It’s been said that, “Music is a universal language”, and recent research with Dementia patients is proving that to be true; music can actually calm many patients and help to improve their memory!

Dementia causes many changes in the brain that can, in a sense, short-circuit the brain.  Alzheimer’s and Dementia patients may begin to get lost in familiar surroundings, repeat questions, become fearful of their surroundings, suspicious of family members that they may not recognize.  They may have trouble following directions and doing the simplest daily tasks.  They can become disoriented about time, places and people around them.  Simply bathing, brushing their teeth, using a fork or spoon or even swallowing are typically forgotten and patients will end up being fed, strictly with liquids through tubes.  Eventually, daily care can require up to six or more caregivers per patient, which is why so many end up in nursing facilities, but life doesn’t have to be all misery for them.

With studies conducted in Belgium, Canada and the US, the findings are amazingly hopeful.  We human beings seem to remember things that have emotional components.  The parts of the brain, the Amygdala and our neurotransmitters, work together to help us recall the more emotional times that occur throughout our lives.

Petr Janata, a University of California, Associate Professor of Psychology, conducted brain activity experiments on a group of people who listened to music and found that the medial prefrontal cortex area of the brain stays healthier in Alzheimer’s patients longer than the other brain parts and has the capacity for emotions and other sensations.

According to, Concetta Tomaino, at the Institute for Music and Neurologic Function, at the Beth Abraham Health Services, in New York; we can recall audio very easily and the audio functions are often one of the last abilities that we lose.  This seems to allow Alzheimer’s and Dementia patients to still have the capacity to sing songs of their youth, despite losing the capacity to recall many words, phrases and names.  Documented research has shown that it can even extend to the more advanced cases of the disease.

Patients will often sing, hum and some even will begin to dance, despite the fact that minutes before they weren’t even speaking.  Revisiting the music of earlier years can actually get these patients up and enjoying their day while even allowing them to have their memories stimulated; some patients recall the words to the songs even when they can’t recall their own family members’ names and faces.  They were able to recall words and lyrics to many songs when hearing an audio recording than when they heard the lyrics spoken.

The music therapy often consists of CD’s being played, appropriate to the age range of the individuals or groups.  Usually, the music that they either enjoyed as children, teens or young adults; sometimes, a discussion of many of the individual pieces and their association with movies or other shows can stimulate memories associated with better times or time spent with loved ones.

You can find CD’s, DVD’s and more at the local library that contain music familiar to the patients for whom you are caring.  Familiar musicals, operas or Broadway show tunes can spark and open those mental trunks of long sealed away memories, giving many patients a memory boost and pleasure during their days.

Classical music has been proven, time and time again, to be soothing, so if you can play music for about an hour during the daytime or evening for those you care for, it will help to keep them calm and relaxed.  Studies have shown that more than an hour can sometimes create agitation or irritability.

Playing an instrument, having a family sing-a-long can, as well and it allows some quality time with the family and friends that these patients wouldn’t otherwise be able to really enjoy.

These and other amazing studies are allowing many patients to stay calm, less agitated; it reduces anxiety and  decreases wandering, may allow patients to improve some memory functions while enjoying their sing-a-long time reminiscing about the music that they grew up with.  It can increase their socialization and decrease some depression which is of immense help to caregivers.  Perhaps someday, music will help researchers to unlock the secrets to aiding these patients and their caregivers in having a more fulfilling life despite their disease.

by M. L. Kiser.

Dr. Chris

Parkinson's Disease Guide - Parkinson’s disease medicines can be expensive and the financial impact can be devastating in the long term, especially if health insurance is an issue. It is not uncommon for any chronic disease sufferer to seek alternate sources, especially if the more expensive branded medicine may be available at a cheaper rate.

However, the possibility should be kept in mind that the drug obtained from such sources is cheaper because it is a counterfeit or fake. This could mean that it may not have all the necessary ingredients, the proportions may be wrong, or it may contain harmful substances. In spite of taking the drugs as prescribed by the doctor, the patient may have slow or no improvement at all or may even deteriorate drastically.

Counterfeit and Cheap Parkinson’s Medicines

•Buying drugs from foreign sources may be cheaper but you can never be sure about the quality or efficacy of such drugs. Local government regulations may be significantly different from your country of origin and counterfeit drugs are not monitored for quality control.

•Cheaper drugs may actually be counterfeit, fake, or adulterated drugs, where useless or toxic substances could be substituted for the actual ingredients. Rather speak to your doctor about generics if you cannot afford your current drug regimen.

