Inside This Issue

In My Own Words ................................................ 2When to See a PD Specialist .......................... 3Upcoming Events .................................................4List of Support Groups ......................................4

Researchers from the University of Mary-land School of Medicine and the Baltimore Veterans Aff airs (VA) Medical Center have launched a study of exercise and computer-ized memory training to see if these activities may help people with Parkinson’s disease prevent memory changes. The type of memory that will be examined is known as “executive function”; it allows people to take in information and use it in a new way. Many Parkinson’s patients develop problems with executive function, which can prevent them from working and may eventually require a caregiver to take over more of the complex cognitive tasks of daily living.

“Studies of normal aging show that memory and executive function can be im-proved with exercise, such as walking several days a week,” explains Karen Anderson, MD, principal investigator and a neuro-psychia-trist at the Maryland Parkinson’s Disease and Movement Disorders Center at the University of Maryland Medical Center. Anderson is also an associate professor of neurology and psy-chiatry at the University of Maryland School of Medicine and a clinician in mental health at the Baltimore VA Medical Center.

The researchers, who received funding through a VA Merit Award, plan to enroll about 90 patients who will be divided randomly into three groups: exercisers walk-ing on a treadmill, memory game players, and those doing both exercise and memory games. Participants in each group will receive a memory assessment at the beginning of the study. They will come in three times a

week for their training for three months and then will be tested again. Three months after that, the researchers will test the participants again to see if there may be longer-term benefi ts to the training.

With both the treadmill walking and the memory game, the exercise or video game will become more challenging as the partici-pant improves. The memory training works like a video game with players advancing to higher levels of diffi culty. For the exercisers, trainers may increase the speed or slope of the treadmill to make it more aerobically challenging.

The treadmill training will take place at the Baltimore VA Medical Center in the Maryland Exercise and Robotics Center of Excellence, a gym facility with specialized equipment for people with physical limitations or balance issues. For safety, participants will wear a safety harness while walking on the treadmill. Experienced exercise physiologists will supervise each training session.

The computerized memory training game will take place both at the VA and at the School of Medicine. The game looks like an underwater trea-sure hunt where players search for jewels and other rewards.

Anderson says: “If either of these interventions proves

to be eff ective, eventually we would like to know what kind of maintenance someone would need to do to preserve these memory improvements. How often should you prac-tice the computer memory game to retain the potential cognitive benefi ts? How many times a week would you need to exercise?”

Parkinson’s disease patients interested in enrolling in the exercise and memory study should call 443-827-0677.

Please call 410-328-7809 and press 4 for general research inquiries.

Researchers Examine Potential Benefit of Exercise, Memory Training

PDBuzzNewsletter for the Maryland Parkinson’s Disease and Movement Disorders Center

Spring/Summer 2012

Spring/Summer 20122

Dear patients, care partners, and friends,

Welcome to the fi rst edition of PDBuzz. This newsletter is meant to provide the community with information, resources, and news related to Parkinson’s disease, Parkinsonism, and related movement disorders. We hope you enjoy the articles and we encourage you to share them with friends and family members.

In the coming months, we hope to provide you with information on relevant topics and upcoming events. We are interested in your ideas and feedback. Please contact us anytime at ishevrin@som.umaryland.edu or 410-328-9016. For more information, visit www.umm.edu/parkinsons.

Ilene Shevrin, MPHAPDA Information and Referral CoordinatorMaryland Parkinson’s Disease and Movement Disorders Center

letter from the editorMovement Disorders Physicians

William J. Weiner, MDProfessor and ChairmanDepartment of NeurologyUniversity of Maryland School of MedicineDirector, Maryland Parkinson’s Disease and Movement Disorders CenterUniversity of Maryland Medical Center

Stephen G. Reich, MDProfessor of NeurologyPrince Distinguished FellowshipThe Frederick Henry Prince Distinguished Professor in NeurologyCo-Director, Maryland Parkinson’s Disease and Movement Disorders Center

Lisa M. Shulman, MDProfessor of NeurologyEugenia Brin Professor of Parkinson’s Disease and Movement DisordersRosalyn Newman Distinguished Scholar In Parkinson’s DiseaseUniversity of Maryland School of MedicineCo-Director, Maryland Parkinson’s Disease and Movement Disorders CenterUniversity of Maryland Medical Center

Paul S. Fishman, MD, PhDProfessor and Research Director of NeurologyUniversity of Maryland School of MedicineChief, Neurology ServiceBaltimore Veterans Aff airs Medical Center

Karen E. Anderson, MDAssociate Professor of Psychiatry and NeurologyUniversity of Maryland School of MedicineBaltimore Veterans Aff airs Medical Center

Melissa J. Armstrong, MDAssistant Professor of NeurologyUniversity of Maryland School of Medicine

By Carl Schuetz

I was diagnosed with Parkinson’s disease (PD) in March 2011. I had been sick and seeking a diagnosis for some four years, and maybe it was PD all along—I think so, but who knows? After being ill for so long, I was relieved when I was informed of the diagno-sis. Relieved? Am I crazy? No, I felt relieved since I now had something to fi ght against; my symptoms now had a name, and I began to work at this.

