New Method Captures Images of All Brain Areas Following Gene Therapy

gene therapy

A new method that allows imaging of all brain areas can help researchers monitor the success of gene therapy in the treatment of neurological diseases such as Parkinson’s.

The study, “A Novel Positron Emission Tomography Reporter Gene/Reporter Probe for the Central Nervous System,” was presented recently during the SNMMI 2018 Annual Meeting in Philadelphia, and published in the Journal of Nuclear Medicine.

Gene therapy is a therapeutic approach that has the potential, by replacing a defective gene copy with a healthy one, to be a one-time treatment that fixes, rather than treats, disease.

In neurological diseases – such as Parkinson’s disease or Alzheimer’s disease – gene therapy is often limited by the lack of an adequate imaging technique that can successfully help monitor the delivery and expression of the therapeutic gene directly into the brain.

While many reporter gene systems — a construct that tags genes with fluorescent probes and allows tracking within the body— have been developed for imaging gene therapies, current systems do not allow imaging all areas of the brain.

It is challenging to find a reporter gene and imaging agent that can be used in all areas of the brain with a high signal-to-background ratio,” Thomas Haywood, PhD, department of radiology at Stanford University, said in a press release.

Researchers now have developed a new positron emission tomography (PET) reporter gene system that allows for monitoring of gene expression (the process by which information in a gene is synthesized to create a working product, like a protein) in all areas of the brain.

PET imaging uses small amounts of radioactive materials, called radiotracers, along with a special camera and computer to help evaluate organ and tissue functions.

The newly developed system allows researchers to monitor the level and location of gene expression in all areas of the brain in a non-invasive manner, helping physicians determine the likelihood of treatment success.

To test their new method, researchers infected mice brain cells with a viral vector containing the PKM2 gene. PKM2 was considered an ideal choice for a reporter gene because the protein it produces, pyruvate kinase M2, is not expressed at very high levels in the healthy brain. As such, it can be specifically monitored and traced in an experimental setting.

Animals then were imaged with the 18F-DASA-23 radiotracer over a period of two months to observe the increase in PKM2 expression over time. Importantly, this radiotracer is able to cross the blood brain barrier (BBB), a semi-permeable membrane that protects the brain from outside circulating blood.

18F-DASA-23 is a novel radiotracer, or reporter probe, developed in the Gambhir lab at Stanford that is capable of crossing the blood–brain barrier and targeting the pyruvate kinase M2 protein in the central nervous system with minimal endogenous [normal] expression in the brain,” Haywood explained. “This allows us to monitor reporter gene expression and ultimately therapeutic gene expression for gene therapy in all regions of the brain.”

Results showed there was an increase in 18F-DASA-23 uptake, which correlated with the levels of PKM2 in the cells. This suggests that not only was PKM2 being expressed, but that the radiotracer was correctly detecting its expression in brain tissue.

“This encouraging data suggests PKM2 has the potential to be further developed into a PET reporter gene system for the imaging of gene therapy in the CNS [central nervous system],” the authors wrote.

“Having a reporter gene/reporter probe system that allows monitoring of all areas of the brain opens the door to more accurate and less invasive imaging of the brain and of gene therapies used to tackle diseases of the brain,” Haywood said.

A Phase 1 clinical trial is currently recruiting patients to test the 18F-DASA-23 radiotracer for the early detection of therapeutic response in patients with glioblastoma, a type of brain tumor that develops in certain brain cells called astrocytes.

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Russian Researchers Create Software that Predicts Parkinson’s Symptoms

software program predictive

A new software can predict with an accuracy of 96 percent the form of Parkinson’s disease and future symptoms that a patient may experience.

The software was the result of a collaboration between researchers at Peter the Great St. Petersburg Polytechnic University (SPbPU), the Institute of Experimental Medicine, and ITMO University, in Russia.

This technology may improve early diagnosis, promote preventive care, and ultimately enhance patients’ overall health.

The program was developed based on a discriminant analysis method that allows researchers to dissect a great amount of data more easily and create groups that share similar features. The technology combines clinical information, test results, and disease progression data, which may provide common patterns used to identify patients or particular features according to those specific characteristics.

This strategy allows clinicians to evaluate which treatments would be more likely to work for a patient or group of patients. Also, the software could predict if patients were likely — or not — to develop certain disorders or symptoms.

For instance, in a previous study researchers found that Parkinson’s patients who have very low blood levels of copper have increased chances of developing abnormal posture.  “If a doctor knows about a potential threat in advance, he or she can start preparing for the treatment beforehand,” Marina Karpenko, PhD, associate professor at the biophysics department of SPbPU, said in a press release.

