When you hear the word Botox, we know what you’re thinking. In the public consciousness, Botox has always been about cosmetic uses. Starting in the early 2000s, it was the way that people in Hollywood were smoothing out their wrinkles, and it was used in constant jokes on sitcoms and late-night talk shows.
But as you may know, botulinum isn’t just something that is used to smooth out crow’s feet. In fact, these neurotoxic proteins are actually very important to movement disorders specialist. Let’s take a look at what these medicines are and how they are used by our neurologists as dystonia treatments.
What Is the Botulinum Toxin?
If you’re just hearing about the botulinum toxin, the word you’ll probably note is toxin. Botulinum is indeed deadly, and is the most lethal toxin known. This toxic protein is produced by a bacterium that thrives in an anaerobic (airless) environment, and in the early days of food canning, it was a serious health concern. Getting botulism, the disease associated with eating food with the toxin, has a very high mortality rate.
Is it dangerous to use in medical procedures? Not really. While ingesting this toxic substance in its non-medical form is indeed dangerous, there is almost no risk associated with using botulinum toxin for either cosmetic or medical purposes. Sometimes a small amount of something that’s usually dangerous can have extreme medical benefits when delivered in a controlled manner.
What Are The Brand Names?
The most well-known botulinum supplier of is Botox. Not only were they first to market in the 1980s for their therapeutic injections, but they were also the first as a cosmetic provider (2002). The marketing campaign behind their cosmetic injection products has so made it a household name.
Myobloc was next to market as a therapeutic treatment, approved in 2000. Dysport was approved by the FDA in 2009.
What Are They Used For?
Aside from being used to reduce wrinkles on the face, there are many medical uses for the botulinum toxin. At our Austin neurology clinic, we offer it mainly as a dystonia treatment.
Botox (botulinum type A)
Botox uses botulinum type A. Botox is most commonly used as a treatment for dystonia, helping to reduce muscle spasticity. These injections tend to last for 3-4 months.
Myobloc (botulinum type B)
Myobloc uses a different type of botulinum called type B. It is used as a treatment for cervical dystonia to help with head position and neck pain.
Dysport, like Botox, uses type A toxin. It is used for many of the same purposes as Botox.
Are You A Candidate For These Dystonia Treatments?
While you might never consider using botulinum treatments for cosmetic purposes, we understand if you’re interested in using them as a treatment for dystonia. Dystonia can make life quite difficult, and these injections can give relief to those who are suffering from constant muscle contractions.
If you’re looking for relief, we’d love to talk to you in our Austin neurologist office. Getting help might be easier than you think, so contact us today to learn more about these amazing injectibles.
If you’re curious about deep brain stimulation (DBS), you’re not alone. It’s one of the most promising Parkinson’s disease treatments out there for patients whose symptoms can’t be controlled with medications. Here at Neurology Solutions Movement Disorders Center, we implant DBS leads in very specific parts of the brain — accurate to under a millimeter — that can provide stimulation and help reduce the effects of Parkinson’s disease.
If you’ve heard about DBS as a Parkinson’s treatment, you’ve probably run across the fact that there are two ways to undergo the procedure: awake and asleep. There is debate going on in the neurology world as to whether awake DBS or asleep DBS is more effective for patients. At Neurology Solutions, we prefer to have the patient awake during the procedure if at all possible. While this might make some patients squeamish, there are some very good reasons we’ll detail below.
The differences between asleep and awake DBS has come to a head in Texas, as some hospitals have begun to offer asleep DBS exclusively, meaning that they are not equipped to do awake DBS. While we understand the interest patients have in asleep DBS, the professional opinion of the neurologist at our movement disorders clinic is that asleep DBS is being oversold. Here’s why.
Asleep DBS Without Testing Is Not FDA Approved
When a doctor prescribes a medication for a patient for a condition other than what the medication is officially approved for, this is called an “off-label” prescription. This means that the medical community believes the drug to be effective, though it is not officially approved by the FDA to treat a condition.
Any time asleep DBS is performed without testing the patient for lead placement benefit versus side effects, it is effectively being performed “off-label.” It is not FDA approved, while awake DBS is approved as a Parkinson disease treatment. The studies have been performed to show the efficacy of awake DBS, but asleep DBS is still in the experimental phase. Third-party tests still need to be performed to compare the two, ones that are free from bias.
Asleep DBS Is Biased
Speaking of bias, it’s important to know that there’s a financial incentive for those who are performing asleep deep brain stimulation. Some patients avoid awake DBS because they fear having the procedure performed while they are awake (see below). This means there’s an incentive for hospitals and the manufacturers of DBS equipment to push the idea of asleep DBS in order to capture this market. No doubt the hope is also to sway people who are on the fence to the asleep DBS side.
Asleep DBS Doesn’t Allow For Patient Response
The primary reason that patients seem to prefer asleep DBS implantation is that they are unconscious for the procedure. This is understandable, though it’s important to note that the brain can feel no pain when directly stimulated. While local anesthetics are used to reduce and often eliminate pain from during awake DBS surgery, the idea of being awake while a neurosurgeon places the DBS leads in the brain can be an unsettling idea.