•Parkinson’s disease patients are heavily dependent upon their medicines to control their symptoms. Even a slight amount of dose alteration can produce severe fluctuations in their symptoms. With counterfeit medicines, you can never be sure about the exact composition of the drug, which can play havoc with the patient’s system. Either too little or too much of the active ingredient can be equally harmful.

•With tampering of the drug, unknown substances may be present in the drug, the effects of which can be dangerous. This can cause drug interactions with your regular PD medicines or other medication.

•There may be no improvement in a patient’s symptoms where previously there was good control of symptoms. Side effects and even an overdose is a possibility.

•New complications may arise which were not present earlier.

•Foreign drugs may contain substances which have not been approved as being safe or effective within your country of residence.

•It is illegal to bring in such drugs into the country and in case of any problem arising from the use of such drugs you will not have recourse to any corrective action.
•In the event that these drugs contain illicit substances, you may be convicted for the possession of narcotic substances.

Buying Cheap or Counterfeit PD Drugs

You may inadvertently acquire counterfeit drugs by :

•Ordering drugs from an online agency/pharmacy (over the internet).

•Buying drugs while holidaying overseas.

•Acquiring drugs from the local “black market”.

•Genuine but stolen drugs which are altered and then sold back into the distribution system.

•Genuine but expired drugs which are sold after re-packaging and changing the expiry date.

•Genuine drugs acquired from patients have got them free and sold them for a minimum price.

•Pharmacies may unknowingly keep counterfeit drugs supplied by dishonest wholesalers.

How to Avoid Using Counterfeit Drugs

While it may seem obvious, many consumers buy fake drugs unknowingly. These are some of the measures to ensure that you are only using genuine PD drugs as prescribed by your doctor.

•Avoiding buying medicines from doubtful online agencies.

•Buy medicines from reputable pharmacies.

•Be alert while buying medicines, taking care to look at the packaging and expiry dates.

•Being aware about the shape, color, size or other characteristics of medicines which are taken regularly.

•Avoiding buying medicines from foreign sources. Carry extra medicines while holidaying abroad and in the event that you need to acquire more medication, visit a reputable pharmacy in the area. 

BY PEGGY O'FARRELL

Every morning, from about 8:30 to 10, Dan Truesdale froze up.

His muscles grew rigid, locked in place because of Parkinson's disease,until the medication finally kicked in, allowing to him get up, move around, live his life.

That changed last year when Truesdale, 47,became the first patient in Ohio to receive an experimental drug delivery system that gives his body a continual dose of the medication that lets him control his muscle movements.

His "frozen" muscles have thawed, Truesdale said.

"It's the best thing that's happened to me since I discovered I had Parkinson's," he said.

Researchers at the University of Cincinnati's Neuroscience Institute at University Hospital are recruiting more patients like Truesdale to test the system as part of a national phase 3 clinical trial.

Phase 3 trials are large-scale tests of new drugs or devices and the final step before federal health regulators decide to allow manufacturers to put new therapies on the market. Earlier phases test safety and effectiveness of new therapies on smaller scales.

Parkinson's disease is a chronic brain disorder in which brain cells that make the chemical dopamine die off. It usually strikes people over 50, and men are about50 percent more likely to get it than women.

Without dopamine,adults lose control of muscle movements and balance. Symptoms get worse over time, said Alberto Espay, the neurologist heading up UC's arm of the trial, and Parkinson's patients may eventually lose the ability to speak, feed themselves, swallow or chew.

Replacing the lost dopamine helps patients regain muscle control, but standard treatmentsgive dopamine in oral medications taken in several doses throughout the day.

That means the brain gets the dopamine it needs in interrupted allotments, so patients have periods throughout the day where they either can't move at all or they can't stop their bodies from moving involuntarily.

The drug delivery system Espay is testing aims to change that.

Abbott Pharmaceuticals' Levodopa-Carbidopa Intestinal Gel treatment system feeds the medication levodopa, which in the body becomes dopamine, into the upper intestine via a small tube surgically placed directly into the duodenum, or the very tip of the small intestine. The drug is fed through the tube from a cassette worn on the patient's body. A programmable pump lets the patient or doctor adjust the rate at which the medication is delivered.

"With this system, we're basically bathing the patient in dopamine at all times," Espay said.

Truesdale of Maineville used to be able to set his watch by his symptoms. The pump has changed all that. "I don't notice the passing of the hours because my symptoms have been reduced so drastically," he said.

He was diagnosed with Parkinson's in 2000, and has been on disability for the last four years. He recently began studying to become a minister.

The pump system is designed for patients like Truesdale with severe symptoms that are no longer controlled by standard medications, Espay said.

"People who've withdrawn from social and intellectual activities, they can resume them. We've seen people take up new activities after they've gone on the pump," he said.