Built on the basis of artificial intelligence, the software has the capacity to constantly improve its predictive abilities, as Karpenko explained: “The program can be ‘trained’: the more information is uploaded in it, the more precise conclusions and recommendations it will provide,” she said.

Overall, the software may empower clinicians to diagnose Parkinson’s disease earlier, which will support prompt and targeted treatments to provide the best patient care and outcomes.

Researchers expect to make the software available in the near future, in a format that can be installed in any computer or smartphone.

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Gocovri Reduces Transitions Between Dyskinesia and ‘Off’ Episodes, Trial Results Show

Gocovri, dyskinesia

Treatment with Gocovri (amantadine) reduced Parkinson’s dyskinesia — involuntary, jerky movements — and so-called “off” episodes, leading to longer periods of controlling motor symptoms, Phase 3 clinical trial results show.

Parkinson’s motor fluctuations (off episodes) occur when the benefits of treatments such as levodopa wear off and symptoms re-emerge. About half of patients taking levodopa experience off periods, which become more frequent and severe as the disease progresses.

In August 2017, Gocovri, a long-acting and extended-release oral capsule formulation,  became the first and only treatment approved by the U.S. Food and Drug Administration for the treatment of dyskinesia in Parkinson’s patients receiving levodopa, with or without other dopaminergic medications.

According to developer Adamas Pharmaceuticals, Gocovri — designed to be taken once daily at bedtime — also is the first FDA-approved therapy to improve dyskinesia while reducing off periods in Parkinson’s patients.

During the study, 162 patients — 77 taking Gocovri and 85 placebo — provided a complete Parkinson’s home diary (either on or off states) at both baseline and week 12.

“The Parkinson’s disease home diary data from the Gocovri Phase 3 pivotal studies clearly show that the entire waking day may be impacted by troublesome dyskinesia,” Rajiv Patni, MD, chief medical officer at Adamas, said in a press release. Dyskinesia may happen after the patient takes the first daily dose of levodopa in the morning, he added.

Reductions in dyskinesia and off episodes with Gocovri at week 12 resulted in markedly longer on periods (when patients can control muscle symptoms) without dyskinesia.

Compared to placebo, Gocovri led to a 3.2-hour increase in the first on episode without troublesome dyskinesia.

Patients taking Gocovri also experienced 4.2 fewer transitions between diary states per day compared to 2.0 fewer transitions with placebo. Approximately 17% of Gocovri-treated patients did not experience any transitions during the day, compared with only 1% of those who took placebo.

The results, “ADS-5102 Reduces ON Time with Troublesome Dyskinesia and OFF Time Throughout the Waking Day-Time Course Analysis,” were presented recently at the 2nd Pan American Parkinson’s Disease and Movement Disorders Congress (MDS-PAS) in Miami.

“Gocovri-treated patients experienced a decrease in the number of transitions between these diary states, resulting in longer periods of uninterrupted on time without troublesome dyskinesia,” Patni commented, while noting that the 17% of Gocovri-treated patients who were transition-free throughout the waking day is “particularly noteworthy”.

“This new analysis provides a useful definition of transitions that reinforces the previously reported data of Gocovri on dyskinesia and off (periods),” Patni said.

Of note, safety results were consistent with the overall population of the pivotal trials for Gocovri, Adamas noted. The most frequent side effects, occurring in more than 10% of patients, were hallucination, dizziness, dry mouth, peripheral edema, constipation, falls, and orthostatic (or postural) hypotension.

Gocovri’s benefits are in line with those of the EASE LID 2 (NCT02202551) open-label study, which evaluated the safety, tolerability, and effectiveness of a two-year treatment with Gocovri in Parkinson’s patients with levodopa-induced dyskinesia. Results showed that Gocovri could lead to long-term improvements of motor complications.

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Combating the Fear of Parkinson’s Disease

fear

Sherri Journeying Through

There is an acrostic I have seen for “fear”:

False
Evidence
Appearing
Real

I am sure the author of that acrostic meant well, and while there is some validity to it, it is not completely accurate. Ask anyone who is dealing with any kind of illness. Speak to an elderly person who knows they only have days, maybe weeks left to live. A mother who is waiting to see if the test results of the baby she carries are accurate. The father who just lost his young wife and must now raise his three young children on his own. Or the single mother who has just lost her job.

