Lee Judge Simpson says he's still effective justice despite Parkinson's disease

Photo by David Ahntholz .da

Joe Simpson

FORT MYERS A Lee circuit judge who hasn't presided over a hearing for a year, but reviews cases and signs orders in an office, contends Parkinson's disease doesn't prevent him from working as a judge and calls his critics misinformed or swayed by stereotypes.

Judge Joseph Simpson, seeking a second six-year term, says it wasn't his choice to be removed from the courtroom last July and given a handicap-accessible office, where he works on a paperwork docket, reviewing domestic violence petitions for temporary injunctions, uncontested divorces, probate files and orders.

"I have been asked why run for re-election and be subjected to ridicule for carrying out my judicial duties with Parkinson's, especially after having spent thousands of dollars to be defended against claims of inability to sit as judge," Simpson wrote in a letter to the Daily News, noting that his mind is still sharp and he uses aids to ensure his voice is clear.

"It is my sincere belief that the public suffers when a judiciary does not include persons with disabilities, with the insight, common sense and experience they bring to the bench," he wrote. " My ability to handle complex legal matters and render sound decisions remains constant."

Simpson detailed his situation in a recent five-page letter to Daily News after the newspaper published a story May 13 about how lawyers and others couldn't understand him, his lack of a hearing docket and the burden it places on judges who share his caseload.

Neither Simpson nor his judicial assistant agreed to interviews for the May 13 story. A Daily News reporter was unable to find or see him because his office isn't accessible without an escort, which wasn't provided.

Circuit Chief Judge Jay Rosman has called Simpson's docket "valuable work" that provides more time for other judges, an accommodation beneficial to the community, the judiciary and Simpson.

But it comes at a time when the state reduced Lee's request for three additional circuit judges to two this year. Lee's circuit civil and probate cases totaled 1.17 million last fiscal year, not including thousands of criminal cases circuit judges hear.

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Lee Judge Simpson says he's still effective justice despite Parkinson's disease

Parkinson's disease patients can become more creative when they take dopamine

Public release date: 23-Feb-2012
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Contact: Annette Whibley
annette.wizard@gmail.com
Wiley-Blackwell

Some Parkinson's Disease patients can suddenly become creative when they take dopamine therapy, producing pictures, sculptures, novels and poetry. But their new-found interests can become so overwhelming that they ignore other aspects of their everyday life, such as daily chores and social activities, according to research published in the March issue of the European Journal of Neurology.

Italian researchers studied 36 patients with Parkinson's Disease - 18 with increased artistic production and 18 without - and compared them with 36 healthy controls without Parkinson's. None of the patients had engaged in artistic hobbies before they took dopamine.

"Patients were included in the artistic group if they started working on creative projects for two or more hours a day after starting taking dopamine" explains lead author Dr Margherita Canesi, a neurological specialist at the Centro Parkinson e Disordini del Movimento in Milan.

"Our findings suggest that the patients' newly acquired artistic skills were probably there all along, but did not start to emerge until they took the dopamine therapy. They did not appear to be connected with abnormal repetitive behaviours, such as impulse control disorders or punding - stereotyped behavior characterised by an intense fascination with a complex, excessive, non-goal oriented, repetitive activity.

"Other researchers have noted that altered creative drive has been observed in patients who have neurodegenerative diseases or have had a stroke. However the anatomical and physiological understanding of creativity is difficult to establish and quantify."

Dopamine is a neurotransmitter that helps control the brain's reward and pleasure centres. It helps to regulate movement and emotional responses and enables people to see rewards and work towards them. Parkinson's Disease is caused by dopamine deficiency and using medication to increase dopamine levels in the brain is one of the most popular kinds of therapy.

