What’s New in Parkinson’s: September 2023

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This month's "What's New in Parkinson's" post features research about sex-specific aspects of Parkinson's, an overview of pain in Parkinson's, the status of genetic testing for Parkinson's in the Dominican Republic, new research about the relationship between glucose levels and Parkinson's, and much more!

SCIENCE AND RESEARCH Updates

  • Researchers investigated differences in survival for women and men living with Parkinson's and considered how these differences relate to rates of dementia. They found that "women with PD survive at higher rates, regardless of their age at onset and disease severity."
  • Certain genes associated with Parkinson's are also associated with sex-specific traits, and researchers are beginning to explore the meaning of these associations.
  • Two European researchers explore the classification, treatment, and pathophysiology of pain in Parkinson's.
  • The Journal of Cell Science presents an overview of LRRK2's function and role in Parkinson's.
  • A large study published in Nature found an association between particular motor subtypes of Parkinson's and specific autonomic symptoms. For example, tremor predominance was associated with increased rates of cardiovascular symptoms.
  • Brain presents findings related to cholinergic degeneration associated with GBA mutations. The cholinergic system is involved in memory, movement, and autonomic functions. Despite finding no clinical differences between the participants in their study, the authors report that imaging studies showed increased damage to the cholinergic system of participants who had GBA mutations compared to those who did not.
  • NPJ features a report on readiness for genetic testing for Parkinson's in the Dominican Republic.
  • In Brain, researchers report that neuroinflammation is associated with a higher risk of early dementia for people with Parkinson's.
  • Researchers found that people with Parkinson's had elevated A1c levels compared to study participants without Parkinson's. Higher A1c levels were associated with more advanced Parkinson's. Researchers write that these findings suggest that hyperglycemia may be an aggravating factor for Parkinson's progression.
  • Glial derived neurotropic factor (GDNF) has been studied as a treatment for Parkinson's but failed to advance in clinical trials. New research suggests that using too much GDNF may have been a factor in early failed studies.
  • Four experts offer their thoughts about sharing unsolicited medical opinions in the context of movement disorders.
  • Researchers report that abnormal beta activity in the brain persists during sleep for people with Parkinson's. This activity is associated with sleep disturbance. The researchers find that the patterns are not addressed by common deep brain stimulation (DBS) settings. This research may help optimize DBS programming to help treat sleep disturbances in the future.
  • Biomarkers have been in the news a lot in 2024. Now, researchers write that they have found that DOPA decarboxylase levels in cerebrospinal fluid can be used to identify people living with Lewy body disease. This is possible even before the condition could be clinically identified by a physician. DOPA decarboxylase is an enzyme involved in the creation and use of dopamine.
  • A study in mice shows that low fiber intake and particular bacterial populations can combine to accelerate Parkinson's symptoms. Low fiber helps shift the microbiome makeup and contributes to damaging the gut. This damage allows bacterial strains to contribute to alpha-synuclein pathology.
  • Dopamine transporter availability is higher during times of the year with increased sunlight.
  • Researchers have found that diagnosis with celiac disease when younger than 60 is associated with an increased risk of being diagnosed with Parkinson's within five years.
  • Exosomes--secretions that are involved in intercellular communication--may have a pathological role in Parkinson's. In an article published by the International Brain Research Organization, researchers explore the role of exosomes in Parkinson's and how they may be useful as biomarkers and drug delivery systems for treatments.
  • Retinal scans can help detect Parkinson's.
  • More on vision and Parkinson's: Researchers find an association between retinal thickness, degree of motor dysfunction, and time since Parkinson's diagnosis.
  • Alpha-synuclein is involved in the progression and pathophysiology of Parkinson's, and Korean researchers write that uric acid, a natural antioxidant, may help mitigate alpha-synuclein's effects.
  • Researchers describe the reasoning behind the design of a trial exploring high-intensity respiratory muscle training for people with Parkinson's.
  • More highlights from the World Parkinson Congress from the perspective of four researchers, including two who live with Parkinson's.

TREATMENT and Therapy Updates

  • Acadia announces updates to prescribing information for NUPLAZID. The updates clarify that NUPLAZID can be used to treat delusions and hallucinations related that occur with or without dementia.
  • A post-hoc analysis of a pivotal study involving apomorphine infusion finds that regional disparities in healthcare access, quality, and depth of a person's care team are important factors in the success of using apomorphine to manage symptoms.
  • Increasing your daily step count is associated with a decreased incidence of dementia. Researchers for JAMA Neurology report that the optimal maximum number of steps per day for this effect is 9,800.
  • Freezing of gait is associated with longer-term levodopa use, according to a study including 49 treatment-naive people and 152 people who take levodopa. This is paradoxical because levodopa remains the best treatment for freezing of gait. The reason for the association remains unclear.
  • The European Journal of Neurology featured an article that found exercising at home using a tailored exercise-focused game can help with gait and balance disorders.