These people’s fears don’t just appear real. They are real. Those who live with a chronic illness deal with fear daily. A chronic disease robs you of the joy in your journey, the delight in your day. It steals your contentment and calm, replaces wonder with worry. So what do you do when the worry ogre comes to call? When fear capsizes its ship in your harbor and leaves you to deal with the wreckage? How do you handle the kind of fear that does that?

In his book, “Fearless,” Max Lucado examines fears relating to finances, children, violence, and more. However, he doesn’t address the fears of living with a chronic illness. Yet, tackling the fear of unemployment, our children’s safety, violence, chronic illness, etc., are all dealt with in the same way.

Fear is a feeling or emotion about a perceived threat, either real or imagined. It’s the condition of being afraid. It is having a feeling of dread and hopelessness. It is assuming something terrible is going to come out of a given situation. Having Parkinson’s disease can make you feel like that: afraid, threatened, hopeless.

We fear losing our ability to talk coherently. To sing or dance. To write, read, paint, draw. We fear losing the ability to hold our children or grandchildren, to hug our spouse. We fear having to depend on others for help with everyday tasks. We fear there will be no cure. We fear we will be left to die with this cruel disease instead of the more abstract fear of being hit by an unmanned, runaway ice cream truck.

Fear implies a sense of anxiety and a loss of courage. With fear, there is an intense reluctance to face or meet a specific situation such as Parkinson’s disease. There is an aversion to fear, and rightly so.

One thing I don’t want to be in this battle against Parkinson’s disease is a coward, but it’s certainly easy to let the fears take control and to think about the “what ifs.” This is when I step back and ask myself where my faith lies.

A friend, Ardyce Glessing, shared the following in a Facebook group: “I too have fears of not being able to look after myself and be dependent on my family for everything. I am used to taking care of everyone else and I wish it could stay that way. Somedays I do pretty good and try to carry on and think positive, but at times I just break down and cry from, I guess, a fear of the unknown. Eventually, I get over it and carry on with the rest of my day. I can honestly say it’s always in the back of my mind though. My family is supportive, but I don’t like to continually complain about my problems so just usually say ‘I’m doing good”. Every day I pray for a cure or a medication that stops the progression of PD.”

A recurring theme in facing and combatting fears seems to be having a positive attitude. Although this may seem basic, it’s often hard to muster up courage when you’re facing your little monster every day. I like Ardyce’s fear-buster tip: “Have a good cry.”

There is a legitimate fear in not knowing what the future holds, but thankfully, I believe God holds the future. So, while we can have a good cry now and then, we can also remember God still remains in control, even though all around us it seems life is unraveling.

I think we all have fears, but we seldom talk about those fears. I find myself moving onto other things to distract myself from harmful thoughts that may never amount to anything.

And again, Ardyce is spot on: Sometimes we just need a good cry to wash those fears away.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

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British Crew Rowing the Distance to Improve Understanding of Parkinson’s Disease

rowing Indian Ocean

A four-man crew from Britain is hoping to increase understanding of Parkinson’s disease by rowing across the Indian Ocean in an attempt to break a world record.

Robin Buttery, Barry Hayes, James Plumley, and skipper Billy Taylor are planning to row for 1,920 hours non-stop, for 65 days straight, all the way from West Australia to Mauritius, with the goal of becoming the fastest four-man crew to row the Indian Ocean.

The effort is an attempt to raise awareness of the disease and raise funds to support research — all while serving as subjects of scientific research aimed at studying the relationship between physical exercise and Parkinson’s.

Buttery, 46, was diagnosed with young-onset Parkinson’s disease two years ago, just before his 44th birthday. He lives in Leicester with his wife, Nicola, and son Rory, and works as a technical instructor at De Montfort University in Leicester.

Determined to show that life does not end with a Parkinson’s diagnosis, he challenged three friends to join him in his attempt to break a world record and serve as an inspiration to the community. The crew members will row non-stop, taking shifts of two hours on, two hours off, for 12 weeks.

They will start their journey in Exmouth, Western Australia, and row 3,600 nautical miles in a 29-foot-long ocean rowing boat until they reach their destination in Port Louis, Mauritius.

Cameras on the boat will film the crew 24/7, gathering footage that will be processed by computers after the journey is complete. Researchers will then analyze the video to study the effects of exercise on Parkinson’s.

Although physicians often prescribe physical exercise for Parkinson’s patients and anecdotal evidence shows that common motor symptoms such as tremors, cramps, and gait issues are improved with exercise, very little is really known about how exactly physical activity affects Parkinson’s patients.

