Public release date: 23-May-2012 [ | E-mail | Share ]

Contact: Mike Morrison mdmorrison@partners.org 617-724-6425 Massachusetts General Hospital

Use of the antioxidant urate to protect against the neurodegeneration caused by Parkinson’s disease appears to rely on more than urate’s ability to protect against oxidative damage. In the May issue of the open-access journal PLoS One, researchers from the MassGeneral Institute for Neurodegenerative Diseases (MGH-MIND) describe experiments suggesting the involvement of a novel mechanism in urate’s protection of cultured brain cells against Parkinson’s-like damage.

“Our experiments showed, unexpectedly, that urate’s ability to protect neurons requires the presence of neighboring cells called astrocytes,” says Michael Schwarzschild, MD, PhD, of MGH-MIND, the study’s senior author. “The results suggest there may be multiple ways that raising urate could help protect against neurodegeneration in diseases like Parkinson’s and further support the development of treatments designed to elevate urate in the brain.” Schwarzschild and colleagues in the Parkinson’s Study Group currently are conducting a clinical trial investigating one approach to that strategy.

Characterized by tremors, rigidity, difficulty walking and other symptoms, Parkinson’s disease is caused by destruction of brain cells that produce the neurotransmitter dopamine. Several epidemiological studies suggested that healthy people with elevated levels of urate, a normal component of the blood, may have a reduced risk of developing Parkinson’s disease, and investigations by Schwarzschild’s team found that Parkinson’s patients with higher naturally occuring urate levels had slower progression of their symptoms.

The current study was designed to investigate whether both added urate and urate already present within the cells protect cultured dopamine-producing neurons against Parkinson-like degeneration. In addition, since previous studies suggested that urate’s protective effects depended on the presence of astrocytes star-shaped cells of the central nervous system that provide both structural and metabolic support to neurons the MGH-MIND team explored how the presence of astrocytes affects the ability of urate to protect against damage induced by MPP+, a toxic molecule that produces the same kind of neurodegeneration seen in Parkinson’s and is widely used in research studies.

The experiments showed that, while added urate reduced MPP+-induced cell death by about 50 percent in cultured dopamine-producing mouse neurons, urate treatment virtually eliminated neuronal death in cultures containing both neurons and astrocytes. They also showed that reducing intracellular urate levels by induced expression of the enzyme that breaks it down increased neuronal vulnerability to MPP+ toxicity significantly in cultures that included astrocytes but only slightly in neuron-rich cultures. The fact that the presence of astrocytes greatly increases the protection of both externally applied urate and urate produced within cells indicates that the effect depends on more than urate’s ability to directly protect neurons against oxidative stress.

“A valuable next step will be determining whether endogenous urate is protective in live animal models of Parkinson’s disease,” says Schwarzschild. “It also will be important to determine whether we can selectively increase urate levels in brain cells by targeting urate transporter molecules. The approach now in early clinical trials examines whether treatment with the urate precursor inosine, which increases urate levels throughout the body, can slow the progression of the disease. If we could raise urate levels in brain cells without changing them in the rest of the body, we could avoid the risks of of excessive urate, which when accumulated in joints can cause gout.”

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Schwarzschild is an associate professor of Neurology at Harvard Medical School. Sara Cipriani, MD, of MGH-MIND is the lead and corresponding author of the PLoS One report. The study was supported by grants from the National Institutes of Health, the Department of Defense and the American Parkinson’s Disease Association.

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Editor’s Choice Main Category: Multiple Sclerosis Article Date: 24 May 2012 – 14:00 PDT

Current ratings for: ‘Recovery From Multiple Sclerosis By Growth Factor In Stem Cells’

5 (2 votes)

4.5 (2 votes)

Animals that were injected with hepatocyte growth factor were noted to have grown new neural cells and lower levels of inflammation. Most significantly, the researchers noted that the protective envelope of myelin, the myelin sheath, which surrounds the core of a nerve fiber and facilitates the transmission of nerve impulses, re-grew and covered lesions that were caused by MS.

