September 2021 – Standing up to Parkinson's

Eyes as diagnostic tools for PD?

Yesterday, John & I enjoyed a lunch with two other Parkies and their spouse/ caregivers. Ed & Jane have put together a slide show presentation giving hints and tips for living with Parkinsons. I looking forward to attending the discussion. They are currently writing a book telling about their Journey. Jane had early onset PD… so the illness progresses more slowly, but after 30 years She now has two Deep Brain Stimulators in her brain and is in a wheelchair. They recommended the place in Gainsville I had gone to once. And Rose, who puts together a weekly newsletter for the parkinson’s group, gave me the name of the Movement Disorder Specialist her husband, John, sees and they recommended. I called to see if I could get an apppointment with her. But was told that they couldn’t allow me to switch doctors after I’ve already seen one. But after further discussion, she said she would pursue my request, so I am hopeful.

And now I know what I want for my birthday. After the ladies shared their experience with UTI’s… Something I recently completed receiving a round of antibiotics for… Jane said, The doctor said the best way to quit having the problem was to get a good Bidet. One that doesnt have plastic valves.. make sure the hardware is metal and it has a heater for the water. The one they got also has a nightlight built into it. They said expect to pay at least $300. for a good one, They run as high as $900. + or as cheep as $39.

Jane, like I, experiences eye challenges. She has to use a VERY Large font to enable her to type. They recommended I go see a neuro-ophthalmologist. I pointed out, there are none in the Lady Lake or The Villages. They knew of a good one… in Gainsville, of course.

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As I was brousing the Parkinson’s News Today, I saw this article:

Eyes’ Pupils May Be Window Into Assessing Disease Stag

The response of the eyes’ pupils — the black circle in the center of the eye that allows light to enter — seems to change according to the progression of Parkinson’s disease, a recent study has found.

The results suggest that measuring the pupils’ response to stimuli could become a noninvasive way to measure disease progression.

The study, “Analysis of pupillometer results according to disease stage in patients with Parkinson’s disease,” was published in Nature: Scientific Reports.

The pupil is the hole situated in the center of the iris (the colored part of the eye) that allows light to enter the retina, a lining of tissue at the back of the eye that is sensitive to light.

The iris is a contractile structure, and expands or dilates depending on the amount of light available. In this way it regulates the amount of light by controlling the size of the pupil, functioning like a photography camera’s aperture. This movement is known as the pupil light reflex (PLR) and plays a key role in determining the eye’s image quality and response to light.

A team of researchers in South Korea looked at the PLR using a pupillometer, an instrument used to measure pupil response to light. This reflex allows one to assess the functionality of the autonomic nervous system — the part of the body that controls involuntary actions such as digestion and heartbeat.

The sympathetic system activates several bodily functions when an imminent threat or major stressor is perceived, while the parasympathetic system works to calm the body afterward. Measuring the balance between these two systems can be a useful test for patients with neurological disorders.

In this study, patients with Parkinson’s were divided into early or late stages based on the Hoehn and Yahr scale (HY scale). Among the 132 patients, 100 were early stage (HY stages 1–2) and 32 were late stage (HY stages 3–5). After matching both groups for age and sex (to compensate for the effect of age on pupil light reflex), only 64 patients remained in the early stage group.

Those with late stage disease had longer disease duration and higher levodopa equivalent daily doses, meaning they were on higher doses of medications to treat their disease.

The study found there was a significant difference between the two groups in terms of pupil constriction velocity (the speed at which the pupil contracts when exposed to light) and maximum constriction velocity, which were significantly slower in the late-stage group.

“Constriction velocity and maximum constriction velocity are parameters involving the parasympathetic system, and changes in these parameters suggest that in patients with PD [Parkinson’s disease], the abnormalities of the PLR are mainly caused by parasympathetic autonomic dysfunction,” the researchers wrote.

There was not a significant difference in the two groups when it came to pupil dilation velocity (how quickly the pupil dilates when light is removed), baseline pupil size, minimum pupil diameter, and constriction latency, the delay in pupil constriction following light stimulation — all parameters that involve the sympathetic system.

The researchers noted that pupillary dilation response may have not been affected because the medications that the patients were taking may have affected the sympathetic nervous system, and thus offset the progression of the disease on dilation response.

“[T]he parameters measured by pupillometry changed according to the motor progression of PD,” the researchers wrote, adding that “pupillary parasympathetic dysfunction progresses with the progression of PD. In contrast, the factors related to sympathetic dysfunction did not change much, implying that pupillary sympathetic dysfunction advances relatively slowly even [in] PD advanced.”

The authors thus suggest the progression of Parkinson’s disease could be identified measuring pupil constriction velocity

by Yedida Y Bogachkov PhD | September 24, 2021

Perspective

I saw a line about the Flicker Effect, so naturally my curiosity was peaked. the following dial0g, explains it.

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Managing the Flicker Effect; Conversation with Neo… From: Parkinson’s News Today by Dr. C | September 17, 202

“Why are you standing on top of that chair?” Dr. C sees Neo precariously balanced on the chair under the kitchen ceiling light. Neo is the part of Dr. C’s brain that functions as his inner voice.