Doctors and others recommended medi-tation or exercise, or a combination of them, along with prescription drugs. I taught myself to meditate, started taking yoga classes, and undertook a strength-training regimen on a

circuit of machines at the local gym. I worked hard, and pushed myself when I felt lazy or reluctant to go to yoga class. I worked at it almost obsessively. But, I discovered that yoga practice provides a combination of mind and body elements, and increased the number of yoga classes I attend. To this end, I recently became certifi ed to teach yoga, and I’m now developing class routines and schedules for yoga classes that are tailored to people with Parkinson’s (PWPs).

To help manage my own PD, I still attend yoga classes four to fi ve days a week, and practice yoga at home on the other days. I have made improvements in mind-body con-nections, and yoga is now a part of my life. But yoga practice is not all results-oriented;

it’s also about the quality of time one spends in yoga. During yoga practice—for that one hour each day—I feel as if I don’t have Parkin-son’s at all.

How about you? Are you ready to try yoga? When your mind and your body are one, you are focused, enjoying the present, fully “here and now.” In my humble opinion, all motivated PWPs should try yoga.

Please contact Ilene Shevrin at 410-328-9016 for more information on classes in the area.

In My Own Words

Spring/Summer 20123

By Lisa M. Shulman, MD

The conventional wisdom is that care from a specialist should be reserved for special situ-ations, and that routine care for Parkinson’s disease (PD) should be provided mainly by general neurologists and primary care physi-cians. Also, conventional wisdom says that care from specialists is more costly than care from non-specialists.

In my experience as a PD specialist, neither of these statements is accurate. I believe that input from specialists in Parkin-son’s disease will make a positive difference in all stages of the disease, from the onset of symptoms to the advanced stages of the dis-ease. Furthermore, specialty care in neurol-ogy is rarely more costly than primary care, and often is more economical. Here is why:

Starting with the onset of symptoms,

a movement disorders specialist can provide the earliest and most accurate information about the diagnosis of PD. In fact, studies that compare the diagnosis of PD to the gold standard of post-mortem diagnosis (direct evaluation of the brain on autopsy) show that diagnostic accuracy for Parkinson’s dis-ease is greatest among movement disorder specialists and much lower for primary care physicians with general neurologists found between these two extremes.

Confusion about the diagnosis often results in unnecessary tests, poor choice of medications, and unnecessary consultations with multiple physicians—all delaying proper

management of symptoms and substantially adding to health care costs.

Greater experience with the management of PD results in better choices of treatment at all stages of the disease. Anti-parkinsonian medications are not easy to administer, and the best re-sults (fewer symptoms and

side effects) will be achieved by the most experienced physicians.

Most importantly, greater relief of symp-toms goes hand-in-hand with delaying disabil-ity. It may not be feasible for you to see the Parkinson’s disease specialist routinely, but an annual visit will give you confidence that you are receiving the optimum quality of care.

When to See a PD Specialist

By Chelsea Morrow and Jessica Rowe, MA

Why is research important?Research contributes to the development of new medicines, new procedures, and new ways of identifying and treating medi-cal conditions. These scientific discoveries change and improve our understanding of a disease or condition. The treatments that are available now were made possible thanks to volunteers who participated in clinical research trials years ago.

What is a clinical trial?Scientists conduct a variety of research studies to learn more about a problem or to answer questions. In general, clinical trials are medical/health-related research studies using human beings or specimens from hu-man beings (such as tissue, blood, saliva) to learn about a disease or condition. There are various types of clinical trials such as treat-ment trials, prevention trials, or diagnostic trials. This type of trial involves a researcher collecting data to evaluate the safety or effectiveness of an intervention. An interven-tion may include a behavior change, drug, device, new form of teaching, or some other form of intervention.

Not all clinical trials are interventional and

include a drug or device. Some research is designed to observe behavior or outcomes. This is often called observational research. Observational research is important as it helps researchers to improve patients’ quality of life, functioning, and evaluate outcomes.

Participation in research trials or other clinical research is voluntary and patients need not participate even if asked. When participating in research, patients may experience potential benefits, such as learn-ing more about their conditions, treatment, and management, improving symptoms, and gaining physical and emotional support. However, all research may have potential risks. Participation in research involves a careful consideration and discussion with your physician about all benefits and risks before a decision is made.

More information on clinical trials can be found at www.clinicaltrials.gov. Reference: Get the Facts, Parkinson’s Disease Foundationwww.pdf.org/en/research_advocate_facts

Chelsea Morrow is a clinical research assistant at the University of Maryland Neurology Ambulatory Center. Jessica Rowe is a clinical research specialist with the University of Maryland School of Medicine Department of Neurology, working in the Parkin-son’s Disease and Movement Disorders Center.

