Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Options for Parkinson’s patients abundant

14.09.2005


Newly diagnosed can get support before drug therapy begins, OHSU neurologists say



Some people call it "the dark time," the period between when a person is diagnosed with Parkinson’s disease and when treatment with medication begins.

Julie Carter, R.N., knows it all too well. The associate professor of neurology in the Oregon Health & Science University School of Medicine hosts workshops to help newly diagnosed Parkinson’s patients and their families cope with the prospect of fighting a chronic, degenerative, incurable neurological disease the rest of their lives.


"Some people say it’s like looking through a picture window and someone comes along and shatters it," said Carter, associate director of the OHSU Parkinson Center of Oregon, which runs the workshops. "Patients are told they’re not ready for medication and to come back in six months. But in these early stages, what you’re really dealing with is a diagnosis. You’re dealing with a fear of what the future will hold."

And there is a lot that can be done to treat Parkinson’s patients, in the early months and beyond. So says an article by John "Jay" G. Nutt, M.D., professor of neurology, and physiology and pharmacology, OHSU School of Medicine, and director of the Parkinson center. The article appearing in the Thursday, Sept. 8, edition of the New England Journal of Medicine outlines reliable, evidence-based strategies for general practitioners to effectively and confidently diagnose Parkinson’s, and suggest ways patients and their caregivers can initially manage the disease.

"These are things the general practitioner might not be as aware of," said Nutt, who co-authored the paper with G. Frederick Wooten Jr., M.D., of the University of Virginia Medical Center in Charlottesville. "This is really looking at what is the clinical evidence right now. It gives clinicians an unbiased view of what they might do. It captures the essence of diagnosis and management, and points out where issues exist."

Among these issues is a debate over dopamine agonists. These drugs mimic the effects of dopamine by stimulating dopamine receptors directly and are associated with a two- to three-fold risk of developing dyskinesia and other motor function fluctuations are generally in the first four to five years of therapy. However, they frequently need to be used in combination with levodopa, the drug converted to dopamine in the brain and considered the most common and effective treatment for fighting Parkinson’s symptoms.

"One of the biggest controversies now is whether a doctor should start by putting patients on a dopamine agonist or start them on levodopa," Nutt explained. "Starting them on a dopamine agonist means they’re less likely to develop dyskinesia," or the "on-off" fluctuations in motor function experienced by many Parkinson’s sufferers.

But levodopa is generally more effective. "You get more anti-Parkinson’s effects from levodopa," Nutt added. Further, there are fewer side effects, such as sleepiness, hallucinations or ankle swelling, with levdodopa.

There are other drugs for treating motor symptoms, such as anticholinergics, which are antispasmodic agents used to treat trembling; amantadine, which are used to improve muscle control and reduce stiffness; and selective MAO-B inhibitors, which increase the potency of dopamine in the brain and serve as antioxidants to clean out neurotoxins resulting from other treatments. But while they have fewer side effects, they provide only modest relief from many symptoms.

Support and education are critical when informing patients of a diagnosis of Parkinson’s disease, the NEJM article points out. Patients should understand that Parkinson’s disease often has a course over decades, the rate of progression varies greatly among patients and there are many treatments available for reducing symptoms. Patients also should be counseled about exercise, including stretching, strengthening, cardiovascular fitness and balance.

"Exercise is thought, although not proven, to be really important," Nutt said. "A person can do a lot for themselves to keep many early-stage Parkinson’s symptoms at bay."

And support groups, such as those organized by Parkinson Resources of Oregon for newly diagnosed patients, offer ongoing support.

"That dark period can be minimized or alleviated with the right kind of care," Carter said. "The beauty of Parkinson’s disease is there are a lot of exciting pharmacological therapies, but people really require the non-pharmacological therapies to live, especially in the early period before drugs are needed. Exercise, nutrition and emotional health are all things that are needed in addition to pharmacological care."

Instilling hope in newly diagnosed patients is part of the treatment process, Carter added. "They’re looking for information that can generate hope, and that it doesn’t mean an end to a meaningful life. There are a lot of reasons to be optimistic about the future."

Jonathan Modie | EurekAlert!
Further information:
http://www.ohsu.edu

More articles from Health and Medicine:

nachricht Study tracks inner workings of the brain with new biosensor
16.08.2018 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht Foods of the future
15.08.2018 | Georg-August-Universität Göttingen

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Color effects from transparent 3D-printed nanostructures

New design tool automatically creates nanostructure 3D-print templates for user-given colors
Scientists present work at prestigious SIGGRAPH conference

Most of the objects we see are colored by pigments, but using pigments has disadvantages: such colors can fade, industrial pigments are often toxic, and...

Im Focus: Unraveling the nature of 'whistlers' from space in the lab

A new study sheds light on how ultralow frequency radio waves and plasmas interact

Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...

Im Focus: New interactive machine learning tool makes car designs more aerodynamic

Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.

When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...

Im Focus: Robots as 'pump attendants': TU Graz develops robot-controlled rapid charging system for e-vehicles

Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.

Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....

Im Focus: The “TRiC” to folding actin

Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.

Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

LaserForum 2018 deals with 3D production of components

17.08.2018 | Event News

Within reach of the Universe

08.08.2018 | Event News

A journey through the history of microscopy – new exhibition opens at the MDC

27.07.2018 | Event News

 
Latest News

Smallest transistor worldwide switches current with a single atom in solid electrolyte

17.08.2018 | Physics and Astronomy

Robots as Tools and Partners in Rehabilitation

17.08.2018 | Information Technology

Climate Impact Research in Hannover: Small Plants against Large Waves

17.08.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>