicated cholinergic denervation in Parkinson's disease hyposmia and linked it to verbal memory. This research hypothesized that severe odor identification deficits may identify patients with Parkinson's disease at risk for cognitive impairment. The current study tested this hypothesis by comparing 24 functionally anosmic, nondemented patients with Parkinson's disease and 39 nonanosmic, nondemented patients with Parkinson's disease with 29 healthy control participants on composite scores of memory, processing speed, executive functi...

Just noticeable difference in olfaction: A discriminative tool between healthy elderly and patients with cognitive disorders associated with dementia Rhinology. 2011 15 1; 49(5): 513-518. Chopard G, Galmiche J, Jacquot L, Brand G Abstract Olfactory dysfunction appears to be one of the earliest signs of several age-related neurodegenerative disorders, including Alzheimer`s disease (AD) or Parkinson`s disease (PD). To rate performance and olfactory deficits in patients with cognitive disorders, various olfactory tasks have been used such as odor detection, discrimination, recognition memory, identification and naming but no study has been focused on just noticeable difference (JND), a sensitive tool of detection. The aim of this study was to investigate and compare variations in JNDs in healthy elderly and in patients with cognitive disorders associated with dementia. The results showed significantly higher olfactory JNDs in a population with cognitive disorders associated with dementia...

Executive functions in Parkinson's disease: Systematic review and meta-analysis Movement Disorders. 2011 Oct 3; Kudlicka A, Clare L, Hindle JV Abstract Impairment of executive function (EF) is commonly reported as a feature of PD. However, the exact pattern of executive impairment remains unclear. Also, there is an ongoing discussion surrounding the definition and conceptualization of EF, which might affect the clarity of research evidence on cognition in PD. The aim of this systematic review was to describe the pattern of executive impairment in early-stage PD emerging from the research literature and to identify critical issues for improving consistency in this field. The PsychInfo, MEDLINE, Science Direct, CINAHL, and Cochrane Library databases were searched using the term "Parkinson's disease" combined with each of 14 cognitive abilities defined as representing aspects of EF. The review was limited to studies that investigated EF as the central variable in early-...

Goetz CG. Scales to evaluate psychosis in Parkinson's disease. Parkinsonism and Related Disorders. 2009 Dec; 15 Suppl 3, 38-341 Hallucinations and psychotic behaviors are a frequent non-motor aspect of Parkinson's disease and its treatment. These behaviors usually do not occur in the presence of the physician and are therefore difficult to rate. Further, because of their bizarre nature, hallucinations are frequently underreported by patients, and caregivers are often unaware of them until they become problematic. A number of scales have been developed for rating these behaviors, most of them borrowed or adapted from assessment tools used in other psychotic disorders like schizophrenia. In the latter disorders, however, hallucinations and psychosis are phenomenologically different than the typical hallucinations of Parkinson's disease. The Movement Disorder Society Task Force on Parkinson's Disease Rating Scales has completed a systematic critique of scales used in cl...

A news release from the NIH: Investment in Parkinson's Disease Data Bank Yields Potential Therapy 12th October, 2009 [snip] Individuals with Parkinson's disease who have higher levels of a metabolite called urate in their blood and in cerebrospinal fluid (CSF) have a slower rate of disease progression, according to a study funded by the National Institutes of Health. A clinical trial is under way to examine the safety and potential benefits of supplemental urate elevation for recently diagnosed Parkinson's patients who have low urate levels. Investigators demonstrated the link with urate by mining a repository of clinical data and tissue samples collected from Parkinson's patients more than 20 years ago as part of a pioneering study called DATATOP, funded by NIH's National Institute of Neurological Disorders and Stroke (NINDS). The new study appears in Archives of Neurology . It was funded primarily by NINDS, with additional support from the Department of Defense an...

From The Times (UK): Case study: ‘It’s hard to recognise the man I married’ Judith Magill’s retirement dreams were dashed when her husband, Patrick, had Parkinson's disease diagnosed aged 57 21 September 2009 [snip] "People die with Parkinson’s disease, not of it,” said the specialist to my husband, Patrick, when he got the diagnosis at the age of 57. He was upbeat, though leaving us in no doubt that the condition would worsen. Parkinson’s would nibble away at Patrick’s physical and, if we were unlucky, his mental reactions. It would fundamentally change our lives after just two years of marriage. [snip] Read the full piece

From The Times (UK): The latest Parkinson’s treatment: Wii-hab Parkinson’s disease symptoms could be controlled by a game that can be bought on every high street, says a recent study Simon Crompton 21 September 2009 [snip] This summer, the Medical College of Georgia in the United States announced the striking results of its research into the effects of “Wii-hab” on people with Parkinson’s disease. In an eight-week study, 18 people were asked to play Wii Sports, including virtual versions of boxing and ten-pin bowling, for an hour a day, three times a week for four weeks. By the end of that time all the participants showed significant improvements in rigidity, movement, fine motor skills and energy levels. Importantly, their depression levels also decreased; depression affects around half of people with Parkinson’s disease. [snip} Read the full article