Thinking About Participating in Research? Optimism …

It’s Contagious!

All across the country, people are teaming up to reach a common goal: to “ease the burden and find a cure” for Parkinson’s disease. Par-ticipating in the American Parkinson Disease Association’s national “Optimism” campaign allows you to spread hope, confidence, and a positive vision for the future—while increasing awareness about Parkin-son’s disease and raising money for education, support services, and to help find a cure.

Optimism events bring people together, empowering them to take action and inspiring them to make a positive impact. Organize an Opti-mism event today … it’s easy.

Call 800-223-2732.

Spring/Summer 20124

Parkinson’s Disease BuzzPublished two times a year by:American Parkinson Disease AssociationInformation and Referral CenterUniversity of Maryland School of Medicine110 S. Paca St., third floor, Baltimore, MD 21201Phone: 410-328-9016 | Fax: 410-328-0167 Produced by the University of Maryland Office of Communications and Public Affairs, 2012

Coordinator and Editor Ilene Shevrin, MPH

Medical Director William Weiner, MD

The material in this newsletter is presented solely for the information of the reader. It is not intended for treatment purposes, but rather for discussion with the patient’s physician.

Stay Tuned! Upcoming Events« Hike the ParkSept. 8, 2012 8 a.m. to noon Oregon Ridge Park, Hunt Valley, Md.

People of all ages and lifestyles are invited to help conquer PD as hikers, loop walkers, volunteers, or hike supporters. The hike is approximately 3 miles on the James Campbell trail in Oregon Ridge Park. There will be post-hike activities and you are invited to bring a picnic lunch. All monies raised go to critical research being conducted at the Maryland Parkinson’s Disease and Movement Disorders Center.

For more information, please visitwww.promisesforparkinsons.org.

« Within Our Reach: Achieving Goals with Parkinson’s DiseaseOct. 16, 20128:30 a.m. to 3 p.m. Westin BWI, Linthicum Heights, Md.

Please register for our annual PD sympo-sium to learn about PD treatments and research. This year we are planning a completely new type of interactive sym-posium incorporating panel discussions, movement therapy, and workshops.

For more information, please contact Ilene Shevrin at ishevrin@som.umaryland.edu.

Deep Brain Stimulation Educational Seminars

Learn about this treatment option in a small and comfortable group setting

where patients and guests are encouraged to ask questions. Sessions are held each month. Please call 1-800-492-5538 for the date of the next seminar.

Frenkil Building, 16 S. Eutaw St., 3rd floorBaltimore, Md.1:30 to 3 p.m.

Optimism Walks Dogs! 2012 APDA Dog WalkJoin the Severna Park APDA Chapter in raising money for PD research by partici-pating in an annual dog walk in the fall of 2012! Exact location and Date TBD. Please contact Ilene Shevrin at ishevrin@som.umaryland.edu if you are interested.

Interested in yoga for PD?The Maryland Parkinson’s Disease and Movement Disorders Center and the Par-kinson’s Foundation of the National Capi-tol Area are joining up to offer FREE yoga for PD classes in the Baltimore area for PD patients and care partners. Yoga can be done in chairs and wheelchairs if needed. Date and location TBD. Please contact Ilene Shevrin at ishevrin@som.umaryland.edu or Banu Luu at banu@parkinsonfoun-datoin.org if you are interested.

List of Select Support Groups in Maryland/DC

Anne Arundel County Group 4th Tuesday monthly at noon Elks Lodge in Severna Park 160 Truck House Road, Severna Park, MD 21146Contact: Brenda Mislan, 410-729-3461

Bowie PD Support Group4th Monday monthly at 10 a.m. 14900 Health Center Drive, Bowie, MD 20716 Contact: Carter Rardon, 301-412-0835

Frederick Group3rd Wednesday monthly at 1 p.m. Mt. Pleasant Ruritan Club8101 Crum Road, Walkersville, MD 21793Contact: John Kraft, 301-845-6514

Howard County Group4th Tuesday monthly at 1:30 p.m. Vantage House5400 Vantage Point Road, Columbia, MD 21044Contact: David Johnson, 410-992-1120

Howard County Care Partner Group2nd Tuesday monthly at 10 a.m. Vantage House5400 Vantage Point Road, Columbia, MD 21044Contact: Lynada Johnson, 410-992-1120

Leisure World Silver Spring Group2nd Tuesday monthly at 3 p.m. Leisure World Clubhouse 23300 N. Leisure World Blvd., Silver Spring, MD 20906 Contact: Manny Horowitz, 301-598-9704

For more support groups in the MD/DC/VA area, please visit: http://www.parkinsonfoundation.org/educa-tion/support-group-network/index.html

World Parkinson’s Disease Awareness Day is April 11. This day commemorates the birthday of Dr. James Parkinson, the English doctor who first described the condition in 1817. The tulip is the symbol of hope for Parkinson’s.

April is Parkinson’s Awareness Month