By studying Buttery and his crew mates, professors Helen Dawes, Fabio Cuzzolin, and Johnny Collett of Oxford Brookes University in the U.K. hope to answer questions such as whether endurance exercise is always better than other types of exercise and if endurance exercise affects Parkinson’s patients differently than non-patients.

They will compare the changes in Buttery’s movements with those of his crew mates to investigate how endurance exercise affects the motor skills of Parkinson’s disease patients. They can also enlarge the video to look at any changes in their heart and lung regulation.

By analyzing the progression of Buttery’s motor skills and other Parkinson’s symptoms while exercising, the researchers hope to learn more about how physical activity really affects this disease.

Other researchers will also use this venture as a case study. Oxford Brookes research fellow Shelly Coe, a qualified nutritionist, for example, will monitor how diet impacts the management of Buttery’s symptoms.

All of the information these researchers gather could potentially help with the development of new treatments for Parkinson’s disease.

In addition to serving as subjects of scientific observations and attempting to break a world record, the team is also raising funds for charity. They are hoping to raise a minimum of $350,000 to support the Restoration of Appearance and Function TrustClear Trust and the European Parkinson’s Disease Association.

Anyone can support the crew and their goal by buying a mile or by making a donation. Once they depart, a livestream of their journey will be available on their website.

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Sunovion’s Oral Apomorphine Film Seen to Ease Parkinson’s Off Periods in Phase 3 Trial

apomorphine trial results

Sunovion Pharmaceuticals’ apomorphine sublingual under-the-tongue film (APL-130277) — now under review for approval —  significantly improved motor fluctuations, or off episodes, in Parkinson’s patients in Phase 3 clinical trial, results show.

The double-blind pivotal study, (NCT02469090), evaluated the efficacy and safety of APL-130277 as a fast-acting oral treatment for Parkinson’s patients with off periods, including those experiencing early morning off episodes. These episodes typically occur in the period between the waning of benefits of medications such as levodopa and the time a next dose can be taken, when motor symptoms re-emerge.

A total of 109 patients were given either APL-130277 (54) or placebo (55). Their mean age was 62, and they had been diagnosed with Parkinson’s for a mean of nine years.

Results were presented at the 2nd Pan American Parkinson’s Disease and Movement Disorders Congress (MDS-PAS) that recently ended in Miami.

Compared to those on placebo, patients given APL-130277 had a statistically significant difference of 7.6 points in the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III score, a measure of motor skills and function. This test was preformed in patients just prior to treatment and again 30 minutes after dosing at week 12.

A statistically significant difference from placebo was seen as early as 15 minutes post-dose and persisted up to 90 minutes, the last time point measured. Similar improvements were observed in the double-blind maintenance period measured at baseline and at weeks 4, 8 and 12.

APL-130277 also led to a higher percentage of treated patients with a full on response — or control of motor symptoms — within 30 minutes at week 12.

Apomorphine sublingual (under-the-tongue) film was generally well-tolerated, with most treatment-related side effects being mild to moderate, and reversible, after its use was discontinued. Nausea, sleepiness, and dizziness were the most frequent adverse effects reported in the maintenance phase.

“Off episodes are disruptive to a person’s daily routine, so a possible treatment that can help alleviate these periods is important for the Parkinson’s disease community and healthcare providers,” Fernando L. Pagan, MD, director of the Movement Disorders Program at Georgetown University Hospital, said in a press release.

Pagan added that the results show promise for APL-130277 “as a fast-acting medicine for on-demand treatment of all types of motor off episodes.”

Sunovion intends APL-130277 to be a treatment for all types of off episodes, those that are unpredictable as well as those that occur at the end-of-dose or in the morning hours after awakening. The formulation is designed to be taken up to five times a day.

About half of all Parkinson’s patients taking levodopa experience off periods, which become more frequent and severe with disease s progression. Apomorphine is the only approved medication for off episodes in the U.S., available as Apokyn (apomorphine hydrochloride, US WorldMeds). But Apokyn is an injection treatment.

Sunovion recently announced that the U.S. Food and Drug Administration has accepted for review its request to approve APL-130277 to treat off episodes in Parkinson’s. The FDA’s decision is expected by Jan. 29, 2019.

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Deep Brain Stimulation May Increase Levels of Inflammatory Factors in Parkinson’s, Study Suggests

DBS in Parkinson's patients 

Deep brain stimulation (DBS) may increase the levels of hepcidin — a hormone associated with iron accumulation and inflammation in the brain — in Parkinson’s disease patients, according to a small Polish study.