FierceBiotech reported today about a failed Phase III trial of Acadia's Pimavanserin in a study of Parkinson's Disease Psychosis (sometimes abbreviated as "PDP"): ACADIA Pharmaceuticals Announces Results from Phase III Trial of Pimavanserin in Parkinson's Disease Psychosis Pimavanserin Misses Primary Endpoint of Antipsychotic Efficacy; Meets Key Secondary Endpoint of Motoric Tolerability [snip] SAN DIEGO -- Sep. 1, 2009-- ACADIA Pharmaceuticals Inc. (Nasdaq: ACAD) today announced top-line results from the first pivotal Phase III trial with pimavanserin in patients with Parkinson's disease psychosis, or PDP. The study did not meet its primary endpoint of antipsychotic efficacy as measured using the Scale for the Assessment of Positive Symptoms, or SAPS. Pimavanserin met the key secondary endpoint of motoric tolerability as measured using the Unified Parkinson's Disease Rating Scale , or UPDRS. Pimavanserin was safe and well tolerated, with the frequency of...

From the website of the Parkinson's Disease Society: PDS fundraiser to stand on the Fourth Plinth in London Tim Andrews, from Milford in Surrey, is taking part in the Antony Gormley project 'One & Other' on Saturday 15 August 2009, taking his place on the Fourth Plinth in Trafalgar Square, London from 6pm to 7pm. Tim is taking part in the project as part of a new found determination to live life to the full since he was diagnosed with Parkinson's disease in 2005, at the age of 54. Despite being afraid of heights, Tim intends to stand on the Fourth Plinth for the full hour. Tim will play tracks from the new album, The Liberty of Norton Folgate by one of his favourite bands, Madness, who have given their permission for it to be played. Tim has chosen the album because the lyrics recount various stories about the city of his birth, London, which he adores. Tim hopes that many will come along, show their support and perhaps dance with him. Tim says: "Being d...

Following up on a posting earlier this week: From a General Electrics press release 11 August 2009 FDA ADVISORY COMMITTEE RECOMMENDS DaTSCAN™ (Ioflupane I 123 Injection) PRINCETON, NJ--GE Healthcare announced today that the Peripheral and Central Nervous System Drugs advisory committee of the U.S. Food and Drug Administration (FDA) has voted to recommend DaTSCAN (Ioflupane I 123 Injection) to the FDA. The panel determined DaTSCAN has a favorable risk to benefit profile, voting 11 to two with one abstention. The proposed indication for DaTSCAN is for the visualization of the dopamine transporter (DaT) distribution within the striata by single photon emission computed tomography (SPECT) imaging in patients presenting with symptoms or signs suggestive of dopaminergic neurodegeneration. In May 2009, the FDA accepted the New Drug Application and granted DaTSCAN priority review, a designation identified for areas of unmet medical need. If approved, DaTSCAN will be the first radiopharmaceut...

The Wall Street Journal's HealthBlog discusses this radiopharmaceutical and the FDA meeting to be held tomorrow about it [ read post here ]

From a company press release : September 30, 2008 Media Contact: Greg Kelley, Feinstein Kean Healthcare (+++) +++-++++ Link Medicine Completes $40 million Series C Financing to Accelerate Development of First Disease-Modifying Treatments for Neurodegenerative Disorders Co-led by Clarus Ventures and SV Life Sciences,the Financing will Advance Preclinical and Clinical Programs CAMBRIDGE, Mass. - Link Medicine Corporation , a privately held biotechnology company advancing novel approaches for the treatment of neurodegenerative diseases, announced today that it has obtained $40 million of Series C equity financing to help move its lead preclinical programs into human clinical testing. The round was funded by two leading biotechnology investors - Clarus Ventures and SV Life Sciences. Link Medicine, founded in March 2005, is focused on developing the first disease-modifying therapies for the treatment of several neurodegenerative diseases - including Alzheimer's, Parkinson's, Hunting...

Landis BN & Burkhard PR. Phantosmias and Parkinson disease. Archives of Neurology . 2008 Sep; 65(9): 1237-1239. BACKGROUND: Impaired olfaction is a common, nonmotor manifestation of Parkinson disease (PD). However, to our knowledge, qualitative olfactory disturbances, such as odor distortions, have not been extensively reported in this condition. OBJECTIVE: To describe 2 patients who reported positive olfactory symptoms preceding typical PD, which were consistent with olfactory hallucinations (phantosmias) in the absence of major smell deficit. DESIGN: Case series. SETTING: University hospital. Patients We describe 2 patients, both seen in 2007, who reported pleasant olfactory hallucinations for several years. MAIN OUTCOME MEASURES: Iodine I 123-labeled ioflupane single-photon emission computed tomography and olfactometric testing results. RESULTS: The (123)I-labeled ioflupane single-photon emission computed tomography showed reduced radiotracer uptake in both striatum more marked...