LIVING WELL STORIES

  • Sharon Krischer shares her thoughts about the benefits of attending the World Parkinson Congress.
  • Four prominent physicians--including Davis Phinney Foundation board member Soania Mathur--published an article discussing the stigma experienced by people with Parkinson's.
  • Bev has been living with Parkinson's since 2007. On her blog, she shares a story about a recent botox injection and the experience of making her doctor laugh during the procedure.
  • The Parkinson's Pals program reports on early success in the Journal of Parkinson's Disease. We featured this program in a 2022 blog post.

SURVEYS, CLINICAL TRIALS, AND VOLUNTEER OPPORTUNITIES

  • Multi-arm, multi-stage (MAMS) trials can accelerate new treatment development, but evaluating the outcomes of these trials is complicated. A large group of Parkinson's experts contribute to the conversation about how to measure outcomes of these trials in the context of Parkinson's.
  • Researchers in Holland are enrolling participants in a trial that aims to evaluate the use of motivational smartphone apps to increase exercise program adherence.
  • Inhibikase is recruiting participants for a phase 2 trial of a new c-Abl tyrosine kinase inhibitor. Inhibikase says in a press release that their research "has validated the critical role that c-Abl plays in the initiation and progression of Parkinson's disease, as well as the potential of IkT-148009 as a promising new approach to disease modification." This trial will also be among the first to utilize recently validated alpha-synuclein seed assay tests.
  • The International Parkinson and Movement Disorders Society (MDS) is developing a new electronic diary (e-Diary): a digital solution for Parkinson's. This e-Diary is intended to better characterize how the disease affects daily life.  They are inviting people to participate in a survey intended to help aid the design of this new tool.
  • A new trial studying Gemfibrozil, a drug that decreases fat production in the liver, is set for a phase two clinical trial in people with Parkinson's. This trial will enroll people between 40 and 75 years of age who have not begun taking medication for Parkinson's.
  • Aspen Neuroscience has been cleared by the FDA to develop a clinical trial for a new stem cell therapy. This trial will be the first multi-center study of its kind in the US, but the trial design and start date have not yet been announced.
  • The Speech Accessibility Project (SAP) seeks volunteers for a research initiative aiming to make voice recognition technology more useful for people with a range of diverse speech patterns. More information is available here and here. To determine whether you are eligible to participate, visit the SAP registration page.
  • A team of Dutch researchers created PregSpark, a registry for women with Parkinson's who are pregnant or have recently given birth. The goal is to build an online international pregnancy and Parkinson’s registry. This registry will prospectively and uniformly collect data on the course and outcome of as many as possible pregnancies in women with Parkinson’s. This data will help women with Parkinson's make more informed decisions about pregnancy and improve the quality of care pregnant women with Parkinson's receive. The PregSpark site is currently under construction but should be completed soon.
  • Researchers in the UK are seeking survey responses about the usefulness of wearable technology to monitor medication effectiveness and adherence to dosing schedules.
  • A phase 1b trial is recruiting volunteers for a study of a treatment that aims to influence inflammation.
  • UK researcher and physician Tom Foltynie writes about ways to improve the structure of clinical trials for Parkinson’s.
  • Biogen announces they're discontinuing the LIGHTHOUSE trial. They note that the discontinuation results from evaluating the complexities and duration of the study and does not result from any safety or efficacy data. The LUMA study will continue, and participants in the LIGHTHOUSE study will be invited to participate.
  • Researchers in Norway are investigating the efficacy of ambroxol in people with dementia with Lewy bodies.
  • Researchers in the UK, in partnership with the Women's Parkinson's Project and MyMovesMatter, invite participation in a survey about the experience of menopause for women with Parkinson's.
  • Another study of ambroxol is launching: The DUPARG study is recruiting participants in Groningen, Netherlands.
  • A new trial examining the possible neuroprotective effect of exercise has been listed by the University of Nevada.
  • Researchers at Oregon Health and Sciences University are conducting a study to test whether a specific, dynamic exercise intervention can help prevent falls in people with Parkinson's. This study uses safety equipment, including harnesses, to facilitate a regimen that involves turning while walking.
  • University of Rochester Center for Health + Technology is undertaking a survey study to assess the ability of the Parkinson’s Disease-Health Index to measure patient-relevant changes in disease burden over the course of two years. Participants will complete surveys five times over two years and must be over 18, speak English, and have a self-reported or clinical diagnosis of Parkinson’s. More information is available here.