The study, “Higher serum levels of pro-hepcidin in patients with Parkinson’s disease treated with deep brain stimulation,” was published in the journal Neuroscience Letters.

As people age, iron accumulates in several brain regions and cells, including the microglia (the immune cells of the brain) and the astrocytes (cells that regulate nerve cell communication and survival ).

Increased iron accumulation, as well as brain inflammation, is associated with oxidative stress and cellular damage and is observed in several neurodegenerative disorders such as Parkinson’s and Alzheimer’s disease.

Hepcidin, an iron balance-regulatory hormone, suppresses ferroportin (FPN1) — the protein that transports iron out of cells — and leads to cellular iron accumulation.

Because inflammation can induce the production of hepcidin, this hormone may be a link between brain inflammation and iron-induced oxidative damage, both of which are involved in neurodegeneration in Parkinson’s patients.

Researchers in Poland evaluated the levels of pro-hepcidin — the precursor of hepcidin — in Parkinson’s patients treated only with medication, in those who, in addition to medication, also received DBS, and in healthy people (controls).

DBS — high-frequency stimulation in strategic brain areas through surgically implanted thin wires in the brain — is a treatment strategy for people with advanced Parkinson’s disease whose motor problems do not improve with medication.

Several studies have shown that DBS reduces motor symptoms as well as the necessary daily dose of medication, and improves patients’ quality of life.

Blood samples were collected from 52 people with Parkinson’s disease (25 women and 27 men) with a mean age of 56, and 31 healthy individuals (15 women and 16 men) with no history of neurodegenerative disorders in the family and a mean age of 58.

Among Parkinson’s patients, 37 had been treated only with medication — levodopa (L-DOPA) and/or ropinirole (Requip) — and 15 with additional DBS (with a mean time from implantation of 28.4 months).

Parkinson’s patients had significantly higher levels of pro-hepcidin compared to healthy individuals, supporting the involvement of hepcidin in Parkinson’s disease.

Those treated with medication and deep brain stimulation showed the highest levels of pro-hepcidin. There was no association between hepcidin levels and the duration of DBS, patient’s age, duration of the disease, or medication dose.

Since DBS has been associated with the activation of microglia and astrocytes — which release inflammatory molecules — researchers hypothesized that the overproduction of pro-hepcidin in these patients may be related to DBS and its associated inflammation.

But considering the small group of patients treated with DBS, additional studies are needed to clarify this association and whether it affects the worsening of Parkinson’s disease.

“The results obtained should be interpreted very carefully but are an interesting observation that requires further research, including a larger group of patients,” the researchers wrote.

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Safer Way of Stimulating Neural Stem Cells for Therapies and Research Developed

neural stem cells

A new device that can increase the production of viable neural stem cells may change the landscape of neural stem cell therapies as potential strategies for neurodegenerative and chronic diseases, including Parkinson’s and Alzheimer’s.

The invention, developed by a team at Hong Kong Baptist University (HKBU), was recently awarded with the Gold Medal with Congratulations of Jury at the 46th International Exhibition of Inventions of Geneva, held in April.

Stem cell therapy uses stem cells — a type of cell that can give rise to almost any other cell in the body — to cultivate new and normal cells, or tissues or organs that are then transplanted back into patients to restore physiological functions lost to damaged or dead cells.

Traditional methods of proliferating and differentiating neural stem cells, however, require a large number of certain molecules, known as growth factors. These factors can also stimulate the growth of cancer cells and increase a person’s risk of developing tumors post-transplant.

The newly developed device uses a technology known as inorganic sculptured extracellular nano matrices (iSECnMS): a tiny Z-shaped layer made of biocompatible materials that aims to not trigger adverse reactions from the cells.

The system is designed to avoid the need for growth factors or other components during cell manipulation, and still be able to simulate stem cells’ natural environment for growth.

After growth and cell differentiation, mature cells can become therapeutic agents for stem cell therapy.

“The neural stem cells are under ‘physical massage’ when they come into physiological contact with the matrix we developed,” Jeffery Huang Zhi Feng, PhD, associate professor at HKBU and one of the inventors, said in a university news release. “The ‘physical massage’ resembles the Chinese medicine acupuncture technique which causes the cells to differentiate into functional cells that are in urgent demand in cell replacement therapy.”

Ken Yung Kin-lam, who also helped in developing the device, said this system may provide a safer platform for research into stem cell therapies, as well as help boost the regenerative medicine field.