Key findings of the study included:

The artwork presented by the patients was mainly drawings/paintings (83%), poetry/novels (50%) and sculpture (28%). In 78% of cases, the patients showed more than one skill, normally writing plus painting or drawing. Some of the patients produced art that was sold and books that were published, but, at the other end of the scale, some of the creative work was of a very poor quality. By using the Torrence Test of Creative Thinking to compare the three groups, the researchers showed that the artistic Parkinson's Disease patients had similar overall and individual scores to the healthy controls. However the non-artistic patients had significantly lower overall scores than the healthy controls and significantly lower scores than the artistic patients when it came to the elaboration sub-score. There was no correlation between the Torrence Test of Creative Thinking scores and the scores obtained using the Barratt Impulsivity Scale, one of the oldest and most widely used measures of impulsive personality traits. The researchers also used the Minnesota Impulsive Disorders Interview. This showed that one creative patient was positive for compulsive sexual behaviour, one creative patient for compulsive buying and two creative and three non-creative patients for pathological gambling. However, there was little difference in the Torrence scores for patients who tested positive or negative on the Minnesota scale. None of the patients or healthy controls displayed the stereotyped behaviour measured by the Punding Rating Scale.

"In conclusion, we found that newly acquired creative drive in patients with Parkinson's Disease, after the introduction of dopaminergic therapy, is not related to impulsivity or impulse control disorders as measured by the Barratt Impulsivity Scale or the Minnesota Impulsive Disorders Interview" says Dr Canesi.

"We believe that their desire to be creative could represent emerging innate skills, possibly linked to repetitive and reward-seeking behaviours. Further studies are needed to support our preliminary observations."

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Notes to editors

Artistic productivity and creative thinking in Parkinson's disease. Canesi et al. European Journal of Neurology. 19, pp468-472. (March 2012) doi:10.1111/j.1468-1331.2011.03546.x The European Journal of Neurology covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases or large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases). The journal provides a forum for European activity in clinical neuroscience and medical practice and helps strengthen the links between research workers and clinicians in Europe and other parts of the world. The journal also publishes the official EFNS taskforce papers. http://wileyonlinelibrary.com/journal/ENE Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit http://www.wileyblackwell.com or our online platform, Wiley Online Library (wileyonlinelibrary.com), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities. [ | E-mail | Share ]

 

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Parkinson's disease patients can become more creative when they take dopamine

Freezing Parkinson's in its tracks: Researcher developing therapy to halt symptoms in Parkinson's patients

ScienceDaily (May 2, 2012) Parkinson's disease, a disorder which affects movement and cognition, affects over a million Americans, including actor Michael J. Fox, who first brought it to the attention of many TV-watching Americans. It's characterized by a gradual loss of neurons that produce dopamine. Mutations in the gene known as DJ-1 lead to accelerated loss of dopaminergic neurons and result in the onset of Parkinson's symptoms at a young age.

The ability to modify the activity of DJ-1 could change the progress of the disease, says Dr. Nirit Lev, a researcher at Tel Aviv University's Sackler Faculty of Medicine and a movement disorders specialist at Rabin Medical Center. Working in collaboration with Profs. Dani Offen and Eldad Melamed, Dr. Lev has now developed a peptide which mimics DJ-1's normal function, thereby protecting dopamine-producing neurons. What's more, the peptide can be easily delivered by daily injections or absorbed into the skin through an adhesive patch.

Based on a short protein derived from DJ-1 itself, the peptide has been shown to freeze neurodegeneration in its tracks, reducing problems with mobility and leading to greater protection of neurons and higher dopamine levels in the brain. Dr. Lev says that this method, which has been published in a number of journals including the Journal of Neural Transmission, could be developed as a preventative therapy.

Guarding dopamine levels

As we age, we naturally lose dopamine-producing neurons. Parkinson's patients experience a rapid loss of these neurons from the onset of the disease, leading to much more drastic deficiencies in dopamine than the average person. Preserving dopamine-producing neurons can mean the difference between living life as a Parkinson's patient or aging normally, says Dr. Lev.

The researchers set out to develop a therapy based on the protective effects of DJ-1, using a short peptide based on the healthy version of DJ-1 itself as a vehicle. "We attached the DJ-1-related peptide to another peptide that would allow it to enter the cells, and be carried to the brain," explains Dr. Lev.

