How can I manage my Parkinson’s disease symptoms better?

Answer: Check with your neurologist about increasing your caffeine intake.

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J Alzheimers Dis. 2010;20 Suppl 1:S205-20.

Effects of caffeine in Parkinson’s disease: from neuroprotection to the management of motor and non-motor symptoms.

Prediger RD.

Abstract

Parkinson’s disease (PD) is the second most common neurodegenerative disorder affecting approximately 1% of the population older than 60 years. Classically, PD is considered to be a motor system disease and its diagnosis is based on the presence of a set of cardinal motor signs (rigidity, bradykinesia, rest tremor) that are consequence of a pronounced death of dopaminergic neurons in the substantia nigra pars compacta. Nowadays there is considerable evidence showing that non-dopaminergic degeneration also occurs in other brain areas which seems to be responsible for the deficits in olfactory, emotional and memory functions that precede the classical motor symptoms in PD. The present review attempts to examine results reported in epidemiological, clinical and animal studies to provide a comprehensive picture of the antiparkinsonian potential of caffeine.

Convergent epidemiological and pre-clinical data suggest that caffeine may confer neuroprotection against the underlying dopaminergic neuron degeneration, and influence the onset and progression of PD. The available data also suggest that caffeine can improve the motor deficits of PD and that adenosine A2A receptor antagonists such as istradefylline reduces OFF time and dyskinesia associated with standard ‘dopamine replacement’ treatments. Finally, recent experimental findings have indicated the potential of caffeine in the management of non-motor symptoms of PD, which do not improve with the current dopaminergic drugs.

Altogether, the studies reviewed provide strong evidence that caffeine may represent a promising therapeutic tool in PD, thus being the first compound to restore both motor and non-motor early symptoms of PD together with its neuroprotective potential.

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Handb Exp Pharmacol. 2011;(200):267-310.

Impacts of methylxanthines and adenosine receptors on neurodegeneration: human and experimental studies.

Chen JF, Chern Y.

Abstract

Neurodegenerative disorders are some of the most feared illnesses in modern society, with no effective treatments to slow or halt this neurodegeneration. Several decades after the earliest attempt to treat Parkinson’s disease using caffeine, tremendous amounts of information regarding the potential beneficial effect of caffeine as well as adenosine drugs on major neurodegenerative disorders have accumulated.

In the first part of this review, we provide general background on the adenosine receptor signaling systems by which caffeine and methylxanthine modulate brain activity and their role in relationship to the development and treatment of neurodegenerative disorders. The demonstration of close interaction between adenosine receptor and other G protein coupled receptors and accessory proteins might offer distinct pharmacological properties from adenosine receptor monomers.

This is followed by an outline of the major mechanism underlying neuroprotection against neurodegeneration offered by caffeine and adenosine receptor agents. In the second part, we discuss the current understanding of caffeine/methylxantheine and its major target adenosine receptors in development of individual neurodegenerative disorders, including stroke, traumatic brain injury Alzheimer’s disease, Parkinson’s disease, Huntington’s disease and multiple sclerosis.

The exciting findings to date include the specific in vivo functions of adenosine receptors revealed by genetic mouse models, the demonstration of a broad spectrum of neuroprotection by chronic treatment of caffeine and adenosine receptor ligands in animal models of neurodegenerative disorders, the encouraging development of several A(2A) receptor selective antagonists which are now in advanced clinical phase III trials for Parkinson’s disease.

Importantly, increasing body of the human and experimental studies reveals encouraging evidence that regular human consumption of caffeine in fact may have several beneficial effects on neurodegenerative disorders, from motor stimulation to cognitive enhancement to potential neuroprotection. Thus, with regard to neurodegenerative disorders, these potential benefits of methylxanthines, caffeine in particular, strongly argue against the common practice by clinicians to discourage regular human consumption of caffeine in aging populations.

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J Neurol Sci. 2006 Oct 25;248(1-2):9-15. Epub 2006 Jun 27.

Novel neuroprotection by caffeine and adenosine A(2A) receptor antagonists in animal models of Parkinson’s disease.

Kalda A, Yu L, Oztas E, Chen JF.

Abstract

The adenosine A(2A) receptor has recently emerged as a leading non-dopaminergic therapeutic target for Parkinson’s disease, largely due to the restricted distribution of the receptor in the striatum and the profound interaction between adenosine and dopamine receptors in brain. Two lines of research in particular have demonstrated the promise of the A(2A) receptor antagonists as novel anti-parkinsonian drugs.

First, building on extensive preclinical animal studies, the A(2A) receptor antagonist KW6002 has demonstrated its potential to increase motor activity in PD patients of the advanced stage in a recent clinical phase IIB trial. Second, recently two prospective epidemiological studies of large cohorts have firmly established the inverse relationship between the consumption of caffeine (a non-specific adenosine antagonist) and the risk of developing PD. The potential neuroprotective effect of caffeine and A(2A) receptor antagonists in PD is further substantiated by the demonstration that pharmacological blockade (by caffeine or specific A(2A) antagonists) or genetic depletion of the A(2A) receptor attenuated dopaminergic neurotoxicity and neurodegeneration in animal models of PD.

Moreover, A(2A) receptor antagonism-mediated neuroprotection goes beyond PD models and can be extended to a variety of other brain injuries induced by stroke, excitotoxicity and mitochondrial toxins. Intensive investigations are under way to dissect out common cellular mechanisms (such as A(2A) receptor modulation of neuroinflammation) which may underlie the broad spectrum of neuroprotection by A(2A) receptor inactivation in brain.

