PARKINSON'S DISEASE: Beyond drugs
Drug treatment for Parkinson's, an incurable neurodegenerative disease, typically targets the characteristic motor disturbances such as tremors, slowed movement, and rigidity by compensating for insufficient dopamine in the brain. As the disease progresses, however, the drugs are less effective and side effects are more evident. The therapy also may not address other significant issues associated with Parkinson's, including depression, anxiety, apathy, thinking and memory problems, and irregular sleep. With the disease now affecting perhaps a million Americans—a number likely to grow as the population ages—complementary strategies are attracting growing interest. Animal studies suggest, for example, that vigorous exercise may have neuroprotective effects, slowing the brain's loss of dopamine.
Gait and balance can also be big problems for Parkinson's patients. At Washington University School of Medicine in St. Louis, researchers tested the impact of tango lessons on two groups with moderate symptoms of the disease. In one group, participants danced alone. In the other, they danced with partners. While both groups showed significant improvement, those who tangoed with partners indicated more interest in continuing—the only way that the benefits could be sustained. The study, published in the May 2010 issue of the journal Neurorehabilitation & Neural Repair, points to the need to get patients involved in physical activities that they can maintain over the long term.
Researchers are also exploring why certain people experience temporary relief from Parkinson's symptoms when they respond to specific cues. For example, some patients can overcome their hobbled movements after hearing familiar rhythms. Others, barely able to walk, can dance when prompted, or can sing effortlessly, even if they have difficulty speaking. For reasons not well understood, auditory cues seem to reawaken, or somehow reconnect, brain circuits that otherwise aren't working as they should.
A team of Italian researchers took this idea a step further, putting people with moderate Parkinson's into a theater group so that they were compelled to take control of their movements and emotions. The three-year pilot study, reported in 2010, found that participants became more confident and motivated. And on a range of measures from mood to mobility, they outperformed a control group given regular physical therapy.
Why such approaches seem to succeed, even if only temporarily, remains largely a mystery. Rigorous studies on them have not been funded to the same extent as efforts to find better drugs, research the feasibility of putting corrected copies of defective genes into the brain, or implant brain-stimulating electrodes, for example. Some experts estimate that the electrodes could help 10 percent of Parkinson's patients. But evidence is mounting that many patients benefit from music and movement therapy, at least in the short term.
SCHIZOPHRENIA: Striving for early detection
This debilitating mental illness has been diagnosed for a century based on symptoms that patients report—the hallucinations, the inability to feel or show emotion, the social withdrawal. That's a major reason there's typically nearly a nine-year gap between the first signs of trouble and the start of treatment. Now, researchers say they are on the verge of developing diagnostic techniques that rely on biomarkers like blood proteins or genes, which could mean much earlier diagnosis and a better outcome. "Our goal is to find something objective," says Stephen Glatt, a psychiatric geneticist at the State University of New York Upstate Medical University in Syracuse. "It holds a lot of potential for people suffering from this condition." Early detection might also identify young people predisposed to schizophrenia in time to head off the worst of its effects.
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