The University of California, San Francisco (UCSF) Memory and Aging Center has recently revised their website and has launched a YouTube channel dedicated to educating patients, caregivers, and health professionals about neurodegenerative diseases and the dementias. The Center has also launched a Facebook webpage. The website can be examined at UCSF website . The YouTube channel - the first one I've heard of dedicated to these topics - can be found at YouTube channel link . As noted by a UCSF contact: "Through the YouTube channel, we also hope to support the caregiver and the caregiver’s loved ones to help them cope with these illnesses. "The channel features UCSF’s renowned clinical-researchers discussing disease characteristics – which are often subtle and not well known, even among members of the medical community. Personal stories of patients and family members are also featured, together with practical advice and coping strategies from healthcare professi...

Kranick SM, & Duda JE. Olfactory dysfunction in Parkinson's disease. Neurosignals. 2008; 16(1): 35-40. Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. Prior to the onset of the cardinal motor features of idiopathic Parkinson's disease (PD), other manifestations of neurodegeneration such as olfactory dysfunction are often apparent. Characterizing these potential biomarkers of preclinical PD is particularly important in identifying individuals who will go on to develop disabling symptoms, and thus be good candidates for new neuroprotective strategies. As shown by the Braak neuropathologic staging of PD, the olfactory system is among the first neuronal populations to display Lewy body pathology. Clinically, loss of smell can be easily tested in the office using several validated techniques and is often helpful to the physician in distinguishing idiopathic PD from other forms of parkinsonism. Recent findings have indicated that a...

Pagonabarraga J, Kulisevsky J, Llebaria G, García-Sánchez C, Pascual-Sedano B, & Gironell A. Parkinson's disease-cognitive rating scale: A new cognitive scale specific for Parkinson's disease. Movement Disorders. 2008 Mar 31 [Epub ahead of print]. Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Autonomous University of Barcelona, and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain. Cognitive defects associated with cortical pathology may be a marker of dementia in Parkinson's disease (PD). There is a need to improve the diagnostic criteria of PD dementia (PDD) and to clarify the cognitive impairment patterns associated with PD. Current neuropsychological batteries designed for PD are focused on fronto-subcortical deficits but are not sensitive for cortical dysfunction. We developed a new scale, the Parkinson's Disease-Cognitive Rating Scale (PD-CRS), that was designed to cover the full spectrum of...

Bohnen NI, Kuwabara H, Constantine GM, Mathis CA, & Moore RY. Grooved pegboard test as a biomarker of nigrostriatal denervation in Parkinson's disease. Neuroscience Letters. 2007 September 13; 424(3): 185-189. Department of Radiology, University of Michigan, Ann Arbor, MI 48109-0028, USA. Recent pharmacotherapy trials in Parkinson's disease (PD) using dopaminergic neuroimaging as outcome parameter failed to show significant relationships between imaging and clinical results. One possible explanation is that there is a non-linear relationship between striatal denervation and motor performance reflecting a statistical "floor" effect in the imaging data with advanced disease. Both the motor manifestations and the striatal dopamine denervation of idiopathic PD, however, are typically asymmetric and more meaningful associations may be found by comparing data from the least denervated striatum with motor performance in the corresponding body side. PD patients (n=28) ...

Chaudhuri KR, Martinez-Martin P, Brown RG, Sethi K, Stocchi F, Odin P, Ondo W, Abe K, Macphee G, Macmahon D, Barone P, Rabey M, Forbes A, Breen K, Tluk S, Naidu Y, Olanow W, Williams AJ, Thomas S, Rye D, Tsuboi Y, Hand A, & Schapira AH. The metric properties of a novel non-motor symptoms scale for Parkinson's disease: Results from an international pilot study. Movement Disorders. 2007 Aug 2; [Epub ahead of print]. National Parkinson Foundation Centre of Excellence, Kings College Hospital, London, United Kingdom. Non-motor symptoms (NMS) in Parkinson's disease (PD) are common, significantly reduce quality of life and at present there is no validated clinical tool to assess the progress or potential response to treatment of NMS. A new 30-item scale for the assessment of NMS in PD (NMSS) was developed. NMSS contains nine dimensions: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems, attention/memory, gastrointestinal, urinary, sexual function, and miscellany...

Hubbard PS, Esiri MM, Reading M, McShane R, & Nagy Z. Alpha-synuclein pathology in the olfactory pathways of dementia patients. Journal of Anatomy. 2007 Jun 6; [Epub ahead of print] Division of Neuroscience, The Medical School, University of Birmingham, UK. Lewy-type pathology is a characteristic of a number of neurodegenerative disorders, including Parkinson's disease and dementia with Lewy bodies. Thus far, the definitive diagnosis of these dementias can only be confirmed at post-mortem. However, it is known that the loss of smell (anosmia) is an early symptom in patients who develop dementia, and the use of the smell test has been proposed as an early diagnostic procedure. The aim of this study was to understand further the extent of Lewy pathology in the olfactory system of patients with neurodegenerative disorders. Post-mortem tissue from 250 subjects was obtained from the OPTIMA brain bank. Five areas of the olfactory pathway were examined by immunolabelling for alpha-s...