But we think it vital that patients are awake for certain parts of the procedure, and we can provide adequate medication to help reduce anxiety and even sedate partially during the more stressful parts of the procedure. When a patient is awake, they are able to let the surgeon know how the deep brain stimulation is working in real time. Speech, dexterity, coordination, vision, mood, and heat intolerance can all be addressed immediately, and the electrical leads can be moved accordingly.
Asleep DBS without thorough testing doesn’t offer these advantages. When a patient is asleep, neither they nor the surgeon have any way of knowing if the brain stimulator is working until the patient is awake. If the stimulator is just a millimeter off, optimal benefit from stimulation will not be achieved.
Talk With Neurology Solutions About DBS
Having performed over 300 DBS procedures in Austin, we are convinced that awake implantation is the only way to confirm the proper lead placement for achieving the best efficacy, all while introducing the least risk of side effects. We hope you’ll contact us with any questions you have, and we can walk you through the procedure to show you the many advantages awake DBS provides.
Parkinson’s Outcomes Project findings on neurologist care, exercise, depression
By Karen Hales, Neurology Solutions Contributing Writer
The Parkinson’s Foundation has enrolled its 10,000th participant in the Parkinson’s Outcomes Project, the largest-ever clinical study of Parkinson’s disease (PD) spanning five nations. Started in 2009, the project studies everyone with PD, from the newly-diagnosed to people who have lived with Parkinson’s for 20 years or more, and aims to provide a comprehensive view of the disease and its overall impact on people’s lives.
Among the key conclusions so far, the research has shown that regular visits to neurologists, such as those at a health and wellness center, could save thousands of lives a year. Additionally, more exercise and focus on mental health could help improve patients’ well-being.
Parkinson’s Outcomes Project Represents Diverse Population
Researchers have been using the Parkinson’s Foundation’s Centers of Excellence network of 42 medical centers to enroll patients in the study. The Parkinson’s Outcomes Project includes over 100 people who have lived with PD for more than 30 years, more than 500 who have lived with PD for 20 years or more, and 83 who learned about their diagnosis before they were 30 years old (Young Onset Parkinson’s patients). The database includes information from 25,000 visits to doctors and from almost 9,000 caregivers. The project’s mission is to determine what works best in treatment with an aim toward slowing the impact of the disease.
PD is a progressive neurodegenerative condition that is expected to double worldwide by 2042 to more than 12 million. Here is a list of key findings from the study so far.
Parkinson’s Outcomes Project Findings
Most Common Non-Movement Symptom of PD
Depression is one of the most common non-movement symptoms of PD, with up to 60 percent of patients affected at one time or another. Diagnosis and management of depression in PD is important, as depression causes significant morbidity in terms of quality of life, disability, and stress for individuals with PD and their caregivers. Physicians should screen for depression at least once a year, and you should discuss any change in your mood with a healthcare professional and make sure your Parkinson’s doctor is aware.
Regular Visits with a Neurologist Saves Lives
Several studies have demonstrated that PD patients who received neurologist care have reduced risk of hip/pelvic fracture, decreased or delayed need for nursing home placement, and improved clinical outcomes compared with primary care physician-treated subjects.
PD patients treated by a neurologist had:
A nearly 15% risk reduction in hip fracture
A 21% reduction in requiring nursing home care
A 23% reduction in risk of death
In a 2011 study, only 58 percent of 138,000 Parkinson’s-related difficulties led to neurologist care. African American women, African American men, and white females patients are more likely to be treated by primary care physicians specializing in internal medicine, family practice, or geriatric care physicians.
Exercise for PD Increases Quality of Life
Increasing exercise and movement to at least 2 1/2 hours a week can slow the decline in patients’ quality of life. The study matched patients who had started Parkinson’s physical therapy and exercise early versus those who had started late and found the change in health status consistently worsened for those who delayed starting an exercise program.
The Parkinson’s Outcomes Project validates other research showing that the type of exercise is less important than frequency. Any exercise program or physical therapy routines for PD should focus on maintaining balance and mobility, which helps individuals maintain the ability to perform daily tasks. A well-designed exercise plan can significantly improve almost everything about your health, including stabilizing walking, calming tremor, improving mood, and possibly even slowing progression of the disease.
Gender Disparities Impact PD Outcomes
The Parkinson’s Foundation recently established the Women and PD Initiative to address significant gender differences in the experience of PD. The Parkinson’s Outcomes Project found that women with PD have significantly less access to caregiving support than men with the disease. Women reported they were twice as likely as men to have a paid caregiver. Eighty-four percent of men identified a spouse as the primary caregiver compared to only 67% of women, and 20% of women reported having no caregiver at all. Identifying how to best provide day-to-day care, especially to women, will help improve the quality of life for those living with PD.
