TREATING INFLAMMATION PROVIDES HOPE IN THE FIGHT AGAINST PARKINSON’S

The acceleration of new Parkinson’s disease cases outpaces other age-related conditions, and as a result, the patient population is growing quickly. In 2022 there were about 90,000 new diagnoses in the U.S., versus the previous prevailing estimate of 60,000. While some of the increase can doubtless be attributed to improved diagnostics and improved access to health care, those factors affect the statistics of other diseases and cannot explain why so many more people seem to be getting the disease.

Another characteristic of Parkinson’s is a relatively long life expectancy, 16 years after diagnosis on average. By comparison, for Alzheimer’s patients, the average is about six years. For many patients, the illness is a very extended battle against awful symptoms, and while there are treatments that provide relief, they have changed very little in many years.

The foundational treatment is the drug levodopa, which enters the brain and helps temporarily replace dopamine that has been lost due to the disease. It has been around since the 1960s. Today it is usually administered in combination with other drugs, like carbidopa, which improves the ability of the levodopa to work. For patients who cannot be sufficiently treated by drugs, there is deep brain stimulation (DBS), which has been approved since 2002. DBS modifies abnormal electrical activity in targeted parts of the brain and can significantly reduce symptoms like tremors, slowness, rigidity, and pain.

There is no cure in sight currently. But through research and documented findings, we continue to learn more about the biological processes that cause the disease and potential paths to follow to find effective treatments.

A recently published study shows, in animal tests, that the wildly popular obesity drugs known as “GLP-1 receptor agonists,” such as Ozempic and Wegovy and others, reduce the inflammation in the central nervous system that is associated with abnormal production of the proteins associated with Parkinson’s and Alzheimer’s.

Another recent study found that intermittent fasting leads to reduced neuroinflammation. The researchers determined that during the fast the body increases production of a polyunsaturated fat called arachidonic acid (ARA), and that the increased ARA levels in the brain reduces inflammation, which slows neurodegeneration.

Fighting neuroinflammation can be accomplished in a variety of ways. In a recent Naples, Florida news story a local man with Parkinson’s is benefiting from daily rigorous pickleball play. Diagnosed in 2008, Bob Helder took up pickleball two years later. Counterintuitively, he found that the constant motion of the sport seemed to help. Now he plays up to four hours daily and reports that his symptoms are minimal. “On a given day, I may not have any tremors at all.” His case is unusual but perhaps instructive because regular exercise reduces inflammation.

Addressing inflammation in the central nervous system through drug treatments is a promising area of research. However, current common anti-inflammation treatments have difficulty crossing the blood-brain barrier. Tests of readily available non-steroidal anti-inflammatory drugs like ibuprofen and naproxen have been disappointing. Several companies (such as Annovis and Biovie) are developing small molecules that enter the brain and effectively block inflammation. Early testing of their drugs provides hope, but they are still years away from market availability. Nonetheless, leading Parkinson’s specialists still find their patients positive about the near future.

Dr. Michael Okun of the University of Florida specializes in treating and researching Parkinson’s. He told me his patients are generally resilient and that, for many, learning their diagnosis leads to an improved life. They get some relief from simply knowing what is happening in their body and from finding out about the effectiveness of tried-and-true treatments like levodopa and deep brain stimulation. But most importantly, most are able to confront the unhealthy aspects of their lives and truly take on the anti-inflammatory actions of lowering stress, sleeping better, exercising more, and attending to their health better. As a result, for many patients, they can end up feeling better, even better than before their illness.

And for the rest of us, our daily lives and our future health will certainly benefit from adopting a consciously healthier and anti-inflammatory lifestyle through improved nutrition, sufficient sleep, and a good daily sweat. If enough of us take that on, perhaps we can even reverse the accelerating statistics for Parkinson’s.