In pre-clinical trials, the treatment was tested on mice utilizing well-established toxic and genetic models for Parkinson's disease. From both a behavioral and biochemical standpoint, the mice that received the peptide treatment showed remarkable improvement. Symptoms such as mobility dysfunctions were reduced significantly, and researchers noted the preservation of dopamine-producing neurons and higher dopamine levels in the brain.

Preliminary tests indicate that the peptide is a viable treatment option. Though many peptides have a short life span and degrade quickly, this peptide does not. Additionally, it provides a safe treatment option because peptides are organic to the body itself.

Filling an urgent need

According to Dr. Lev, this peptide could fill a gap in the treatment of Parkinson's disease. "Current treatments are lacking because they can only address symptoms -- there is nothing that can change or halt the disease," she says. "Until now, we have lacked tools for neuroprotection."

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Freezing Parkinson's in its tracks: Researcher developing therapy to halt symptoms in Parkinson's patients

Tai Chi may help Parkinson's patients regain balance

A six-month program of Tai Chi exercises helped people with various stages of Parkinson's disease improve stability, their ability to walk and reduced the frequency of falls.

A study released this week in the New England Journal of Medicine compared a six-month tailored Tai Chi program to resistance training and stretching to see which was most effective at improving functional movement, walking and balance for Parkinson's patients.

Researchers randomly assigned 195 men and women ages 40 to 85 who were in stages one to four of Parkinson's disease (on a scale of one to five). Parkinson's is a neurological disorder caused by a loss of neurons that produce dopamine, a chemical involved with muscle function and movement coordination. That can result in tremors, stiffness, poor coordination and more difficulty doing daily activities. It can also lead to a higher risk of falls, which can cause serious injuries.

Tai Chi, a discipline that incorporates slow, deliberate movements, plus breathing, has health benefits that include reducing stress and improving balance and posture.

The study participants were randomly assigned to hourlong, twice weekly sessions of Tai Chi, resistance training or stretching for six months. Researchers assessed their status at the beginning of the study, at three and six months, and three months after the study ended.

The Tai Chi group did better than the stretching group on a few measures: leaning without losing balance, having better directional control of their body, and walking skills. They outperformed the resistance training group on balance and stride length. Those in the Tai Chi group also reduced their frequency of falls more than the stretching group, and on a par with the resistance group.

Three months after the study ended, those in the Tai Chi group were able to maintain the benefits they had gained.

"Since many training features in the program are functionally oriented," said Oregon Research Institute scientist Fuzhong Li in a news release, "the improvements in the balance and gait measures that we demonstrated highlight the potential of Tai Chi-based movements in rehabilitating patients with these types of problems and, consequently, easing cardinal symptoms of Parkinson's disease and improving mobility, flexibility, balance and range of motion." Li was the lead author of the study.

He added that Tai Chi has several advantages: "It is a low-cost activity that does not require equipment, it can be done anywhere, at any time, and the movements can be easily learned. It can also be incorporated into a rehabilitation setting as part of existing treatment. Similarly, because of its simplicity, certain aspects of this Tai Chi program can also be prescribed to patients as a self-care/home activity."

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Tai Chi may help Parkinson's patients regain balance