The Neurology Solutions wellness center is accepting new patients seeking a specialist in treating Parkinson’s disease, dystonia, essential tremor, and age-related disorders affecting movement. If you would like to schedule a movement disorder specialist consultation, please contact Neurology Solutions by email or call 512-865-6310 to schedule an appointment.
Neurology Solutions offers a Neuroscience blog designed to educate patients and the community at large on various areas of metabolism and promote longer and better quality of life for individuals with neurodegenerative disorders. Our Parkinson’s physical therapy plan can help those seeking better quality of life during the course of the disease, including few injuries.
Parkinson’s Disease (PD) has a wide range of symptoms that generally begin with tremor, stiffness, and slowing of movement. As the disease progresses, PD motor symptoms can include foot-dragging, freezing, less-pronounced movements, and facial expression. Treating Parkinson’s with physical therapy is recommended to reduce stiffness and discomfort and to allow patients to continue to perform daily tasks and retain independence.
Parkinson’s physical therapy should be the first medicine in the treatment of PD. Properly trained physical therapists (PTs) can address issues beyond just the condition’s motor symptoms. Specific exercises targeting PD can have a large impact, and PD experts agree that physical activity is beneficial to PD patients at all stages of their disease, including at early diagnosis. Physical therapists trained in treating neurological conditions recommend exercises for people with PD aimed at improved balance and coordination, flexibility, endurance, and strength.
Each person with PD is affected differently, and specialists in Parkinson’s treatments should take an individualized approach to managing the disorder. Read on for our Physical Therapy for PD Q & A.
Physical Therapy As Parkinson’s Treatment: Q & A
What Are the Symptoms of Parkinson’s disease?
There are two different types of symptoms of PD: Motor symptoms which have to do with movement, and nonmotor which do not. Nonmotor symptoms, such as sleep problems, loss of sense of smell, anxiety, depression, apathy, and lightheadedness when standing up, can develop well before any motor symptoms are present. Motor symptoms are known to begin around the age of 60.
Some motor symptoms people with PD may notice include:
Small tremors in hands or jaw while resting
Muscle stiffness or rigidity
Poor balance, changes in gait, and falling more easily
Difficulty swallowing, making facial expressions, or vocalizing at a normal voice
Can this Condition be Prevented?
Currently, there is no known way to prevent or reverse Parkinson’s disease. Studies have shown that treating Parkinson’s Disease physical therapy has led to improvements in movement and fitness. Those improvements, however, have only been seen to last as long as the individuals keep up their exercise routines.
How Can a Physical Therapist Help?
Physical therapists partner with people with PD and their families to manage their symptoms, maintain their fitness levels, and help them stay as active as possible. A physical therapist will teach exercises to strengthen muscles and help compensate for the changes brought onto your body by PD.
Your physical therapist will treat you differently than other patients with PD. Since PD affects every patient differently, your PT will conduct an evaluation to test your fitness, strength, coordination and more and develop an individualized exercise plan that you will be able to do on your own. The Michael J. Fox Foundation for Parkinson’s Research provides tips for how to get the most out of your physical therapy for Parkinson’s.
How does Exercise Affect the Brain in PD?
Exercise has been shown to have a neuroprotective effect on the brain. Researchers have demonstrated that exercise enhances the release of protective Brain Derived Neurotrophic Factors (BDNF) and increases brain plasticity, the ability of the brain to reorganize and form new connections between neurons to compensate for injury and disease. Studies show exercises incorporating goal-based training and aerobic activity improve blood flow and facilitation of neuroplasticity in elderly people and improve motor function in PD.
Dopamine is the neurotransmitter, or nerve cell, that communicates movement to the brain. Researchers studying the effect of exercise on the brain in PD have found that, while exercise does not increase the production of dopamine, it does help the body use dopamine more efficiently and also may reduce damage to the neurons that produce dopamine.
Exercises for Treating Parkinson’s with Physical Therapy
Physical therapists, whether at a hospital or a wellness center, can teach restorative and compensatory strategies that help to compensate for the changes your body is undergoing due to this disability. These include learning new movement techniques, such as taking two steps backward before turning down a hallway to prevent freezing, practicing how to get in and out of a chair, and fall prevention. Amplitude training, which uses high steps, large arm swings, and other exaggerated movements, fights the progression of hypokinesia due to muscle rigidity, which results in small, shuffling movements.
What Kind of Physical Therapist Do I Need?
All physical therapists are educated on performing balance training and what PD is; however advanced training is needed to give proper care when administering Parkinsons’s physical therapy. Some physical therapists have a neurological focus or have completed a residency in neurological physical therapy. These therapists have advanced experience and knowledge in your condition and may prove to be a better fit for you. Neurology Solutions’ physical therapy clinic Austin Renewal Therapy is led by a doctor of Physical Therapy who is a certified Parkinson’s Wellness Recovery (PWR) therapist specialized in the Parkinson’s population.
The American Physical Therapy Association (APTA) offers a directory to find a PT anywhere in the United States. If possible, it is best to see a physical therapist who has experience treating people with Parkinson’s. Make sure to ask about past experience helping patients with PD when contacting a physical therapy clinic.
