Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, February 7, 2019

Experts Propose Revising the Criteria for Diagnosis of Parkinson’s Disease

You and your doctor need to be following this closely because of this. 

Parkinson’s Disease May Have Link to Stroke March 2017 

I'm doing coffee for prevention. Don't listen to me, I'm not medically trained. Is your doctor?

How coffee protects against Parkinson’s Aug. 2014

 

 

Experts Propose Revising the Criteria for Diagnosis of Parkinson’s Disease

In the past 25 years it has become clear that some symptoms of Parkinson’s disease (PD) occur decades before the development of motor symptoms and clinical diagnosis, and that monitoring these emerging symptoms may provide important insights into the origin and development of the disease. Understanding this “prodromal” phase, along with the development of new treatments, may enable earlier treatment to prevent the disease from developing, according to experts writing in a supplement to the Journal of Parkinson’s Disease.
“Brilliant work of many in different scientific fields has paved the way for the concept of prodromal PD -- that is, a phase of years to decades in which non-motor and subtle motor symptoms may indicate spreading PD pathology, but do not meet the threshold for diagnosis according to the classic motor-based clinical criteria,” wrote Daniela Berg, MD, Christian-Albrechts-University of Kiel, Kiel, Germany, and colleagues.
The authors define the main anchors of the concept of the prodromal phase as the broadly accepted fact that the neurodegenerative process in PD spreads slowly, possibly starting in the gut or olfactory system and finally encompassing much of the nervous system.
Increasing knowledge of risk factors and clinical symptoms that precede the typical motor manifestations by years to decades and can be correlated to imaging and histopathological findings
The authors have constructed a mathematical model that makes it possible to calculate an individual’s personal risk of being in the prodromal phase of PD. However, there are several limitations to this model, such as the time taken to conversion to PD, age, sex factors, and subtypes with undetectable prodromal stages.
“The prodromal PD criteria are meant to be research criteria and constitute a first step in what should be a continually-updated process,” the authors wrote.
Biomarkers and wearable technology such as mobile phones are expected to play a role in greater accuracy of diagnosis in the prodromal phase. The goal of biomarker research, as well as quantitative motor assessment, is to use new data arising from objective measurements to enable earlier detection of the neurodegenerative process and possibly motor symptoms. It would also facilitate the development of neuroprotective trials in early stages.
Some key questions that the authors hope to see resolved are: When is the starting point of PD? What will define the disease? Will it still be motor symptoms (possibly typical subtle ones), or will it be biomarker evidence of nigrostriatal system neurodegeneration without motor symptoms? Will it be a certain combination of non-motor signs? Or will it be based upon non-clinical biomarkers, similar to changes in Alzheimer’s disease?
By 2040, the authors hope that prodromal criteria will be incorporated into active neuroprotective treatment programs, allowing a program of population-based screening followed by early treatment and ultimately the prevention of clinical PD from ever becoming manifest.
“Our review highlights the importance of making an earlier diagnosis of neurodegenerative diseases, and in particular PD, for now primarily to understand the disease better,” the authors wrote. “However, in the future, once we have preventive therapy, it will become critical to find patients in the earliest stages of disease, so that we can prevent the disease from developing and affecting quality of life.”
Reference: http://dx.doi.org/10.3233/JPD-181457
SOURCE: IOS Press
A very clear cut clinical syndrome, REM Behavior Disorder (RBD) is a very good indicator that typical Parkinson's Disease or it's variants will develop at some future time and can begin a decade or more before the first classic PD symptoms and signs. In RBD patients act out what are usually violent or physically active dreams despite being sound asleep, typically resulting in minor (abrasions, bruises) to serious (fractures, head trauma) injuries to the patient or bedpartner and/or property damage. While it occurs mostly in male patients, virtually all patients will eventually develop PD. Perhaps the researchers should focus their studies on RBD since it is an excellent and specific early symptom of PD that is easily diagnosed by history. Fortunately for patients, it is almost always quite manageable with clonazepam (and no other drug) in low to moderate doses at bedtime.

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