Previous work led by Dr. Chen-Plotkin suggested that ApoA1 levels may be a new biomarker for Parkinson’s disease risk. The team is now conducting a follow-up study on plasma ApoA1 and statins, evaluating participants in the Michael J. Fox Foundation’s Parkinson’s Progression Marker Initiative cohort to confirm whether ApoA1-modifying drugs such as statins may be a promising neuroprotective therapy for Parkinson’s disease.
Estrogen Investigated for Protection From Parkinson’s Disease
In another study, an analysis by Kara Smith, MD, a movement disorders fellow in Neurology at the Perelman School of Medicine, and colleagues investigated the role that estrogen plays in decreasing the lifetime risk of Parkinson’s disease, in light of the fact that men have a relative risk of 1.5 for having Parkinson’s disease compared with women. In a systematic review of studies using animal models of Parkinson’s disease, the research team found consistent evidence that 17β-estradiol, in particular, may play a key role in binding to the estrogen receptor and protecting cells from Parkinson’s pathology. The team said that further research needs to look at 17β-estradiol in more accurate models of Parkinson’s disease before results can be translated to clinical trials in patients with Parkinson’s disease.
Telemedicine Improves Access to Specialty Parkinson’s Care
To help remove barriers to specialty care experienced by many patients who live far from care or have disabilities that make it difficult to travel, University of Pennsylvania researchers examined use of telemedicine visits to increase access to specialty care for patients with Parkinson’s disease.
A research team led by Jayne Wilkinson, MD, and Meredith Spinder, MD, conducted a randomized controlled trial using video telemedicine in the patient’s home or at a facility near the patient. In the case of this study, that location was VA Community-Based Outpatient Clinics, which connected them to a neurologist specializing in movement disorders and Parkinson’s disease who was based at the Parkinson’s Disease Research, Education, and Clinical Center at the Philadelphia VA Medical Center.
Early results demonstrate that the process of using telemedicine for Parkinson’s disease care is feasible, provided similar quality of life, care, and communication, and significantly decreased travel.
Acetazolamide May Improve Vision in Patients With Idiopathic Intracranial Hypertension
When administered with a low-sodium weight-reduction diet, acetazolamide modestly improves visual field function in patients with idiopathic intracranial hypertension, according to research presented at the 66th Annual Meeting of the American Academy of Neurology. The drug and diet together may be more effective than the diet alone for improving vision. Acetazolamide also may prevent further progression of visual loss in these patients.
Michael Wall, MD, Professor of Neurology at the University of Iowa Carver College of Medicine in Iowa City, and colleagues enrolled 165 participants with idiopathic intracranial hypertension and mild visual loss in a multicenter study. Patients’ mean age was 29, and all but four participants were women. All patients received a low-sodium weight-reduction diet. Participants were randomized to as much as 4 g/day of acetazolamide or matching placebo and followed up for six months.
The trial’s primary end point was the change in perimetric mean deviation (PMD) from baseline to month six in the most affected eye, as measured by Humphrey Field Analyzer. PMD is a measure of global visual field loss with a range of 2 to −32 dB. Larger negative values indicate greater vision loss.
At six months, the mean improvement in PMD was greater with acetazolamide (1.43 dB) than with placebo (0.71 dB). In addition, papilledema grade improved from 2.76 to 1.45 for patients receiving acetazolamide, compared with an improvement from 2.76 to 2.15 for patients receiving placebo. Vision-related quality of life, as measured by the Visual Function Questionnaire 25, improved from 82.97 to 91.30 for patients receiving acetazolamide, compared with an improvement from 82.97 to 84.95 for patients receiving placebo. Participants assigned to acetazolamide also lost 7.50 kg, compared with 3.45 kg for patients receiving placebo.
Idiopathic intracranial hypertension primarily affects young women who are overweight or obese. The disease’s incidence ranges from 10 to 20 patients per 100,000, and incidence increases with increasing BMI. The condition presents with persistent debilitating headaches and visual loss.
Acetazolamide previously has been used to treat idiopathic and secondary intracranial hypertension syndromes. The drug has been on the market “for a long time” and “is a fairly benign medication,” said Natalia Rost, MD, Associate Director of Acute Stroke Services at Massachusetts General Hospital in Boston. Some patients who take acetazolamide report tremors, added Dr. Rost, who described Dr. Wall’s study.
—Erik Greb
A Link Between Caffeinated Soda and Huntington’s Disease?
Total lifetime caffeinated soda consumption may be associated with an earlier onset of Huntington’s disease, reported Caroline Tanner, MD, PhD, and colleagues at the 66th Annual Meeting of the American Academy of Neurology.