How Many Physical Therapy Visits Will I Need?
Learning techniques to begin treating PD with physical therapy typically requires several 30- to 60-minute sessions at the outset. The first meeting serves as an evaluation and includes recommended exercises. The following few appointments are used to check your progress and make any adjustments to your home exercise program if necessary.
What Other Services Do Physical Therapist Provide?
Patients will receive functional capacity evaluations from their physical therapist. These evaluations help provide information for disability claims based on physical performance, such as not being able to work an eight-hour day. A physical therapist can also recommend outpatient or rehabilitation facilities and direct you to other exercise programs in your community. They can also suggest complementary therapies, such as boxing, dancing or yoga. Yoga has been shown to positively impact areas of the brain affected by PD as well as improve posture, mobility, and sleep.
Neurology Solutions offers a Neuroscience blog designed to educate patients and the community at large on various areas of metabolism and promote longer and better quality of life for individuals with neurodegenerative disorders.
Our health and wellness clinic is accepting new patients seeking a specialist in treating Parkinson’s disease, dystonia, essential tremor and age-related disorders affecting movement. If you would like to schedule a movement disorder specialist consultation, please contact Neurology Solutions by email or call 512-865-6310 to schedule an appointment.
Countless studies have researched the effectiveness of different dietary supplements for cognitive function. Nutritional supplements are part of the comprehensive medical protocol referred to as MEND, or metabolic enhancement for neurodegenerative diseases, that incorporates optimizing lifestyle factors such as stress reduction, sleep and nutrition, hormone levels and a variety of other factors. Neurology Solutions, a comprehensive evaluation and treatment center based in Austin, Texas, specializing in Parkinson’s disease (PD), tremor and dystonia, provides nutritional supplement counseling to help counter the effects of neurological conditions as well as overall anti-aging. Our wellness center can help you, too.
It is important to consult with your doctor before starting any supplement regimen, as some have negative interactions with standard medications.
Dietary Supplements for Cognitive Function, Memory
Some common dietary supplements for brain health include B6, B12 and Folate, which help regulate homocysteine levels; Astaxanthin, Omega-3s and Alpha-Lipoic Acid (ALA) for their anti-inflammatory properties; Vitamins E, A and C and Beta-carotene for antioxidant support; and Vitamin D and magnesium, which are tied to overall metabolic and brain function.
Although several nutritional supplements are believed to have a positive effect on the brain, two lesser-known supplements, Bacopa Monnieri and magnesium-L-threonate, have been shown to play a role in improving memory, cognition and executive function. When considering dietary supplements for cognitive function and memory, Bacopa Monnieri and magnesium threonate are supported by several research studies as memory enhancers, whether managing a neurodegenerative disease or to help fend off age-related decline.
Bacopa Monnieri is a creeping succulent plant that has been used in India for over a thousand years as a natural tonic; however, it was not until 2016 that scientists performed research to verify the benefits of this herb. One study used bacopa monnieri to alleviate acute and chronic stress and showed the supplement helps prevent depletion of dopamine and serotonin associated with stressful situations. These neurotransmitters are negatively impacted by Parkinson’s disease.
What have recent studies discovered about Bacopa Monnieri?
The herb offers dopamine support to neurons in areas of the brain involved in memory, specifically the hippocampus and basal amygdala.
Bacopa monnieri reduces oxidative damage from excessive mineral damage, including aluminum and mercury.
In human studies, positive results were evident with usage of about 4 to 6 weeks and include reliably improved memory both in healthy persons and in elderly people suffering from a decline in brain function.
Magnesium threonate is a form of magnesium that can pass through the blood-brain barrier, a membrane that separates blood circulating into the brain from the central nervous system. The amino acid threonate helps to effectively increase magnesium concentration in the cerebral spinal fluid (CBF). Magnesium also is tied to improved sleep and reduced anxiety, both factors in Parkinson’s-related dementia, which impacts 20-30 percent of PD patients.
Lab studies have documented that magnesium fortifies synapse formation associated with improved brain plasticity, a factor in neurodegenerative diseases.
Studies suggest that a full nine-year treatment could significantly improve a patient’s quality of life due to enhanced executive function.
Our wellness clinic offers a Neuroscience blog designed to educate patients and the community at large on various areas of metabolism and promote longer and better quality of life for individuals with neurodegenerative disorders.
Latest Neuroscience Findings include Lifestyle Factors, Advances in Treatment
By Karen Hales, Neurology Solutions Contributing Writer
Parkinson’s disease is a complex multi-system brain disorder impacting movement and the regulation of mood. Strides have been made in understanding the mechanism of PD and ways to prevent and slow neurodegeneration. Below is a roundup of 10 of the latest advances in understanding and treating Parkinson’s that our wellness center is keeping an eye on.