Robert H. Miller, professor of neurosciences at the School of Medicine and vice president for research at Case Western Reserve University declared: “The importance of this work is we think we’ve identified the driver of the recovery.”

MS is caused by damage to the myelin sheath, the protective covering that surrounds nerve cells. The nerve damage is caused by inflammation, which occurs when the body’s own immune cells attacks the nervous systems located in areas of the brain, the optic nerve, and spinal cord. This damage can cause an interruption of the nerve signals, which results in loss of balance and coordination, cognitive ability, as well as in other functions and in time, these intermittent losses may become permanent. In 2009, Caplan and Miller discovered that mice with MS injected with human mesenchymal stem cells recovered from the type of damage that was brought on by MS. A clinical trial is currently underway based on their research, whereby patients with MS are injected with their own stems cells.

During this trial, the team decided to first establish whether the presence of stem cells or other cells induce recovery. They injected a total of 11 animals with MS with the medium, in which mesenchymal stem cells that were taken from bone marrow grew, discovering that all animals displayed a rapid reduction in functional deficits. An analysis demonstrated that unless the injected molecules had a certain size or weight, i.e. between 50 and 100 kiloDaltons, the course of the disease remained unchanged.

Other research, as well as the team’s own studies, suggested that this was likely to be instigated by the hepatocyte growth factor, which is secreted by mesenchymal stem cells.

The team then injected the animals with either 50 or 100 nanograms of the growth factor on alternate days for a 5-day period and observed a decrease in the level of signaling molecules that promote inflammation, whilst the level of signaling molecules that oppose inflammation increased. The researchers noted a growth of neural cells, whilst nerves that were exposed because of MS were rewrapped with myelin. Recovery was marginally better in those mice that received the 100-nanogram injections compared with those receiving the 50-nanogram injections.

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by Sylvia Perez and Christine Tressel

May 24, 2012 (CHICAGO) — Colonoscopies are known for detecting early signs of cancer in the colon. Now Chicago researchers say this common test may help reveal who might be at risk of developing Parkinson’s disease. They have discovered a clue in the gut that could be a game changer for early diagnosis and even treating the disease.

Richard Fiske Bailey says even he had a hard time realizing something was happening with his body. It was the way he was driving his sports car that caught the attention of friends.

“When I went to shift gears I would reach down with my left hand and shift I would shift with my left hand instead of my right hand, I never noticed it. And people would start to say, what is wrong,” Fiske said.

It took a long time but eventually he had a diagnosis: Parkinson’s disease.

“I was formally diagnosed in 2003 by my fifth neurologist,” Fiske said.

A slight tremor in a hand, tense muscles and slow movements are some of the more distinctive signs suggesting Parkinson’s disease. But even these can be confused with other conditions. That means thousands of cases are not diagnosed until a lot of brain cells are gone.

Parkinson’s disease occurs when the nerve cells in the brain that make a chemical called dopamine are slowly destroyed. No one is sure why that happens.

Now researchers are turning to what would seem an unlikely source of a brain disorder: the gut.

“This area of research is really hot right now, and we think it’s really important,” said Dr. Kathleen Shannon, neurologist, Rush University Medical Center

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Participants warm up for the walk held in conjunction with World Multiple Sclerosis Day. Pix by Iqmal Haqim Rosman

Padma Panikker says many know little about the rare disease, a situation that the Multiple Sclerosis Society Malaysia hopes to change. Pix by Iqmal Haqim Rosman

IN conjunction with World Multiple Sclerosis Day on May 30, a charity walk was held at Titiwangsa Lake.

Organised by Multiple Sclerosis Society Malaysia and supported by Novartis Corporation (M) Sdn Bhd, the event had the support of 300, who walked around the lake wearing the society’s official T-shirt.

