Parkinson’s Disease challenge and advise collage from Doctors across India

https://youtu.be/F3XH503h9I0

#PDchallenge was initiated on July 22nd 2020 on the occasion of World Brain Day to create awareness about Parkinson’s Disease. The challenge included, showing various activities with a theme to win over Parkinson’s Disease. It included videos of patients, caregivers, friends, relatives, movement disorder specialists, neurologists, neurosurgeons, therapists, researchers from across the globe.

The following collage video shows the various Movement Disorders specialists, Neurologists, Neurosurgeons, researchers taking part in the #PDchallenge, released on August 15, 2020. This matches with the essence of ‘Mile Sur Mera Tumhara‘ theme of Unity in diversity theme song launched on August 15th 1988.

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World Brain Day – #PDchallenge

#PDchallenge

Lets Shake the Parkinson’s Disease

World Brain Day 2020

#Parkinsons

Every year July 22nd is commemorated as WORLD BRAIN DAY.  Annually one disorder will be highlighted to increase the awareness of the disorder.  World Brain Day 2020 is dedicated to raising awareness for Parkinson’s Disease, a neurodegenerative brain disorder affecting more than 70 lakh people of all ages worldwide.   This year, World Federation of Neurology and International Parkinson and Movement Disorder Society have joined together to end #parkinsons.

In this context, here in India, we are doing an active Parkinson’s Disease awareness campaign in the form of #PDchallenge.  The challenge is open to all patients, caregivers, friends, health care workers and everyone across.  The primary goal is to create awareness about Parkinson’s Disease.  Please do a brief video about your active movements or agility and challenge your family members, friends, colleagues to show their agility. Come lets create awareness about Parkinson’s disease and remove the myths about it.  Let’s create awareness by challenging our friends and relatives

10 things about Parkinson’s Disease for this World Brain Day:

  1. Parkinson’s Disease is neurodegenerative disease affecting the brain
  2. More than 70 Lakh people of all age groups affected by Parkinson’s Disease Worldwide.
  3. Parkinson’s Disease classically causes Slowness, Stiffness, Tremors and Balance problems.
  4. Mood changes, Anxiety, Depression, reduced smelling ability, Sleep disturbances, Urinary issues, Constipation, can also be affected.
  5. The Scare of the name “PARKINSON’S DISEASE”, make many people to loose hope in life.
  6. Parkinson’s disease is treatable
  7. People affected with Parkinson’s disease can lead a near normal quality of life.
  8. Good treatment options are available including mediations, injections and surgeries.  
  9. Active life style and Exercises form the most important part of management of Parkinson’s Disease.
  10. Come on the World Brain Day, “Lets Shake the Parkinson’s”
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Dance for PDParkinson Disease

Dance for Parkinson’s Disease – Learn Online

The COVID-19 breakout has lead to a significant limitations in mobility of people across the world. This is primary concern for People with Parkinson disease and Parkinsonism disorders. In these disorders people need to do workouts on daily basis to have a good quality of life. Many people require supervised care and some require a group to motivate the exercise schedules. This has been significantly hindered by the current #pandemic outbreak and #Lockdown. To over come this modern day problem, people have adapted and improvised to bridge the current issues. In this context “Hirshikesh’s Center for Contemporary Dance” in Pune, has been successfully working on online dance programs for Parkinson’s Disease and Parkinsonism Disorder patients. The dance program for Parkinson’s disease facilitators integrate movement from Indian classical and modern dance, and choreographic repertory. This initiative has been helping many Parkinson’s Disease people from across India.

Difficulties with gait and balance are common among individuals with Parkinson disease (PD), contributing to an increased incidence of falls. Gait changes include slowness of walking with short, shuffling steps and a flexed posture, and may also include festination and/or freezing of gait. Aspects of walking that appear to be particularly impaired include dual tasking, turning and walking backward

Given the potential benefits of exercise for those with PD, recommendations have been made regarding key components of an exercise program designed for those with PD. The recommendations include four key areas: 1) cueing strategies to improve gait, 2) cognitive movement strategies to improve transfers, 3) exercises to improve balance, and 4) training of joint mobility and muscle power to improve physical capacity. Emerging evidence also suggests that aerobic training, such as walking on a treadmill, may result in improved quality of life, reduced disease severity as reflected by lowering of UPDRS-III scores, and improved aerobic capacity

Dance as a group-based treatment for Parkinson’s disease (PD) incorporates physical exercise, cognitive tasks, sensory experience (music), emotional expression, and social interaction. As such a multidimensional activity, dance has the potential to address many of the challenges faced by patients. Indeed, in addition to significant motor and cognitive impairment, patients are troubled by mood changes and social isolation. Therefore, dance may highly impact the quality of life in patients with PD.

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Parkinsons diseaseAwareness

Destination Unknown – My Journey with Parkinson’s – An Autobiography by Rajeev K Gupta

Destination Unknown – My Journey with Parkinson’s

Destination Unknown – My Journey with Parkinson’s, is an autobiography of Mr. Rajeev K Gupta, who is diagnosed with Young Onset Parkinson’s Disease.   The book fills a long overdue void about personal experiences about Parkinson’s Disease, especially from Indian Context.  It goes through the various phases from, ‘Overcoming the Shock’ attached with diagnosis of Parkinson’s disease in a young active professional life.  The story leads on to explain the “Million Dollar Decision” on how and when to reveal the diagnosis to the family members and on professional front.  It also gives insights about how to cope with the diagnosis, adapt and overcome, to win over this ‘Mental Game’.  Mr. Gupta, further goes into the depth of various treatments he received, their benefits / limitations.  Later, he continues on his decision on ‘Deep Brain Stimulation’ surgery and his whole experience from the point of considering it to the post-surgery outcomes.   The book also gives a Q&A section, which will be helpful for all Parkinson’s disease patients, to understand about Parkinson’s disease and its treatment.  Overall, a must read for every Young Onset Parkinson’s Disease Patients and their families.   The Book is currently available on various online sellers including Amazon, Kobo, Google Play books and on publishers site (Notion Press).