Advances in Understanding, Treating Parkinson’s
Depression in PD
Parkinson’s disease (PD) affects an estimated 1 million people in the United States, according to the National Institutes of Health. One of the most common psychiatric symptoms of Parkinson’s disease is depression. Studies estimate 50% of PD patients have symptoms of depression. A four-year study found people with PD who did not adhere to prescribed antidepressants had decreased quality of life, worse clinical outcomes, and higher morbidity. Researchers recommend neurologists, psychiatrists, and primary-care physicians prioritize the diligent use of antidepressants as a Parkinson’s treatment to improve patient outcomes.
Dancing for Brain Health
This year brought another confirmation of dancing’s positive effects on the brain. A study published in the journal Frontiers in Human Neuroscience shows that older people who routinely partake in physical exercise can reverse the signs of aging in the brain. Because dancing challenges the body and the mind, it has among the most profound effects of any exercise program, researchers say.
Homocysteine and Parkinson’s
Researchers are studying a correlation between the amino acid homocysteine (Hcy) and degenerative disorders such as Parkinson’s and Alzheimer’s disease. Elevated homocysteine has been connected to vascular disease, dementia and poor health. Regulating homocysteine is a regular practice of specialists treating Parkinson’s disease. High homocysteine worsens oxidative stress on dopamine-producing neurons and accelerates progression of PD, among other impacts.
Hormone Therapy for Parkinson’s
Another tool for managing symptoms and treating Parkinson’s is hormone therapy. Hormone replacement therapy (HRT) has been shown to prevent memory loss and halve the risk of Alzheimer’s disease, according to several studies. Neurology Solutions offers bioidentical HRT to patients seen frequently by the practice to help address mobility, mood, loss of energy, and to improve quality of life.
Neuroprotection of Vigorous Exercise
High levels of moderate to vigorous exercise is seen as a key interventional therapy due to exercise’s neuroprotective effect. It both enhances the release of protective neurotrophins and increases neuroplasticity, the ability of the brain to reorganize or compensate for injury and disease.
A new clinical trial by the University of Colorado Hospital validates the benefits of vigorous exercise in slowing worsening Parkinson’s symptoms, as reported in JAMA Neurology. Patients who adhered to a regular exercise program for six months had an average Unified Parkinson’s Disease Rating Scale (UPDRS) motor score of 0.3, compared with 3.2.
Metabolic Enhancement for Neurodegenerative Disorders
Metabolic enhancements for neurodegenerative disorders, or MEND, is a holistic approach to treating Parkinson’s. The MEND protocol is based on an assessment of 36 different factors impacting health. MEND incorporates diet, exercise, stress reduction, supplements, brain stimulation therapy and interventions to address sleep, hormone levels, and a variety of other factors.
A small study trial of participants who adhered to MEND found it can reverse memory loss and cognitive decline in patients with early Alzheimer’s.
Less Invasive Deep Brain Stimulation Surgery
Neurology Solutions Movement Disorders Center Medical Director Dr. Robert Izor and Neurosurgeon Dr. Anant Patel, of St. David’s North Austin Medical Center, are at the forefront of a less invasive, more precise Deep Brain Stimulation (DBS) implant procedure. The two specialists train neurosurgeons and neurologists in the new DBS technique as certified experts in Medtronic’s Parkinson’s Visiting Clinician Program.
DBS may slow progression of PD in addition to helping control symptoms. According to a 2014 report in Neurology Reviews, animal studies show DBS of the subthalamic nucleus protects “against the progressive loss of nigral cells” associated with PD. A recent analysis comparing veterans with PD who received DBS with those who did not undergo surgery suggests DBS may help PD patients live longer, according to research released in the journal Movement Disorders.
Yoga Therapy for Parkinson’s
Practicing yoga improves muscle strength, flexibility, posture and sleep. Recent studies also have demonstrated that yoga and meditation improve cognitive function in areas of the brain impacted by PD. The hope is that meditation practice can help support and maintain brain function and slow progression of neurodegeneration.
Olive oil is a key part of the Mediterranean diet which is a nutritional plan similar to the DASH Diet (Dietary Approaches to Stop Hypertension). Both diets focus on vegetables, whole grains, and low fat diary, and are recommended as highly anti-aging and neuroprotective nutritional approaches for people with Parkinson’s. The DASH diet ranked as the best overall diet for the 8th year in a row, and was tied for the first time by the Mediterranean diet, in an annual review by U.S. News and World Report.
Intermittent Fasting Enhances Brain Health
Short-term fasting stimulates autophagy, the metabolic process that eliminates cell waste responsible for many of the effects of aging. Studies have demonstrated fasting can help prevent heart disease, speed fat loss and slow or reverse aging. The autophagy process is often defective in cancer, infectious diseases, immunological disorders and neurological diseases such as Alzheimer’s and PD. Normalizing the autophagy system could help damaged cells clear out toxic accumulated proteins prevalent in neurological conditions.
Neurology Solutions is a comprehensive evaluation and treatment center based in Austin, Texas, specializing in Parkinson’s disease, tremor, and dystonia. Our wellness clinic offers a Neuroscience blog designed to educate patients and the community at large on various areas of metabolism and promote longer and better quality of life for individuals with neurodegenerative disorders.