“This lightbulb has been flickering. It’s so annoying! I’m trying to fix that.” Neo wobbles a bit on the chair, reaching a bit farther to tap on the lightbulb. “Sometimes, if I give it a little whack across its metaphorical lightbulb ‘head,’ it will stop flickering.”

While Neo climbs down and drags the chair back to the table, he asks, “Come to think of it, isn’t that like the ‘flicker effect’ you’ve been writing about?”

Dr. C carefully puts down his morning bowl of strawberries and finishes the last careful swallow before he replies. “Like the flow of electricity to a lightbulb, we have a flow of neural activity in our brain. A constant stream of it. When the brain gets damaged with Parkinson’s disease (PD), the flow of this stream gets interrupted. We get brief episodes of PD symptoms in the early stages. We start to feel symptoms that seem to flicker on and off.”

Neo nods. “That makes sense. Like the lightbulb, our system will flicker before it fails. Does that mean if I tap your head, you will function better?”

“Well, sort of.” Dr. C laughs. “What helps is using a shift in perspective — a head tap of sorts — to bring new possibilities to light. The shift is about changing how the flicker affects my life. When I decrease the flicker effect, my symptoms are not so loud.”

“Are you saying that PD causes a ‘flicker effect,’ and you can do something about that?” Neo asks, a bit incredulous.

“Exactly! If we can manage the flicker effect, it keeps the well of resources from running dry and decreases our chance of experiencing a threshold crossing event, thus avoiding the ugly days.

“I know when I’ve crossed the threshold. My thinking isn’t clear, and my muscles aren’t working properly. The ability to interact with the world in a meaningful manner is significantly curtailed. I manage the flickers of my ‘broken brain’ to minimize crossing over.”

Dr. C continues, “If I do cross over, it takes me 24 to 48 hours to recover from the ugly day and return to just having a bad day. So many resources are drained when dealing with the ugly day. To lessen that, I use threshold management. Successful threshold management frees up resources, which allows me to work on mindful movement.

“I use the phrase ‘broken brain’ in reference to the experiences of crossing over the threshold. It doesn’t mean that PD patients aren’t fully functional the rest of the time. It isn’t meant to be disparaging. It is a wake-up call that says, ‘PD patients need to manage, as much as they can, the symptoms and their lives to be as functional, productive, and, may I say, happy as possible. I’m using the term ‘broken brain’ as a huge, red stop sign that says, ‘Don’t give up the fight.’”

Dr. C. offers, “It has taken seven years of mental retraining to discover and implement my personal PD brain rehab program. One of the most important parts is exercise. Many researchers and clinicians know that exercise can offset the progression of PD. I am always citing research and references that support the compensatory strategies that I share with my readers.

“Medical studies have indicated that proper exercise consistently improves cognition and is linked to enhanced neuroplasticity,” Dr. C continues. “Exercise is a huge part of my PD brain rehab program. Fortunately, I still work in our gardens several times a week. A couple of hours on good or even bad days, and the benefits are worth the effort in overcoming my resistance. There are plenty of days when exercise is the last thing this body wants to do.

“Some may hold on to the idea that there is a quick fix and cure out there,” Dr. C says. “For me, I believe in the power of the human mind to rewire and heal. We just need a good map. This map-making is what I started devoting my efforts to seven years ago.”

Neo smiles and points at the overhead kitchen light. The light has stopped its blinking. Neo says, “We are on the edge of a new frontier, learning how to use the new map. New tools to help people live better with Parkinson’s will continue to emerge, improving what is possible. Maybe someday we will understand how to help people use threshold management as part of a rehab map for living better with PD.

Diagnostic tool

I thought this was so cool, I wanted to share it when I saw it this morning. I just cut and pasted the entire article from Parkinson’s News Today, an online forum. And it reminded me of the first time I met a movement disorder specailist, she took one look at me and said: “YES, you have Parkinson’s” I asked her how she could be so sure, we just barely met. She said:” Your facial mask, your arms don’t swing when you walk, and now that I’ve heard you speak, your soft voice.” I asked her what she meant by mask. She explained that PwP loose the ability to show much emotion.

I’d like to see them do a second study with people with ‘early onset Parkinson’s I’d like to see the medical profession be aware of a diagnostic tool to assist, when they are stumped to determine a cause for unexplainable symptoms. There may soon be a tool to assist in diagnosing or ruling out.

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From Parkinson’s News Today Marta Figueiredo PhD | September 13, 2021

An artificial intelligence (AI) tool was able to distinguish, with great accuracy, Parkinson’s patients from healthy peers by analyzing short videos of facial expressions, particularly smiles, a small study shows.

The predictive accuracy of the new tool was comparable to that of video analysis that uses motor tasks to detect Parkinson’s, pinpointing facial expressions as a potential digital, diagnostic biomarker of the disease.

This type of biomarker could allow remote diagnosis without the need for personal interaction and extensive testing. This would be particularly relevant in situations such as a pandemic, in cases of reduced mobility, or in underdeveloped countries where few neurologists exist but most people have access to a phone with a camera, researchers noted.

