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Kinesiology News

Putting the Brakes on Parkinson's Disease

October 17, 2007

Because she’s not a microbiologist. Jo-Anne Lazarus says, “I’m never going to be the person to find a cure for Parkinson’s disease.”

Still, Lazarus, a professor in UW-Madison’s Department of Kinesiology, has been getting considerable attention for her current work on the neurodegenerative disease and advocacy for those who have it. 

She has been talking before support groups and other audiences. In June, she delivered one of the senior scholar lectures at the 2007 conference of the North American Society for the Psychology of Sport and Physical Activity.  She has been invited to play and speak at a benefit golf tournament for Parkinson’s research. 

Lazarus was among the 14 founding members of a national council consisting mostly of people with Parkinson’s that advises the Parkinson’s Disease Foundation on research, education, and advocacy.  And people from around the country have been contacting her for advice and hard-to-find information about the disease.

“It’s just exploding,” says Lazarus, who seems delighted and energized by all of the attention and activity.  This has become her life’s mission, she explains. “I want to be the person who makes life better for people who have Parkinson’s … I want to help delay progression of the disease.”

Her interest in Parkinson’s grew naturally out of her doctoral research on motor control and coordination.  She published her first paper on the disease in 1992.  Just a few years later, her interest became more personal when she recognized symptoms of the disease in herself.  Her suspicions were confirmed in 1998, when she was diagnosed.

Lazarus responded by intensifying her search for reliable information and, like many Parkinson’s patients, wasn’t satisfied by what little she found.  As a result, she says, “I have broadened my research. I look at everything as much as I can.  It has become a mission for me.”

To describe her current research, she refers back to her doctoral studies more than 20 years ago on the “coupling” and “decoupling” of hand movements.  When young children do something with one hand, they mirror that movement with the other hand, which is coupling.  As individuals grow older, they learn to decouple, or inhibit the mirroring.

“Parkinson’s disease destroys some of the coordination between hands,” making coupling more difficult, she says. “You end up having your hands not working with each other.”

By the time it has been diagnosed, Parkinson’s has begun to destroy neurons in a section of the brain called the basal ganglia, which produces dopamine, a neurotransmitter that plays an important role in coordinating motor activity.

Lazarus is engaged as both researcher and subject in exploring a range of therapies —from traditional Chinese treatments to experimental high-tech gadgets — aimed at stimulating dormant and dying neurons.  Her approach, which she describes as “use it or lose it,” differs from that of other researchers, who have been seeking ways to enhance movement by bypassing affected pathways.

She explains her approach: “Let’s see if we can keep some of those brain cells active so that we can keep those cells useful.”  She has been encouraged by early findings, but acknowledges that large-scale studies will be needed before she can publish what she has learned.

In one line of research, she has been testing the role of increased effort in enabling Parkinson’s patients to sustain a coordinated activity — in this case tapping with the index fingers of both hands.  She has found that people with Parkinson’s disease who initiate the movement by tapping hard with their index fingers — rather than by tapping comfortably — can tap longer with greater coordination.

She is collaborating with Sherri Zelazny, a speech pathologist in the UW-Madison School of Medicine and Public Health, on a study that also involves increased effort — in this case, vocal loudness. The idea is that stimulating the brain by speaking loudly can enable people with Parkinson’s disease to shift from a low, breathy voice to a louder, clearer voice.  Again, Lazarus has observed positive results in her own speaking abilities.

To ward off progression of the disease, Lazarus follows a holistic treatment regimen that includes bimonthly acupuncture with David Hassert of the Acupuncture Centre of Madison.

“When I have acupuncture, I’m less fatigued, and I can get more work done.  It affects everything I do,” she explains. She credits acupuncture for loosening her up, so that she can walk better, and even improving her golf game.  The benefits last up to a week, she says. During that week, she cuts back on her medications.

Functional MRI examinations on Lazarus and another Parkinson’s patient who uses acupuncture have added to the evidence that acupuncture treatments energize the brain.

Within eight to ten years of diagnosis, Parkinson’s disease usually progresses to the point that patients need levodopa, a strong drug that converts to dopamine.  Lazarus proudly notes that her disease has not progressed to that point as of yet.  “The longer I can delay, the better off I am.”

Her use of acupuncture has generated interest, questions, and some skepticism.  But she says that the latest findings and theories about Parkinson’s disease have brought Eastern and Western medicine closer, even though they are distinct types of thought.

Recent findings and theories have cast doubt on earlier theories about where the disease originates.  German researchers have shown that signs of the disease show up in the brain stem years before they manifest in the basal ganglia and produce symptoms that usually go unnoticed, such as loss of the ability to smell.

“I lost my sense of smell eight to ten years before I was diagnosed with Parkinson’s,” Lazarus notes

She also reviewed the writings of James Parkinson, who, in 1817, made a long-overlooked link between the disease that bears his name and the medulla, the lower part of the brain stem.  This reference amazed an audience of researchers, she says.

Other recent research suggests that Parkinson’s might even originate in the gastro-intestinal tract, triggered in susceptible individuals by Helicobacter pylori, the same bacteria linked to peptic ulcers.  Lazarus notes that Eastern medicine links Parkinson’s to a blocked stomach channel, and that opening this channel has been a major part of her acupuncture treatments.

Lazarus also is working with WICAB, Inc., a local company that developed the BrainPort (TM).  (She had done post-doctoral work with the founder of WICAB, the late Dr. Paul Bach-y-Rita, whom she credits for bringing her to UW-Madison.) 

The BrainPort (TM) device, which stimulates the brain through the tongue, was developed to help improve balance. Lazarus was enlisted as the first guinea pig to see if the device could work for Parkinson’s patients.  Again, she has been encouraged by the initial results.

Even as questions remain over exactly how these treatments work, she is clearly excited by the promising results seen thus far.  She is eager to move forward with large-scale trials and ultimately to improve and perhaps extend the lives of people with Parkinson’s disease.
-- by Kerry G. Hill

To learn more about Parkinson’s disease, go online to the Parkinson’s Disease Foundation:  www.pdf.org/

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