HRT can improve mobility, lower risk of dementia
By Karen Hales, Neurology Solutions Contributing Writer
Neurology Solutions Movement Disorders Center offers bioidentical hormone replacement therapy (HRT) to patients seen frequently by the practice to help address mobility and mood and improve quality of life. Hormone Therapy for Parkinson’sdisease and other neurodegenerative diseases can reduce certain symptoms associated with PD and reduces dementia risk in the general elderly population. Our health and wellness center is here to help.
A study of over 230,000 postmenopausal women in four nations found that HRT halved the risk of Alzheimer’s for those who used hormone therapy for more than a decade. If started at the onset of menopause, hormone therapy also was found to prevent memory loss and confusion, according to a study following participants for up to 20 years. Long-term use also was associated with better overall mental skills including episodic memory – the recall of times, places and events.
Hormone therapy for Parkinson’s in men targets testosterone deficiency. A sudden decrease in testosterone may be tied to the increased prevalence of PD in men, who are diagnosed with the disorder by almost a 2 to 1 margin to women. Researchers have studied the impact of testosterone deficiency on male mice and found that castrated mice begin to develop motor symptoms similar to PD, which were reversed with 5-alpha-dihydrotestosterone (DHT) supplements.
Neurology Solutions closely monitors patients who are using HRT as a Parkinson’s treatment to determine optimal hormone levels and realize a hormone profile closer to their youth.
Physical benefits of HRT for Neurodegenerative Diseases
Research has shown hormone therapy may benefit certain symptoms associated with Parkinson’s. For example, testosterone deficiency is common in older individuals and has symptoms that directly overlap with non-motor symptoms of PD that do not necessarily respond to antidepressant therapy or traditional PD therapies.
Two forms of bioidentical estrogen, estradiol and estriol, have a positive destabilizing effect on alpha-synuclein (a-synuclein), a protein in the brain that has the tendency to aggregate and form fibrils, or clumps, a hallmark of many neurological diseases.
HRT as Parkinson’s disease treatments has also has been found to:
Reduce fractures and muscular atrophy
Lessen fatigue and depressed mood
Reduce loss of libido
Increase energy and exercise tolerance
What Hormones are used in HRT?
Bioidentical HRT uses hormones that are synthesized from plant chemicals extracted from yams that mimic the structure of human endogenous hormones. These hormones are identical to the estrogens and testosterone found in the human body and have been demonstrated to have less risk of side effects or complications than animal-derived or synthetic hormones.
Bioidentical hormones include: estrogens (17 beta-estradiol, estrone, and estriol), progesterone, testosterone and DHEA.
Should I Consider Hormone Therapy for Parkinson’s Disease?
Generally, any postmenopausal woman or male age 50 or over can potentially benefit from hormone therapy.
Our wellness center will need the approval of an oncologist for any patient who has had breast cancer, endometrial cancer, or prostate cancer who wants to engage in this treatment. These patients as well as individuals who have suffered strokes or blood clots to the legs or lungs are considered on an individual basis for bioidentical hormone therapy.
Participants in Neurology Solutions HRT program have primarily included Parkinson’s disease patients who also use Deep Brain Stimulation (DBS) therapy in their disease management, since DBS appointments tend to be more frequent due to monitoring of DBS stimulation. More recently, Neurology Solutions and its Austin Renewal Therapy wellness clinic have introduced HRT consultation and administration for the general population as well as other movement disorder patients.
It takes at least four weeks before healthcare providers are able to check how the HRT supplement impacts individual hormone levels and at least eight weeks for improvement in cognitive scores to be apparent.
Neurology Solutions closely monitors hormone levels for side effects and safely gauges whether adjustments should be made to hormone supplements until an optimal level is met.
To learn more about hormone replacement therapy at Neurology Solutions, read more on this HRT Q & A.
Neurology Solutions is a comprehensive evaluation and treatment center based in Austin, Texas, specializing in Parkinson’s disease, tremor and dystonia. Neurology Solutions offers comprehensive individualized care for individuals with Parkinson’s disease, dystonia, essential tremor and age-related movement disorders. If you would like a consultation for managing symptoms of a movement disorder, please or call 512-865-6310 to schedule an appointment.
Homocysteine is linked to cardiovascular disease, neurological conditions
By Karen Hales, Neurology Solutions Contributing Writer
Scientific literature contains a multitude of research studies linking homocysteine to poor health. Elevated homocysteine in Parkinson’s is thought to worsen oxidative stress on the neurons that produce dopamine, making them more easily damaged by environmental toxins. This video by Neurology Solutions Nurse Practitioner Jordan Harborth explains the correlation between homocysteine (Hcy) and neurological conditions such as Parkinson’s and Alzheimer’s disease.
What is Homocysteine?
Homocysteine is a sulfur-containing non-protein amino acid involved in the way proteins within cells are folded, maintain their shape, and link to each other. Researchers have discovered that homocysteine can prevent the formation of nitric oxide, a substance that keeps blood vessels pliable and prevents formation of atherosclerosis.