The study, “Facial expressions can detect Parkinson’s disease: preliminary evidence from videos collected online,” was published as a brief communication in the journal npj Digital Medicine.

Parkinson’s-associated motor symptoms, such as tremors and muscular rigidity, affect facial muscle movements, leading to overall reduced facial expression, also known as facial masking or hypomimia

An increasing number of studies suggest that reduced facial expressions may be an “extremely sensitive biomarker for [Parkinson’s disease], making it a promising tool for early diagnosis,” the researchers wrote.

In addition, facial expression analysis is a non-invasive tool that only requires a webcam or a phone with a camera, in contrast to the expensive, non-scalable, wearable sensors currently used to analyze movements during motor tasks as digital biomarkers of Parkinson’s.

Now, a team of researchers at the University of Rochester, New York, showed that analyses of facial micro-expressions using an AI tool can accurately detect Parkinson’s.

The study involved the analysis of 1,812 videos, collected online through a web-based tool (Park test), of 604 people (61 with Parkinson’s and 543 without the disease). In these videos, participants were asked to make three facial expressions — a smiling, disgusted, and surprised face — each followed by a neutral face.

Participants’ mean age was 63.9 years, and most of them were white and living in the U.S. Patients with Parkinson’s had been living with a diagnosis of the disease for a mean of 8.4 years.

Changes in muscle movements in each of the three facial expressions were objectively measured and computed in terms of nine action units, or micro-expressions.

In agreement with previous research, the analysis showed that Parkinson’s patients had fewer facial muscle movements than people without the disease. This was particularly significant for three micro-expressions: raising cheeks and pulling the lip corner — typically observed when people smile — and lowering the brows, usually seen when people express a disgusted face.

According to the team, “the smiling facial expression has the greatest potential in differentiating individuals with and without” Parkinson’s, the researchers wrote.

The team then used these differences in micro-expressions to train a machine learning tool to distinguish between individuals with and without Parkinson’s. Machine learning is a form of AI that uses algorithms to analyze data, learn from its analyses, and then make a prediction about something.

According to the team, “the smiling facial expression has the greatest potential in differentiating individuals with and without” Parkinson’s, the researchers wrote.

They found that their AI tool could correctly identify Parkinson’s patients based on their facial expressions with an accuracy of 95.6%, which is comparable to the 92% prediction accuracy reported for existing state-of-the-art video analysis that relies on limb movements.

“We show that an algorithm’s ability to analyze the subtle characteristics of facial expressions, often invisible to a naked eye, adds significant new information to a neurologist,” the team wrote.

As such, facial expressions, especially smiling, “may become a reliable biomarker for [Parkinson’s disease] detection,” they added.

Hydrogen Peroxide

I have been aware of some of the benefits of 35% food grade hydrogen Peroxide.

My father had COPD for years, but after diffusing Hydrogen peroxide into hia bedroom every night, when he turned 90, he reported he no longer suffered from COPD . But a word of warning: I slept with a diffuser blowing hydrogen peroxide on my face, to help my cough and experienced an unexpected side effect. .. My Auburn hair was lightened and turned red!

Stabilized Oxygen This link is to where I previously shared much information about H2O2

I provided stabilized oxygen for our children every time they went camping with the scouts where the other camp participants brought nasty tasting tablets to purify their drinking water. It worked wonderfully and their camp mates were happy that I sent enough, so the children could share.

I know it isn’t a common suggestion for PwP, But I use 8 drops of 35% hydrogen peroxide in a glass of water every morning because I know the body is starved for clean oxygen. This doctor Marquis inspired me to go online and find a Nebulizer. Ours arrived today.

This is the Youtube link Dr. David Marquis tells about

Dr. David Marquis said:: “Inhaling a nebulized hydrogen peroxide/water mixture is one of my personal optimal whole health strategies, one I have utilized long before COVID took center stage. In this video, I demonstrate how easy it is to utilize a micro-nebulizer. Hydrogen peroxide has been effective as an antibacterial, antiviral and antiseptic therapy for literally hundreds of years. Its many benefits, including its support of upper respiratory health and healing have also been extensively studied.””

“We are all unique, so if you are interested in utilizing this therapy, as always I encourage you to do your own research and consult your own healthcare practitioner if needed.”

” Disclaimer: The entire contents of this Video and YouTube Channel are based upon the opinions of Dr. David Marquis, unless otherwise noted. Videos are based upon the opinions of the respective author. The information on this website is not intended to replace a one-on-one relationship with your own health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Marquis. Dr. Marquis encourages you to make your own health care decisions based upon your research and in partnership with your own health care professional. If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products”

I personally discovered the benefits of using a micro-nebulizer to inhale hydrogen peroxide and water after my lungs were scarred in my youth due to contracting walking pneumonia while doing missionary work in Japan. So, as you can imagine, I am very conscious of any subtle changes in my airways, to being potentially exposed to bacteria, a virus…and/or if I am starting to feel under-the-weather. When indicated I add inhaling nebulized hydrogen peroxide to my standard immune system support regimen.”