Medical Breakthrough: First Test To Show Parkinson's Disease

POSTED: 4:31 pm MST February 14, 2012

UPDATED: 4:59 pm MST February 14, 2012

LOS ANGELES -- More than one million Americans are living with Parkinson's disease. Right now, doctors diagnose it by conducting a physical exam that?s often unreliable, but that?s about to change.William used to be a professional welterweight fighter. Today, he?s fighting a different yet powerful opponent, Parkinson?s disease."I got Parkinson?s, Parkinson?s ain?t got me," William "Tank" Hill, a former boxer said. Debora Bergstrom is also battling the condition that causes tremors, balance problems and speech issues. The mom of three was diagnosed four years ago by a neurologist."She told me to stand up, walk, she rotated my arms and hands, and she said, yes, you have Parkinson's," Debora Bergstrom said.Many people wait years before getting that diagnosis. Doctors physically examine patients for the telltale symptoms to formulate their conclusion, but their observations aren?t always accurate.Forty percent of Parkinson?s patients are undiagnosed and at least 10 percent who are diagnosed don?t really have it. Doctor Louise Thomson says a new imaging test called DATscan is giving doctors a glimpse inside the Parkinson?s brain. First, doctors inject patients with a tracer. Then they scan the brain for dopamine, a chemical that Parkinson?s patients lack.Thomson says the test can tell doctors if the patient has Parkinson?s or just a tremor disorder, which is treated differently"This is a game changer. It?s going to lead to earlier diagnosis and clearer diagnosis for patients with tremors," Doctor Louise Thomson, MBChB, from Cedars-Sinai Medical Center explained.An earlier diagnosis means patients can start treatments sooner, potentially slowing symptom development of this devastating disease. For William and Debora, every symptom-free day matters. Now , doctors are one step closer to figuring that out. The following are comments from our users. Opinions expressed are neither created nor endorsed by TheDenverChannel.com. By posting a comment you agree to accept our Terms of Use. Comments are moderated by the community. To report an offensive or otherwise inappropriate comment, click the "Flag" link that appears beneath that comment. Comments that are flagged by a set number of users will be automatically removed.

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Medical Breakthrough: First Test To Show Parkinson's Disease

LSVT® LOUD Treatment Benefits Parkinson's Disease Patient — Hendricks Regional Health – Video

31-10-2011 14:20 Nearly 90 percent of patients with Parkinson's Disease (PD) have speech problems that start early in the disease process and progressively worsen. These speech problems can make it difficult for patients to be heard or understood by others, affecting their quality of life. Hendricks Regional Health offers LSVT®LOUD, an innovative treatment protocol that has been proven to improve voice and speech in individuals with PD. The program, offered by our speech therapy team, is recommended for virtually any patient with PD. Patient Ed Burns recently had great success improving his communication skills throughout the course of treatment. Burns works as a call-center representative, so his voice is his livelihood. Hear how this program has made a great difference in his life.

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LSVT® LOUD Treatment Benefits Parkinson's Disease Patient -- Hendricks Regional Health - Video

Parkinson's Disease: Study of Live Human Neurons Reveals the Disease's Genetic Origins, New Drug Targets

News Release

UB's Feng says the use of iPSCs was "a game-changer for Parkinson's disease. It finally allowed us to obtain the material we needed to study this disease."

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Release Date: February 7, 2012

Summary:

-- UB researchers have discovered how mutations in parkin disrupt proper function of dopamine, the neurotransmitter that controls body movement.

-- They found that parkin mutations disrupt the precise actions of dopamine and produce more free radicals, which in turn destroy the dopamine neurons, leading to Parkinson's disease.

-- This is the first study to use live human neurons to investigate what role parkin plays in Parkinson's disease; this dramatic advance was made possible by the use of induced pluripotent stem cells.

-- Funding was provided by the Michael J. Fox Foundation for Parkinson's Research; the National Institutes of Health; SUNY REACH, a research network of SUNY academic medical centers; and NYSTEM, New York State's stem cell initiative.

BUFFALO, N.Y. -- Parkinson's disease researchers at the University at Buffalo have discovered how mutations in the parkin gene cause the disease, which afflicts at least 500,000 Americans and for which there is no cure.

The results are published in the current issue of Nature Communications.

The UB findings reveal potential new drug targets for the disease as well as a screening platform for discovering new treatments that might mimic the protective functions of parkin. UB has applied for patent protection on the screening platform.

"This is the first time that human dopamine neurons have ever been generated from Parkinson's disease patients with parkin mutations," says Jian Feng, PhD, professor of physiology and biophysics in the UB School of Medicine and Biomedical Sciences and the study's lead author.

As the first study of human neurons affected by parkin, the UB research overcomes a major roadblock in research on Parkinson's disease and on neurological diseases in general.