Individuals with Parkinson's disease were more likely to have a neurochemical response to a placebo medication if they were told they had higher odds of receiving an active drug.

Chicago, IL - infoZine - "The promise of symptom improvement that is elicited by a placebo is a powerful modulator of brain neurochemistry," the authors write as background information to a report in the August issue of Archives of General Psychiatry, one of the JAMA/Archives journals. "Understanding the factors that modify the strength of the placebo effect is of major clinical as well as fundamental scientific significance." In patients with Parkinson's disease, the expectation of symptom improvement is associated with the release of the neurotransmitter dopamine, and the manipulation of this expectation has been shown to affect the motor performance of patients with the condition.

Sarah C. Lidstone, Ph.D., of Pacific Parkinson's Research Centre at Vancouver Coastal Health and the University of British Columbia, Vancouver, Canada, and colleagues studied 35 patients with mild to moderate Parkinson's disease undergoing treatment with the medication levodopa. On the first day of the study, a baseline positron emission tomographic (PET) scan was performed, participants were given levodopa and a second scan was performed one hour later to assess dopamine response. On the second day, patients were randomly assigned to one of four groups, during which they were told they had either a 25-percent, 50-percent, 75-percent or 100-percent chance of receiving active medication before the third scan; however, all patients were given placebo.

Patients who were told they had a 75-percent chance of receiving active medication demonstrated a significant release of dopamine in response to the placebo, whereas those in the other groups did not.

Patients' reactions to the active medication before the first scan was also correlated with their response to placebo. "Importantly, whereas prior medication experience (i.e., the dopaminergic response to levodopa) was the major determinant of dopamine release in the dorsal striatum, expectation of clinical improvement (i.e., the probability determined by group allocation) was additionally required to drive dopamine release in the ventral striatum," the authors write. Both areas have been shown to be involved with reward processing; in patients with a chronic debilitating illness who have responded to therapy in the past, expectation of therapeutic benefit in response to placebo has been likened to the expectation of receiving a reward.

"Our findings may have important implications for the design of clinical trials, as we have shown that both the probability of receiving active treatment—which varies in clinical trials depending on the study design and the information provided to the patient—as well as the treatment history of the patient influence dopamine system activity and consequently clinical outcome," the authors conclude. "While our finding of a biochemical placebo response restricted to a 75 percent likelihood of receiving active treatment may not generalize to diseases other than Parkinson's disease, it is extremely likely that both probability and prior experience have similarly profound effects in those conditions."

This study was funded by the Michael Smith Foundation for Health Research, the Canadian Institutes for Health Research and a TRIUMF Life Sciences Grant. Dr. Stoessl is supported by the Canada Research Chairs Program.

by Lauren Hammit

A novel technique created at UCSF to deliver a growth factor directly to brain cells has shown promising results in treating Parkinson’s symptoms and could enter human clinical trials as early as next year.

The technique is part of an experimental treatment called gene therapy, which is considered a hopeful medical advance for neurodegenerative diseases such as Parkinson’s. Gene therapy involves introducing genetic material into a cell to cause the expression of a particular protein that can replace a missing or defective protein responsible for disease.

The UCSF team demonstrated for the first time that the infusion system they designed successfully spread a targeted protein to critical regions in the primate brain. This resulted, on average, in a 50 percent improvement of symptoms that continued out to two years.

“The approach is among the first shown to be beneficial to animals after they have already developed signs of Parkinson’s,” said Krystof Bankiewicz, MD, PhD, Kinetics Foundation Chair in Translational Research and professor of Neurological Surgery at UCSF. “Our ultimate goal is to reverse this disease in patients, and we hope this method will enable doctors to do exactly that.”

Findings are published online and in the July 14, 2010, issue of the Journal of Neuroscience.

In addition to an improvement in Parkinson’s symptoms, the treated animals also maintained a higher density of neurons that produce the brain chemical dopamine – the same neurons that disappear in Parkinson’s disease. Live imaging of the brain by positron emission tomography (PET) scanning, which has been used to gauge treatment effects in clinical studies of Parkinson’s, showed that those neurons remained active.

“The scans enabled us to see where the protein went – and just as hoped, it had been taken up by neurons and transported along nerve fibers to where it was needed, the substantia nigra.” Bankiewicz said. Parkinson’s disease attacks thesubstantia nigra, which is a part of the brain that controls movement.

A clinical trial is planned to test the safety of the method, according to the National Institutes of Neurological Disorders and Stroke, which funded this research. In a workup for the trial, the National Institutes of Health Rapid Access to Interventional Development (NIH RAID) program is supporting additional toxicity studies, as well as the production of clinical grade virus.