As the years roll by, too often we continue to preach and throw academic pearls in the general direction of our patients. We preach these pearls and cite their validity by pointing the patient toward well-crafted consensus statements appearing in high impact medical journals. This sterile academic approach has left more than a handful of patients confused in making decisions regarding their own therapy.
Parkinson's Today Blog
When I was a kid we used to ride our bicycles around the neighborhood and in the afternoons we chased one of two trucks; the ice cream truck or the pesticide spraying “stink” truck. Needless to say, ice cream has not been implicated in causing Parkinson’s disease, however, certain pesticides and environmental exposures have been making the news for possible Parkinson associations. There has been a recent explosion of research into pesticide exposure and Parkinson’s disease.
Many years before adequate medication treatments were developed to address the symptoms of Parkinson’s disease, some doctors recommended exercise, staying busy, and when engaging in activities being as “physical” as possible. There are stories of institutionalized Parkinson’s disease patients (prior to the levodopa era) who were asked to push the chart cart for doctors on rounds, or to fold towels for hospital staff. Early observations about improvement in Parkinson’s disease patients following task specific physical exertion have contributed to the belief that exercise may be beneficial.
Recently, another transplant trial in Parkinson’s disease was reported as a failure (Spheramine). It seemed rational many years ago when scientists proposed cell replacement as the penultimate neurorestorative therapy for Parkinson’s disease, but sometimes rational is not enough. The track record, however has been less than expected. There have however, been many lessons learned and the experience will hopefully help us toward better therapies in the future.
There has long been interest as to whether monoamine oxidase type B inhibitors may have disease modifying or neuroprotective benefits in Parkinson’s disease(1-4). Disease modifying agents are thought to alter the course or progression of a particular disease. Neuroprotective therapies alternatively provide protection of neurons from neurodegeneration or other injuries (2-4). No therapies to date have been proven to be disease modifying or neuroprotective in Parkinson’s disease patients.
A common question asked by many patients and families afflicted with Parkinson’s disease is, “what is gene therapy?” Quite simply, gene therapy is placing genetic information (DNA) into the cells and tissues of humans with Parkinson’s disease. In the purest form a defective part of the genome is replaced with a new copy. Perhaps the most interesting part of the evolving story of gene therapy has been the use of a virus as a vector to carry the genetic information into the brain. These viruses have been deactivated and can be safely used for this purpose (1, 2).