  • Researchers at Columbia University’s Irving Medical Center are seeking participants for a study exploring the role of immune response in Parkinson’s. Participation is open to those with and without Parkinson’s and will involve donating blood, a questionnaire, a cognitive test, and a neurological examination. Click here to express interest in participating.
  • Johns Hopkins University has announced a trial to evaluate whether levetiracetam can improve symptoms of Parkinson's psychosis. The trial is not yet recruiting, but the plan is for it to begin by September. The trial design features a crossover assignment, which means every participant will receive an active trial drug for their participation.
  • The LUMA trial continues to recruit participants. This trial aims to assess the safety and efficacy of BIIB122 tablets in slowing the progression of early-stage Parkinson’s. This study has sites in the US, China, France, Germany, the Netherlands, Poland, Spain, and the UK.
  • The ACTIVATE trial is recruiting participants for a phase 2 trial of BIA 28-6156 in people with GBA mutations. This 78-week trial has site locations in the US, Canada, and Europe.
  • In Colorado, a study the Foundation is funding continues to recruit participants. The study explores low-load resistance training with blood flow restriction to help develop exercise interventions for improved quality of life for people with advanced Parkinson’s.
  • Washington University School of Medicine is sponsoring a study aiming to enroll participants with idiopathic REM sleep behavior disorder, as well as healthy controls, in preparation for a trial of neuroprotective treatments against synucleinopathies.
  • Florida State University is sponsoring a study of speech articulation deficits in Parkinson’s.
  • A study in South Carolina aims to identify brain biomarkers to predict the risk of cognitive change following DBS surgery.
  • A survey for those in Ireland seeks to understand the influence of Parkinson’s symptoms and other factors on the quality of life of people with Parkinson’s.
  • Another survey for those in Ireland seeks to understand how people access information about Parkinson's.
  • A trial sponsored by the University of Aberdeen in Scotland is recruiting participants for a study of the effects of constipation and changes in the microbiota in Parkinson’s.
  • US-based company Neuronascent announces plans for a phase II trial of their neuro-restorative agent NNI-362. The agent is disease-agnostic, and a previous phase I trial for Alzheimer’s disease produced positive early-stage findings.
  • Sinopia Biosciences announces they have secured funding for a clinical trial to explore the safety and efficacy of their novel agent in treating levodopa-induced dyskinesia.
  • Staying Connected through Communication Study: The University of Washington SPEAC Lab invites individuals living with Parkinson’s to answer survey questions about their communication experiences. This is an online survey study that will take about 30-45 minutes. (Paper surveys are also available.) People with Parkinson's and their family/friends/coworkers will complete SEPARATE surveys, and data are not shared between participants. This study is open to anyone in the US. Each participant will be mailed a $25 check upon survey completion.
  • PreActive PD Study: This study, available for both English and Spanish speakers, implements an occupational-therapist-delivered physical activity behavior change coaching intervention in people with early-stage Parkinson's. The study is based upon a recent single-arm cohort feasibility study (Pre-Activate PD/HD) that evaluated acceptability, implementation, and resulting effect estimates of the Pre-Activate PD intervention in 13 participants. The intervention provides one-on-one coaching sessions from an occupational therapist to individuals newly diagnosed with Parkinson's. The individualized structured support in the sessions is aimed at facilitating and optimizing exercise uptake as part of an effective self-management program.
  • Gamma Wave Trial: Sponsored by the Massachusetts Institute of Technology (MIT), this trial investigates the efficacy of a non-invasive method of neuromodulation called Gamma Entrainment Using Sensory Stimulation (GENUS) for managing Parkinson's motor symptoms. GENUS is administered via light, sound, and tactile stimulation devices and has been tested on cognitively normal individuals and individuals with mild Alzheimer's; the device was found to be safe for use and effective for entrainment in both populations.
  • Deep Brain Stimulation (DBS) and Exercise Study at Barrow Neurological Institute: This study aims to help researchers learn more about how aerobic exercise affects symptoms of Parkinson’s and the quality of life in people who have DBS. They will also look at brain wave activity using the Medtronic Percept DBS device to better understand what changes in the brain might be caused by exercise and how that affects Parkinson's symptoms. Phoenix-area residents reach out to Markey if interested.