The walk was flagged off by model Amber Chia, who was there to show support to the cause and learn more about the disease.

“I heard that the percentage of Malaysians with the disease is low, and some do not even know they have it.

“I am here to learn more about the disease. I hope that more people will be aware of multiple sclerosis after this,” she said.

Chia said she did not know much about the disease before she was invited to the event, and was surprised by some of the things she had learnt.

“For example, I thought that only old people get it but some of the patients here have got the disease since they were 13,” said Chia.

Multiple Sclerosis Society Malaysia president Padma Panikker said those who were diagnosed with the disease were usually frightened at first and the society acted as a support group for them.

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NZACA Welcomes $7 million Increase for Dementia

NZACA Press Release 24 May 2012

NZACA welcomes the governments $7 million p.a. increase for dementia care announced today.

The budget announcement of $40 million for dementia is arrived at by adding together, over a four year period, yearly increases along with the additional funding required to cover demand growth.

This represents a 5.8% increase in the daily subsidy rate and taking into inflationary pressures of 1.8% this represents a 4% overall gain for dementia care operators.

The average amount paid for dementia care per day is $149 depending on where you live in New Zealand.

This is another good increase in the dementia rate and means the underfunding of this service has reduced from about 36% to 20% in the last two years based on the independent 2010 Aged Residential Care Review paid for by the Government, the Chief Executive of NZACA, Martin Taylor, said today.

Everyone in the aged-care sector and the health sector understands the demand for dementia care will increase dramatically and that it is one of the hardest services to deliver. As such this increase will be of great assistance to the 150 operators delivering dementia care to 3100 elderly each and every day in New Zealand.

The independent 2010 Aged Residential Care Review also established the rest home care subsidy was 40% underfunded and the hospital rate 17% underfunded. Unfortunately, these underfunding levels have increased over the last two years as inflationary pressures for these services have not been met.

In 2011, about 3100 people were in dementia care, 11,000 in hospital level care and 16,700 in rest home level care.

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Editor’s Choice Main Category: Alzheimer’s / Dementia Article Date: 23 May 2012 – 15:00 PDT

Current ratings for: ‘Rates Of Dementia In Underdeveloped Countries Are Double Than Previously Reported’

In addition, the team found that just like in developed countries, education offers substantial protection against dementia in less developed nations. The study is published Online First in The Lancet.

Lead study author Martin Prince from King’s College London said:

Our findings suggest that early life influences, education and learning to read and write, may be particularly important for reducing the risk of dementia in late life. We need to understand more about cognitive reserve, how to measure it, and how it is stimulated across cultures.

The high incidence of dementia in less developed countries remind us that we are facing a global epidemic, and there needs to be more focus on prevention.”

Using conventional western diagnostic approaches, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV criteria, earlier studies have suggested that the incidence of dementia might be significantly lower in low- and middle-income countries vs. high-income nations.

However, the new 10/66 Dementia Diagnosis approach uses methods developed and validated in 25 low and middle-income countries. The new approach has been demonstrated to provide accurate diagnoses even in individuals with little or no education.

In order to the compare the incidence of dementia, and to determine whether education and literacy, among other factors are protective against the development of dementia, the team applied both the standard DSM-IV criteria and the 10/66 approach to around 12,800 individuals aged 65+, across 9 urban and rural sites in Mexico, Cuba, Peru, Venezuela, the Dominican Republic, and China.

The researchers found that the 10/66 dementia incidence is 1.5 – 2.5 times higher than the standard DSM-IV criteria calculated. In addition, 10/66 dementia incidence was consistently comparable to, or high than, dementia incidence reported by earlier studies.

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Ministers believe the basic training in dementia awareness is relevant to anyone working in a public environment, such as shops, transport and banks.

Speaking at the event in East London, the Prime Minister urged businesses to join his national fightback against dementia.

Mr Cameron said companies should do more to make people with dementia able to use their services.