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Parkinson Disease TreatmentParkinson Disease

Opicapone, New medication for Parkinson’s Disease got FDA approval

Opicapone, got FDA approval for Parkinson’s Disease Treatment

Parkinson’s disease treatment got a new drug for its management. Opicapone a newer once a day medication helps in better functioning of levodopa/carbidopa (Syndopa / LCD / Madopar / Sinemet). It got Food and Drug Administration (FDA) of USA approval under the brand name of ONGENTYS. It comes with 25mg and 50mg capsules. It helps to treatment and improvement of ON periods in Parkinson’s disease. The company Neurocrine Biosciences plans to launch ONGENTYS later this year.

Opicapone blocks the enzyme catechol-O-methyltransferase (COMT) effectively (>90% at therapeutic doses), selectively and reversibly, and only outside the central nervous system. It dissociates slowly from COMT, resulting in a duration of action longer than 24 hours despite its short blood plasma half-life. As COMT and DOPA decarboxylase are the main enzymes for degrading levodopa, blocking the two effectively increases its concentrations in the bloodstream. More levodopa reaches the brain, where it is activated to dopamine. This helps to improve the symptoms of Parkinson’s disease, such as stiffness and slowness of movement.In June 2016, it was authorised for use in the European Union. It was authorised for use in the United States in April 2020.

This drug is contraindicated in people with cancers that secrete catecholamines (for example epinephrine), such as phaeochromocytoma or paraganglioma, because as a COMT inhibitor it blocks catecholamine degradation. Other contraindications are a history of neuroleptic malignant syndrome (NMS) or non-traumatic rhabdomyolysis, and combination with monoamine oxidase inhibitors that are not used as antiparkinsonians, because of possible drug interactions

People taking opicapone very commonly (18%) experience dyskinesia. Other common side effects (in 1 to 10% of patients) include dizziness, strange dreams, hallucinations, constipation, dry mouth, orthostatic hypotension (low blood pressure), and muscle spasms. Apart from spasms, these side effects are also known from tolcapone and entacapone

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DBS for dystoniaDeep Brain Stimulation

Deep Brain Stimulation (DBS) in a 5 year old child – Youngest to undergo surgery in India

DBS for dystonia

A 5 yr child who is affected by a rare type of dystonia called DYT16 was managed in Vikram hospital, Bengaluru. Only about 10-12 cases have been described worldwide with this rare disease. The child was completely bed bound and dependent for all the activities. The child underwent Deep Brain Stimulation surgery (DBS), the youngest person to undergo this procedure in India till date. Its been 3 months now and the child is making great improvements. Kudos to all involved. Looking forward to hear more about the recovery curve about this rare disease

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Parkinson Disease

First Apomorphine Pump Initation in India – Vikram Hospitals, Bangalore

Finally, the Apomorphine pumps are available in Indian market. The first instillation of the Apomorphine pump happened in India at Vikram Hospitals, Bangalore on 15th May 2019. This young patient had been affected with Parkinson’s disease for almost 10 years now with currently medication alone working for about 45mins to one hour. With Apomorphine it is expected to significantly even out the motor fluctuations (On and OFF phenomenons) in the patients.

To recaptuate, Apomorphine is a medication used to manage the symptoms of Parkinson’s Disease. It is a strong dopamine agonist (Medications which act to stimulate nerve cells to release more dopamine). This leads to improvement of body functions in patients with Parkinson’s disease, who have low dopamine levels. Despite its name, apomorphine does not contain morphine. Unlike other dopamine agonist drugs (like Pramipexole, Ropinirole), which are taken as tablets or patches, apomorphine is given by injection or continuous infusion, using a pump. Apomorphine doesn’t help everyone manage their Parkinson’s symptoms, and it may not replace oral medication entirely. It usually suggested for patients who have: 1. Oral medications taking long time to act, 2. Have sudden and unpredictable changes in symptoms, 3. Severe OFF periods, 4. Cannot be considered for surgery for other medical issues / Patient not willing for surgery, 5. Patients who cannot take medications orally

It is expected that over next year, the medications should be available across the Indian market, with many from medical community getting trained for the same.

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Apomorphine Therapy

Apomorphine Launched in India

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Deep Brain Stimulation

NATIONAL GEOGRAPHIC CHANNEL TO SHOW LIVE DBS SURGERY

As a live TV audience watches, a neurosurgery team at UH Case Medical Center in Cleveland will perform an operation that has helped many Parkinson’s disease patients get significant relief from their debilitating symptoms—tremors, rigidity, stiffness, slowed movements and difficulty walking—and also enabled them to reduce their amount of medication.

Deep Brain Stimulation, or DBS, was pioneered as a Parkinson’s treatment by Dr. Alim-Louis Benabid, a neurosurgeon who also possessed a Ph.D. in physics. In the 1980s, patients were treated by surgically destroying parts of their brains where tremors originated, or using medication with unpleasant side-effects. In 1987, Benabid was performing a surgery using the then-standard method of burning away brain tissue with an electrode. As he tested various regions with electrical pulses, Benabid wondered what would happen if he used different frequencies. To his surprise, he found one that suppressed the patient’s tremor. “I thought, aha, this might be the solution,” he later recalled in a 2010 Lancet article.

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