How can I slow down the progression of my Parkinson’s disease?

Answer: Try doing the Tango!

Fox Files: Dancing the Tango, May Help Parkinson’s

From the video intro:

They say it takes two to Tango, but what happens if one of them has Parkinson’s disease. Researchers from Washington University are conducting a study, funded by the Parkinson’s Disease Foundation, to see if Tango dancing can help diminish Parkinson’s debilitating effects.

The study worked!
Neurorehabil Neural Repair. 2011 Sep 29. [Epub ahead of print]

Randomized Controlled Trial of Community-Based Dancing to Modify Disease Progression in Parkinson Disease.

Abstract

BACKGROUND:

Tango dancing has been effective in improving measures of physical function in people with Parkinson disease (PD). However, all previous studies were institution-based, tested participants on medication, and employed short-term interventions.

OBJECTIVE:

To determine the effects of a 12-month community-based tango program for individuals with PD on disease severity and physical function.

METHODS:

Sixty-two participants were randomly assigned to a twice weekly, community-based Argentine Tango program or a Control group (no intervention). Participants were assessed off anti-Parkinson medication at baseline, 3, 6, and 12 months. The primary outcome measure was the Movement Disorders Society-Unified Parkinson Disease Rating Scale 3 (MDS-UPDRS-3). Secondary outcome measures were the MDS-UPDRS-1, MDS-UPDRS-2, MiniBESTest balance test; Freezing of Gait Questionnaire (FOG_Q); 6-Minute Walk Test (6MWT); gait velocity for comfortable forward, fast as possible forward, dual task, and backward walking; and Nine-Hole Peg Test (9HPT).

RESULTS:

Groups were not different at baseline. Overall, the Tango group improved whereas the Control group showed little change on most measures. For the MDS-UPDRS-3, there was no significant change in the Control group from baseline to 12 months, whereas the Tango group had a reduction of 28.7% (12.8 points). There were significant group by time interactions for MDS-UPDRS-3, MiniBESTest, FOG_Q, 6MWT, forward and dual task walking velocities, and 9HPT in favor of the dance group.

CONCLUSIONS:

Improvements in the Tango group were apparent off medication, suggesting that long-term participation in tango may modify progression of disability in PD.

Complement Ther Med. 2009 Aug;17(4):203-7. Epub 2009 Jan 7.

Short duration, intensive tango dancing for Parkinson disease: an uncontrolled pilot study.

Source

Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA.

Abstract

OBJECTIVE:

The goal of this pilot study was to determine the effects of short duration, intensive tango lessons on functional mobility in people with Parkinson disease.

DESIGN:

This study employed a within-subject, prospective, repeated measures design.

SUBJECTS/PATIENTS:

Fourteen people with idiopathic Parkinson disease participated.

SETTING:

All balance and gait assessments were performed in a laboratory, but dance classes took place in a large, open classroom.

INTERVENTIONS:

Participants completed ten 1.5-h long Argentine tango dance lessons within 2 weeks. Their balance, gait and mobility were assessed before and after the training sessions.

MAIN OUTCOME MEASURES:

Measures included the Berg Balance Scale, the Unified Parkinson Disease Rating Scale, gait velocity, functional ambulation profile, step length, stance and single support percent of gait, Timed Up and Go, and the 6 min walk.

RESULTS:

Participants significantly improved on the Berg Balance Scale (effect size (ES)=0.83, p=0.021), Unified Parkinson Disease Rating Scale Motor Subscale III (ES=-0.64, p=0.029), and percent of time spent in stance during forward walking (ES=0.97, p=0.015). Non-significant improvements were noted on the Timed Up and Go (ES=-0.38, p=0.220) and 6 min walk (ES=0.35, p=0.170).

CONCLUSIONS:

Frequent social dance lessons completed within a short time period appear to be appropriate and effective for these individuals with mild-moderately severe Parkinson disease.

J Rehabil Med. 2009 May;41(6):475-81.

Effects of dance on movement control in Parkinson’s disease: a comparison of Argentine tango and American ballroom.

Source

Program in Physical Therapy, Washington University School of Medicine, St Louis, MO 63108, USA.

Abstract

OBJECTIVE:

The basal ganglia may be selectively activated during rhythmic, metered movement such as tango dancing, which may improve motor control in individuals with Parkinson’s disease. Other partner dances may be more suitable and preferable for those with Parkinson’s disease. The purpose of this study was to compare the effects of tango, waltz/foxtrot and no intervention on functional motor control in individuals with Parkinson’s disease.

DESIGN:

This study employed a randomized, between- notsubject, prospective, repeated measures design.

SUBJECTS/PATIENTS:

Fifty-eight people with mild-moderate Parkinson’s disease participated.

METHODS:

Participants were randomly assigned to tango, waltz/foxtrot or no intervention (control) groups. Those in the dance groups attended 1-h classes twice a week, completing 20 lessons in 13 weeks. Balance, functional mobility, forward and backward walking were evaluated before and after the intervention.

RESULTS:

Both dance groups improved more than the control group, which did not improve. The tango and waltz/foxtrot groups improved significantly on the Berg Balance Scale, 6-minute walk distance, and backward stride length. The tango group improved as much or more than those in the waltz/foxtrot group on several measures.

CONCLUSION:

Tango may target deficits associated with Parkinson’s disease more than waltz/foxtrot, but both dances may benefit balance and locomotion.