He declared that tackling the disease, which is thought to affect 670,000 people in England, was one of his personal priorities.

Dementia is a terrible, heart breaking disease, he said. Tackling it is a personal priority of mine.

Already 20 big organisations like Lloyds Group, Tesco and E.On have signed up to become more dementia-friendly and over the coming months I want to see many more follow suit.

For the sake of millions in our country weve got to keep this spirit of energy and defiance alive.

Were going to keep searching for treatments, keep looking for ways to make life easier for those with this disease and keep taking the fight to dementia.

Mr Cameron urged young volunteers with the National Citizen Service to help sufferers in care homes.

The youngsters aged 16 and 17 are being asked to help dementia patients take part in craft activities and to take them on trips out of care homes.

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British scientists developed an iPad-based memory test that can spot dementia in its earliest stages, when treatment can be most beneficial.

Researchers from Cambridge University helped to develop the CANTABmobile test, which assesses patients’ short-term memory with a series of challenges in which they have to remember symbols.

Trials show that the computer program accurately distinguishes normal age-related forgetfulness from dementia and other treatable memory problems.

Dr. John O’Loan, who tested the app at his lab in Warrington, northwestern England, said, “Not everyone with memory problems has dementia. There are a small number of medical conditions — vitamin deficiencies or an underactive thyroid — that we check for if patients have problems with their memory.”

Doctors currently use pen-and-paper tests to screen for the condition, with patients asked a series of questions including the date and whether they can spell “world” backwards.

However, the tests can fail to pick up dementia, particularly in patients with higher academic qualifications.

The iPad app is far more sensitive, even picking up mild cognitive impairment, which can be a precursor to dementia.

Michael Hurt, Dementia Care Program Manager for NHS Walsall added, “We might find that we get people through the system more quickly and more effectively because the screening tool is more accurate, and that’s better for GPs, hospital staff, as well as the people receiving the test.”

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By Kay Lazar, Globe Staff

A loophole in Massachusetts law that allows nursing homes to advertise specialized Alzheimers and dementia care units, even though their workers may have no training in caring for such residents, is one step closer to being closed.

A proposal that would establish minimum standards for such units was approved by the House of Representatives Wednesday, and is headed for the state Senate.

The bill would require the Massachusetts Department of Public Health, which regulates nursing homes, to establish minimum standards for facilities with dementia care units.

Similar legislation has been proposed for the past seven years without success, supporters said. But this is the first time the measure has made it this far, this early in the year, they said.

This is certainly way overdue, said James Wessler, president and chief executive of the Alzheimers Association of Massachusetts and New Hampshire.

Often nursing home placement is done in time of crisis, and families are then not good shoppers, Wessler said. So the state has an obligation to have a minimal level of guarantees that facilities are providing the level of dementia care that they say they are giving.

Massachusetts is one of a handful of states without such requirements. A 2005 federal report noted that 44 states at that time had requirements governing training, staffing, security, and other areas for facilities that provided specialized dementia care.

The Massachusetts legislation would require all licensed nursing homes to provide dementia-specific training for all direct-care workers, activities directors, and supervisors. Supporters said it was important to mandate dementia training for staff at all licensed facilities because more than half of people in nursing homes suffer from dementia, even if they are not living in specialized dementia care units.

Additionally, the legislation stipulates that there should be activities programs in dementia special care units that provide activities geared to people with dementia.

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Leila Navidi

Mercy Doyle, 6, visits with Tina Lindquist, the program director at Brain Balance Achievement Centers in Henderson on Wednesday, May 23, 2012. Doyle has been diagnosed with the rare neurological disorder Opsoclonus MyoclonusSyndrome.

By Conor Shine (contact)

Thursday, May 24, 2012 | 2 a.m.

Six-year-old Mercy Doyle is like a lot of girls her age.

She loves coloring, swimming and The Little Mermaid. She looks up to her big sister and finds her younger brother kind of annoying.