Based on their proprietary invention, the researchers have established the company Mat-A-Cell Limited  to enable other research institutions and companies to access to this technology for research.

The team has also filed a patent application with the United States Patent and Trademark Office.

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FDA Grants Regenerative Medicine Advanced Therapy Designation to VY-AADC for Parkinson’s

VY-AADC gene therapy

The U.S. Food and Drug Administration granted Voyager Therapeutics’ gene therapy candidate VY-AADC regenerative medicine advanced therapy (RMAT) designation for the treatment of therapy-resistant motor fluctuations in Parkinson’s patients.

The RMAT designation, recently created by the FDA, is given to regenerative medicine products intended to treat, modify, reverse, or cure a serious or life-threatening disease or condition, and that have early clinical evidence supporting their effectiveness.

This designation enables early interactions with the FDA to discuss intermediate evidence to support accelerated approval and meet post-approval requirements.

“The RMAT designation was based on our Phase 1b clinical data with VY-AADC and represents an important milestone for the program and recognition of this gene therapy as a potential treatment for Parkinson’s,” Robert Pietrusko, senior vice president of regulatory affairs and quality assurance at Voyager, said in a press release.

Parkinson’s is characterized by the loss of dopamine-producing neurons in the substantia nigra, a brain region key in controlling movement. Neurons in the substantia nigra release dopamine into an area of the brain called putamen, which contains dopamine receptors.

Although effective in the early stages of Parkinson’s, the effectiveness of levodopa — a standard Parkinson’s treatment — gradually decreases with disease progression. As a result, patients experience longer periods of reduced mobility and stiffness, where medication is not effective — called off periods — and shorter episodes where motor symptoms are controlled with medication, or on periods. This is referred to as motor fluctuations.

An enzyme called 1-amino acid decarboxylase (AADC) regulates the generation of dopamine from levodopa. Because AADC levels are reduced in the putamen of Parkinson’s patients, the conversion of oral levodopa to dopamine is limited.

VY-AADC, which consists of a modified, harmless adeno-associated virus, is intended to deliver the DDC gene — which contains the instructions for making AADC — directly into the putamen.

According to Voyager, VY-AADC has the potential to increase the generation of dopamine in a durable manner, and provide clinically meaningful improvements by restoring motor function and improving symptoms.

Voyager’s ongoing Phase 1b clinical trial in Parkinson’s patients showed that a one-time administration of VY-AADC led to robust and sustained improvements in motor function, as well as marked reductions in the use of levodopa and other medications.

The investigational treatment was well-tolerated, and has not caused any serious adverse events to date.

Besides Parkinson’s, Voyager is collaborating with pharmaceutical companies and academic institutions to develop its gene therapy approach for patients with amyotrophic lateral sclerosis (ALS) due to mutations in the SOD1 gene, Huntington’s, Friedreich’s ataxia, Alzheimer’s, and severe, chronic pain.

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The ABCs of Parkinson’s Disease: The Letter B

letter B, botox

Sherri Journeying Through

Second in a series. Read part one.

The letter B is for balance and Botox.

Balance

Many people with Parkinson’s experience walking or balance problems, which can occur in differing degrees. Gait problems can range from the disease slowing your speed, to a lessening of your arm swing and steps that tend to mimic shuffling instead of having a regular stride. You may also struggle with difficulty getting started or freezing in place. Experiencing problems with your balance can cause unsteadiness and falls that make everyday tasks challenging and frustrating.

These symptoms can be tough to treat, but there are ways to manage them: medication adjustment, exercise, and physical therapy. A home safety evaluation may also help.

There are exercises to improve balance for people with Parkinson’s disease. Plus, you can learn methods for getting back up after a fall to avoid injury as much as possible.

Botox

And what else is connected to Parkinson’s disease that begins with “B”?

Why, Botox, of course. People have Botox injections for many different reasons, but in Parkinson’s disease, researchers have found it to be a great help for those suffering from dystonia.

Dystonia is the contraction of a muscle or group of muscles. These contractions can often cause painful and abnormal positions of various parts of the body, for example, the curling of a patient’s toes.

Botox is injected into the affected muscles. The contracted muscles are weakened by the use of Botox, causing them to return to a more normal state. Because of its short effectiveness duration, Botox will most likely need to be reinjected every three to four months.

My neurologist talked about the benefits of Botox for relieving the areas where I was suffering from dystonia, mainly in my back and neck. He injected me with Botox, and within two days I could move my neck again and the pain in my back subsided. It made a world of difference.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

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