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The Monthly Transmitter (September 2010)

                        


 

Briefing

 

 

The 2010 Consortium Conference held September 8-10, 2010 in San Francisco was a great success! A special thank you to those who participated.

Presentation slides will be available on our website shortly.




Prepared by:  Indu  Subramanian, MD, West LA PADRECC

CSF amyloid {beta} 1-42 predicts cognitive decline in Parkinson disease Biomarkers that help identify patients at risk for cognitive decline would be useful additions to the clinical management of Parkinson disease. 45 patients with PD were enrolled in this prospective cohort study and had at least 1 yearly longitudinal follow-up evaluation. CSF was collected at baseline and cognition was assessed at baseline and follow-up visits using the Mattis Dementia Rating Scale (DRS-2). CSF was tested for amyloid beta 1-42 (Abeta1-42), p-tau181p, and total tau levels using the Luminex xMAP platform.  Lower baseline CSF Abeta1-42 was associated with more rapid cognitive decline. Subjects with CSF Abeta1-42 levels </=192 pg/mL declined an average of 5.85 (95% confidence interval 2.11-9.58, p = 0.002) points per year more rapidly on the DRS-2 than subjects above that cutoff, after adjustment for age, disease duration, and baseline cognitive status. CSF total tau and p-tau181p levels were not significantly associated with cognitive decline. Reduced CSF Abeta1-42 was an independent predictor of cognitive decline in patients with PD. This observation is consistent with previous research showing that Alzheimer disease pathology contributes to cognitive impairment in PD. This biomarker may provide clinically useful prognostic information, particularly if combined with other risk factors for cognitive impairment in PD.

Neurology. 2010 Aug 18. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/20720189

PMID: 20720189

 

Effects of a central cholinesterase inhibitor on reducing fall in Parkinson disease.

The purpose of the study was to investigate if a central cholinesterase inhibitor will reduce falling frequency in subjects with Parkinson disease (PD) with advanced postural instability. The reason they chose this approach was because anticholinergic medications increase falling in the elderly. Further, CNS cholinergic neuron loss occurs in PD.  23 subjects were enrolled with PD who reported falling or nearly falling more than 2 times per week. In a randomized, placebo-controlled, crossover design, subjects were given 6 weeks of donepezil or placebo with a 3-week washout between phases. The primary outcomes were daily falls and near falls reported on postcards. Secondary outcomes included scores on the Activities of Balance Confidence Scale, Berg Balance Scale, Clinical Global Impression of Change, Folstein Mini-Mental State Examination, and the motor section of the Unified Parkinson's Disease Rating Scale. Fall frequency per day on placebo was 0.25 +/- 0.08 (SEM) compared with 0.13 +/- 0.03 on donepezil (p < 0.05). The frequency of near falls was not significantly different between phases. The secondary outcomes did not differ; however, there was a trend to improvement on the subject-completed Global Impression of Change scale. Subjects with PD fell approximately half as often during the 6 weeks on donepezil than on placebo.

Neurology. 2010 Sep 1. [Epub ahead of print]

http://www.ncbi.nlm.nih.gov/pubmed/20810998

PMID: 20810998

Risk and learning in impulsive and nonimpulsive patients with Parkinson's disease.

Relatively little is known about the interaction between behavioral changes, medication, and cognitive function in Parkinson's disease (PD). The group examined working memory, learning and risk aversion in PD patients with and without impulsive or compulsive behavior (ICB) and compared the results with those in a group of age-matched control subjects. Parkinson patients with PD+ICB had poorer working memory performance than either controls or PD patients without ICB. PD+ICB patients also showed decreased learning from negative feedback and increased learning from positive feedback in off compared with on dopaminergic medication. This interaction between medication status and learning was the opposite of that found in the PD patients without a diagnosis of ICB. Finally, the PD group showed increased risk preference on medication relative to controls, and the subgroup of PD+ICB patients with pathological gambling were overall more risk prone than the PD group. Thus, medication status and an impulsive behavioral diagnosis differentially affect several behaviors in PD. (c) 2010 Movement Disorder Society.

Mov Disord. 2010 Aug 18. [Epub ahead of print]

http://www.ncbi.nlm.nih.gov/pubmed/20721918

PMID: 20721918

 

 

 

 

 

 

Dates to Remember

 

Committee Recap

MARK YOUR CALENDARS…

 

 

 

 

September 28th-October 1, 2010

World Parkinson

Congress

The 2nd WPC 2010

Glasgow, Scotland

www.worldpdcongress.org

 

November 4, 2010

PADRECC/EES Movement Disorders Series

CSP#468 Phase II DBS Research

Audio conference 1-800-767-1750 Access 53353#

www.parkinsons.va.gov

 

June 5-9, 2011

15th International Congress of Parkinson’s Disease and Movement Disorders

Toronto, Canada

www.movementdisorders.org

 

 

 

 

 

 

 

 

 

 

 

Clinical Care Committee

  • Rotation of Committee Chair: leadership for the clinical care committee rotates amongst the PADRECCs. West LA leads for Sept-Oct.
  • Standardize Clinical Care: continues to work on measures to standardize clinical care across the PADRECC network and provide clinical support to the Consortium network.

Education Committee

  • PADRECC/EES Movement Disorder Series: FY 2011 series begins Nov 4, 2010 at 12-1pm ET or 3-4pm ET with “CSP#468 Phase II DBS Research” by Fran Weaver, PhD and Ken Follet, MD. Future dates in 2011 are: Jan 13, Mar 10, May 12, Jul 14, and Sep 8. These audio conference series will be archived on the www.parkinsons.va.gov website under the Movement Disorder Series tab. 
  • Patient Education Video project: Susan Heath (SF PADRECC) is working with EES and the education committee to develop a series of videos for patient education in FY2011.
  • Parkinson’s disease Across the Lifespan: a Roadmap for Nurses: PADRECC nurses were presenters at this symposium hosted by APDA, NPF, and PD. This program will be available free and on-line until May 2011and provides 7.5 credits of continuing nursing education. Go to http://support.pdf.org/nursing. 
  • PADRECC Transmitter: assembly and distribution of this e-newsletter every other month.

Spotlight on Consortium Centers: none this edition

 

 



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