But to doctors in Nevada and around the country, Mercy is a medical mystery, a child with a unique set of symptoms theyve never seen before.

Mercys medical odyssey began seemingly overnight, her parents say, four years ago during a family vacation to the beach in California.

She kept falling in the sand. She couldnt run around. She was shaky. It was weird, said her father, Kevin Doyle, a worship pastor at Green Valley Christian Center.

Her family rushed back home to Henderson, where Mercy was diagnosed with a viral infection that was attacking her brain. After a few months, her condition seemed to be improving. Then her symptoms worsened again.

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MONROE April was recognized across the United States as National Autism Month and served as an opportunity for everyone to educate the public about autism and the issues within the autism community.

Resident Kimberley Toto decided to go bigger this year and promoted more awareness during World Autism Awareness Day April 2, and not only included the schools but made it a community wide event and asked the two local communities to light it up blue.

This marked her third year promoting this campaign through Autism Speaks, where prominent buildings across North America turned their lights blue in honor of World Autism Awareness Day.

The Empire State Building in New York City did the same thing to promote awareness for the condition.

Inspired by this, Ms. Toto used spotlights and blue Christmas lights on her home in April.

Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors, according to the Autism Speaks website, http://www.autismspeaks.org.

When my daughter was diagnosed it was 1 in 150. In the last several years the numbers increased to 1 in 110, Ms. Toto said. Right before the month of April 2012, the Centers for Disease Control came out with new numbers. It is now 1 in 88 kids that are affected with some form of ASD (Autism Spectrum Disorder).

Autism statistics from the U.S. Centers for Disease Control and Prevention (CDC) identify around 1 in 88 American children as on the autism spectruma 10-fold increase in prevalence in 40 years, according to the organization. Careful research shows that this increase is only partly explained by improved diagnosis and awareness.

Studies also show that autism is three to four times more common among boys than girls. An estimated 1 out of 54 boys and 1 in 252 girls are diagnosed with autism in the United States, according to the Autism Speaks website.

By way of comparison, this is more children than are affected by diabetes, AIDS, cancer, cerebral palsy, cystic fibrosis, muscular dystrophy or Down syndrome, combined, according to the organization.

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Data Provide Snapshot of Autism Spectrum Disorder and Special Health Care Needs

By Denise Mann WebMD Health News

Reviewed by Louise Chang, MD

May 24, 2012 — New research provides a snapshot of what life is like for school-aged children with autism spectrum disorder in the U.S.

The findings, which appear in the NCHS Data Brief, highlight areas where there is room for improvement, including earlier diagnosis of autism spectrum disorder and access to behavioral therapies and other services. The new study looked at children aged 6 to 17 with special health care needs and autism spectrum disorder in 2011.

More than half of school-aged kids were age 5 or older when they were first diagnosed with autism spectrum disorder, the study showed. Less than 20% were diagnosed by age 2. The American Academy of Pediatrics recommends that pediatricians screen children for autism at 18 months of age.

The CDC estimates that 1 in 88 children in the U.S. has an autism spectrum disorder. This is the umbrella term for a group of developmental disorders that can range from mild to severe and that often affect social and communication skills. Treatment is individualized, and often involves behavioral therapies to address developmental delays along with medication.

Of the children in the study, about 9 of 10 received one or more therapies. Most commonly these included speech or language therapy and/or social skills training. More than half of these kids took at least one psychiatric medication, including stimulants, anti-anxiety drugs, or antidepressants.

“Our data indicate that many children with autism — the majority — are getting some sort of services such as speech or other individual-based interventions,” says researcher Lisa J. Colpe, PhD, MPH, of the National Institute of Mental Health in Bethesda, Md. “That is great news.”

Outside experts say there are still many gaps in the diagnosis and treatment of autism spectrum disorder among school-aged kids in the U.S.

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Most Children With Autism Diagnosed at 5 or Older

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