  • Colorado Oral Strengthening Device: The University of Colorado Denver is looking for adults with Parkinson's to participate in a study exploring how a novel low-technology device can increase tongue strength comparable to standard-of-care exercise using tongue depressors but with the kinematics and simple biofeedback of existing high-cost devices. Research has shown that tongue resistance exercises paired with biofeedback result in improved tongue strength to support chewing, control of food and liquid in the mouth, and propulsion of material for a swallow.
  • PD GENEration: The Parkinson’s Foundation announces a major expansion of its national study to make genetic testing and counseling more available for people with Parkinson’s. The study (NCT04057794) hopes to enroll 15,000 people in all 50 US states, Puerto Rico, and the Dominican Republic. For questions about enrollment, email [email protected]. Know someone who speaks Spanish and wants to learn more and maybe participate in the study? Share this link.
  • Parkinson’s Progression Markers Initiative: In an expanded study, the Parkinson’s Progression Markers Initiative (PPMI) is currently working to enroll up to 100,000 people with and without Parkinson’s. The study team is especially seeking to enroll people diagnosed with Parkinson’s in the past two years and who are not yet on treatment, as well as people 60 and older who aren't living with Parkinson’s but have a risk factor for it (such as a close relative with Parkinson’s, a known Parkinson’s-associated mutation, and/or REM sleep behavior disorder). The observational study is also enrolling people with no known connection to Parkinson’s to serve as a control group.
  • TOPAZ (Trial of Parkinson’s and Zoledronic Acid): Caroline Tanner, MD, PhD, is recruiting participants for a new remote clinical trial led by a team of Parkinson’s experts at UCSF in partnership with researchers from across the country. The study aims to help people with Parkinson’s or parkinsonism maintain their independence by reducing the risk of hip fractures. The study will test if zoledronate, an FDA-approved medication for osteoporosis, can prevent fractures in people with Parkinson’s--whether or not they have osteoporosis. To learn more, visit the study website at TOPAZstudy.org, email [email protected], or call (415) 317-5748.
  • A PD Avengers research group is undertaking a new project called Sparks of Experience, designed to be more systematic about collecting and considering the experiences and ideas that come from the curious minds of people living with Parkinson’s. "In the past, these sometimes quirky ideas inspired by lived experience have turned into significant new directions for research. It could be said we are trying to capture serendipity," the team says. To learn more and get involved, see the flyer here
  • Game-Based Exercise Project: Researchers at the University of Auckland are investigating how games can be used as potential rehabilitation systems. This project aims to develop suitable game-based exercise experiences to help people living with Parkinson's. If you are 45 or older, living with a chronic condition such as Parkinson's, and/or are experiencing age-related health conditions, you are invited to participate in a survey that will help the researchers to understand the community's interest in games and gameplay in the context of exercise and rehabilitation. To learn more and take the 15-minute survey, see the flyer here
  • SPARX3 - A Phase 3 Clinical Trial about Exercise and Parkinson's: This research team is currently seeking volunteers to participate in a clinical trial about the effects of aerobic exercise on people with Parkinson’s. Learn more and see if you qualify here. For more details, contact Katherine Balfany at [email protected].
  • PAIRing Up: If you are a person with Parkinson's or a care partner to someone with Parkinson's, you are invited to participate in an online survey to address neuropsychiatric (cognition, depression, anxiety) concerns in Parkinson's. The survey aims to learn about the needs and priorities for clinical care, education, support, and research related to neuropsychiatric symptoms. To learn more and participate, click here to download the flyer.
  • The University of Oulu and collaborators from Aalborg University, Fraunhofer University, the University of Manchester, the University of Glasgow, the University of Lisbon, and the University of Melbourne are conducting a survey for people with Parkinson's and care partners about self-care. Complete the survey here to share your self-care strategies and techniques. You can also review ideas submitted by others and add them to your own self-care toolbox.
  • Home-Based Exercise and Cognitive Behavior Therapy: University of Alabama in Huntsville
  • Speech and Telemedicine Study: The Purdue Motor Speech Lab
  • Parkinson’s and Service Dogs: University of Groningen, Netherlands
  • Neurology Study Interest Registry: University of Rochester

For more of what's new in Parkinson's news, check out our full series here

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