The problem has been that human neurons live in a complex network in the brain and thus are off-limits to invasive studies, Feng explains.

"Before this, we didn't even think about being able to study the disease in human neurons," he says. "The brain is so fully integrated. It's impossible to obtain live human neurons to study."

But studying human neurons is critical in Parkinson's disease, Feng explains, because animal models that lack the parkin gene do not develop the disease; thus, human neurons are thought to have "unique vulnerabilities."

"Our large brains may use more dopamine to support the neural computation needed for bipedal movement, compared to quadrupedal movement of almost all other animals," he says.

Since in 2007, when Japanese researchers announced they had converted human cells to induced pluripotent stem cells (iPSCs) that could then be converted to nearly any cells in the body, mimicking embryonic stem cells, Feng and his UB colleagues saw their enormous potential. They have been working on it ever since.

"This new technology was a game-changer for Parkinson's disease and for other neurological diseases," says Feng. "It finally allowed us to obtain the material we needed to study this disease."

The current paper is the fruition of the UB team's ability to "reverse engineer" human neurons from human skin cells taken from four subjects: two with a rare type of Parkinson's disease in which the parkin mutation is the cause of their disease and two healthy subjects who served as controls.

"Once parkin is mutated, it can no longer precisely control the action of dopamine, which supports the neural computation required for our movement," says Feng.

The UB team also found that parkin mutations prevent it from tightly controlling the production of monoamine oxidase (MAO), which catalyzes dopamine oxidation.

"Normally, parkin makes sure that MAO, which can be toxic, is expressed at a very low level so that dopamine oxidation is under control," Feng explains. "But we found that when parkin is mutated, that regulation is gone, so MAO is expressed at a much higher level. The nerve cells from our Parkinson's patients had much higher levels of MAO expression than those from our controls. We suggest in our study that it might be possible to design a new class of drugs that would dial down the expression level of MAO."

He notes that one of the drugs currently used to treat Parkinson's disease inhibits the enzymatic activity of MAO and has been shown in clinical trials to slow down the progression of the disease.

Parkinson's disease is caused by the death of dopamine neurons. In the vast majority of cases, the reason for this is unknown, Feng explains. But in 10 percent of Parkinson's cases, the disease is caused by mutations of genes, such as parkin: the subjects with Parkinson's in the UB study had this rare form of the disease.

"We found that a key reason for the death of dopamine neurons is oxidative stress due to the overproduction of MAO," explains Feng. "But before the death of the neurons, the precise action of dopamine in supporting neural computation is disrupted by parkin mutations. This paper provides the first clues about what the parkin gene is doing in healthy controls and what it fails to achieve in Parkinson's patients."

He noted in this study that these defects are reversed by delivering the normal parkin gene into the patients' neurons, thus offering hope that these neurons may be used as a screening platform for discovering new drug candidates that could mimic the protective functions of parkin and potentially even lead to a cure for Parkinson's.

While the parkin mutations are only responsible for a small percentage of Parkinson's cases, Feng notes that understanding how parkin works is relevant to all Parkinson's patients. His ongoing research on sporadic Parkinson's disease, in which the cause is unknown, also points to the same direction.

In addition to Feng, co-authors are Houbo Jiang, PhD, Yong Ren, PhD, Eunice Y. Yuen, all research assistant professors at UB; Ping Zhong, PhD, research scientist, Mahboobe Ghaedi, PhD, postdoctoral associate, Zhixing Hu, PhD, postdoctoral associate, and Zhen Yan, PhD, professor, all of the UB Department of Physiology and Biophysics. Other co-authors are Gissou Azabdaftari, MD, of the Roswell Park Cancer Institute, and Kazuhiro Nakaso, MD, of Tottori University in Japan.

The University at Buffalo is a premier research-intensive public university, the largest and most comprehensive campus in the State University of New York. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.

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Parkinson's Disease: Study of Live Human Neurons Reveals the Disease's Genetic Origins, New Drug Targets