Elevation of plasma homocysteine (hyperhomocysteinemi) has been linked to cardiovascular disorders, an increased risk of fractures in the elderly, stroke, and to neurological conditions such as PD and Alzheimer’s. Even mild elevations in homocysteine can significantly increase the risk of cardiovascular events such as stroke and heart attack and increase the risk of cognitive decline in the future.
Elevated Homocysteine in Parkinsons disease - YouTube
The normal level of homocysteine is considered to be between 5 and 15 micromoles per liter; however, researchers found that those whose homocysteine levels were over 14 micromoles per liter had twice the risk of developing Alzheimer’s disease as those with lower levels.
Because elevated homocysteine may support progression in Parkinson’s disease, Neurology Solutions monitors the homocysteine levels of all their Parkinson’s disease treatment patients during initial and regular follow-up appointments and aggressively treats those with a homocysteine level of 12 and above.
What Causes Elevated Homocysteine?
Some causes of elevated homocysteine include lifestyle factors such as: poor diet, protein deficiency, smoking, high coffee and alcohol intake, and sedentary lifestyle.
Levodopa, used during Parkinson’s treatment to reduce the symptoms, also leads to overproduction of homocysteine.
Conditions including diabetes, rheumatoid arthritis, chronic inflammatory disorders and some intestinal disorders such as celiac and Crohn’s disease can lead to higher homocysteine levels.
Age, as well as some prescription drugs, also can increase an individual’s homocysteine levels.
Family history and genetic makeup play a role in increasing homocysteine levels, which are generally higher in men than women.
How Does One Treat Elevated Homocysteine?
Dietary changes are imperative to properly treating elevated homocysteine levels. Supplements are encouraged in order to correct demethylation abnormalities and lower homocysteine levels. It is important to consult with your doctor before starting any supplement regimen, as some have negative interactions with standard medications.
Vitamin B (B12 and B6) supplementation, folic acid (folate), and proper protein intake have been recommended in cognitive and neurodegenerative disorders.
Taking 1500 mg per day (two 750 mg doses) of Trimethylglycene can normalize homocysteine by inhibiting the body’s ability to produce it. It also increases production of glutathione (GSH), an important antioxidant capable of preventing oxidative stress, which interferes with the cells’ ability to detoxify free radicals, peroxides and heavy metals.
Metabolic Enhancement for Neurodegenerative Disorders
Diet and nutrition are an important part in preventing disease, enhancing metabolism and improving outcomes. Neurology Solutions’ goal is to delay progression of disease by correcting metabolic abnormalities with a comprehensive approach that incorporates the MEND protocol, which stands for metabolic enhancement for neurodegenerative diseases.
Follow Neurology Solutions’ Video Series on Youtube
This video on elevated Homocysteine in Parkinson’s disease is part of a series on MEND by Neurology Solutions. a comprehensive evaluation and treatment center based in Austin, Texas, specializing in Parkinson’s disease treatments, tremor, and dystonia treatments. The video series is designed to educate patients and the community at large on various areas of metabolism and promote longer and better quality of life for individuals with neurodegenerative disorders. Please follow Neurology Solutions’ Youtube page to be notified of future videos on lifestyle and treatment options for movement disorders.
How Fasting Activates Cell Rejuvenation, Autophagy
By Karen Hales, Neurology Solutions Contributing Writer
Intermittent fasting, the practice of going without food for some period of time, and caloric restriction are powerfully neuroprotective. Intermittent fasting increases autophagy, a metabolic process that eliminates cell waste that may be responsible for many of the effects of aging. Studies have demonstrated that fasting can help prevent heart disease, speed fat loss, and slow or reverse aging. Researchers have found that the autophagy process is often defective in cancer, infectious diseases, immunological disorders and neurological diseases such as Alzheimer’s disease and Parkinson’s disease (PD). This might suggest that fasting can be used as part of Alzheimer’s or Parkinson’s disease treatment.
Intermittent or short-term fasting, as well as exercise, are known to increase growth hormone release and generation of healthy tissue, leading to improvements in the body over time.
In addition to the timing of food consumption and digestion, another dietary intervention that may be of particular importance for those seeking Parkinson’s treatment is the ketogenic diet. One 2006 study suggests that a diet high in fat with highly restricted protein and carbohydrate intake has neuroprotective effects in both Parkinson’s and Alzheimer’s sufferers.
Intermittent Fasting to Enhance Metabolism - YouTube
How intermittent fasting helps slow or reduce aging
Autophagy, which is translated from the term “self-eating,” is the body’s cellular self-cleansing process. Completed in vascular structures called lysosomes, autophagy reduces inflammation and lowers insulin levels, allowing for the breakdown of fat. Cells also use autophagy to rid the body of damaged cell components.
Autophagy is shut down dramatically after consuming food. Glucose, insulin (or decreased glucagon), and proteins all turn off this self-cleaning process. Likewise, growth hormones and other anabolic steroid hormones diminish gradually with age, also contributing to loss of healthy tissue function. During starvation, cells break down proteins and non-essential components and reuse them for energy. Fasting also increases growth hormone release.
Both Alzheimer’s and Parkinson’s disease involve the accumulation of abnormal proteins in specific subsets of neurons. Autophagy works to remove substandard subcellular parts and unused proteins that can accumulate and cause inflammation and oxidative stress.
Many neurodegenerative conditions have some degree of mitochondrial dysfunction in common. The mitochondria in the cells produce 90 percent of the energy needed to support organ function and sustain life.
How to begin intermittent fasting
As we age, we no longer recycle damage as readily. Normalizing the autophagy system could theoretically help damaged cells clear out toxic accumulated proteins. Doctors therefore recommend fasting for short periods to activate this system as well as increase the number and quality of mitochondria. Instituting intermittent fasting or any other nutrition program should be done under the supervision of a medical professional or specialist who is experienced in your particular health history and medical condition.
There are many ways to fast, some healthier than others. Animal studies show the greatest metabolic enhancement is directly proportional to the length of fasting during the inactive phase of the day before and after sleep to allow the body to eliminate toxins and damaged structures and rejuvenate tissues. The simplest approach recommended under the MEND protocol is time-restricted feeding that ensures 12 hours of fasting during the non-active part of the day. This technique has shown significant results in helping restore health and tissue function during sleep.
Follow Neurology Solutions’ Video Series on Youtube
This video on Intermittent Fasting to Enhance Metabolism is the second in a series on MEND by Neurology Solutions, a comprehensive treatment center located in Austin, Texas, that specializes in Parkinson’s disease treatments, (PD), essential tremor treatments, and dystonia treatments. The video series is designed to educate regarding various areas of metabolism and promote longer and better quality of life for patients with neurodegenerative disorders and the community at large. Please follow Neurology Solutions’ Youtube page to be notified of future videos on lifestyle and treatment options for movement disorders.
Video Series Explores Metabolic Enhancement for Neurodegenerative Disorders
By Karen Hales, Neurology Solutions Contributing Writer
Neurology Solutions Movement Disorders Center Medical Director Dr. Robert Izor elaborates on the positive outcome of lifestyle and metabolic enhancement for those seeking Parkinson’s disease treatments. Metabolic enhancements for neurodegenerative disorders, also known as MEND, is a medical protocol that incorporates optimizing diet, exercise, stress reduction, supplements, brain stimulation therapy, and interventions to address sleep, changes in hormone levels, and a variety of other factors. This video is the first of a series on MEND by Neurology Solutions, a comprehensive movement disorders clinic located in Austin, Texas, that specializes in PD treatments, essential tremor treatments, and dystonia treatments.
Lifestyle & Metabolic Enhancement for Parkinsons Neurology Solutions - YouTube
Dr. Izor, a fellowship-trained movement disorder specialist, calls PD “a complex multi-system disorder.” Neurodegenerative disorders such as Alzheimer’s and PD are caused by pathological changes in metabolism. PD, like a number of neurodegenerative diseases associated with aging, is characterized by the abnormal accumulation of protein in a specific subset of neurons. Some proteins are so toxic to the cells that they not only inhibit growth but also cause them to die off when abnormal proteins are produced. Parkinson’s symptoms develop when alpha-synuclein (a protein) accumulates and forms a major buildup, which results in the loss of dopamine, a neurotransmitter that normally sends signals in the brain to control body movement. Alzheimer’s involves the collection of two other proteins called tau and beta-amyloid that also become toxic.
MEND Protocol Shown to Reverse Cognitive Decline
MEND was developed by Dr. Dale Bredesen of the University of California at Los Angeles (UCLA) in an effort to enhance metabolism and prevent negative outcomes in those seeking Alzheimer’s and Parkinson’s Disease treatments. MEND, which is based on an assessment of 36 different factors impacting health, was shown in a small study trial to reverse memory loss and cognitive decline in patients with early Alzheimer’s.
MEND improves metabolic function through complex, wide-ranging efforts to address various functions at once. Optimizing overall lifestyle and nutrition, maximizing sleep, and using supplements are just some of the ways to create a healthier lifestyle.
Metabolic Enhancement for Parkinson’s Video Series
With this video series, Neurology Solutions intends to educate our patients and the community on optimizing various areas of metabolism in order to improve quality of life for individuals with a movement disorder. It’s our mission to prevent and slow these disabilities caused by the neurodegenerative diseases for a healthier life and a reduction in symptoms.
Follow our video series in the coming weeks to learn more about lifestyle and metabolic enhancements for Parkinson’s treatments and other approaches to address movement disorders and improve outcomes.
Neurology Solutions is accepting new patients seeking a specialist concerning Parkinson’s disease, dystonia, and essential tremor treatments, as well as and age-related movement disorders. If you are looking to confirm a diagnosis or find different treatment choices for managing symptoms of a movement disorder, please contact Neurology Solutions or call 512-865-6310 to schedule an appointment.