Friday, June 22, 2018

Another one bites the dust

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Friday, 22 June 2018

Another one bites the dust

This week’s medical journal, The Lancet, carries an editorial about the latest spate of anti-Alzheimer’s trials that have been stopped early. Two of the biggest pharmaceutical companies in the world, AstraZeneca and Eli Lilly, have announced that they have stopped phase 3 trials of a new kind of treatment called BACE inhibitors (β-amyloid precursor protein cleaving enzyme inhibitors). These studies were designed on the back of good evicence that they might work, and indeed the compounds have made it all the way to phase 3 trials – a large number of individuals with Alzheimer’s being given either the compound or placebo. These trials are hugely costly to run, and so typically, the drug companies and financial investors, tend to only back what they think will be a winning horse.
This year brings more disappointment for the Alzheimer’s community, Janssen stopped a BACE inhibitor trial in May, and Merck pulled their BACE inhibitor trial in February. 

The editorial comments that although these studies have been stopped frequently because an early look at the data suggest no meaningful effect, so no point in continuing the study, it is not necessarily the end of the road for these treatments, but that the prodromal phase of Alzheimer’s may be where the treatments will work.

I fear that the Parkinson’s world should ready ourselves for a similar journey. The road may be long, and fraught with disappointments, but the goal remains to develop a safe and effective treatment to stop or slow down Parkinson’s. Each failure does not sound the death knell, and each time we, as a global Parkinson’s community, must learn as much as we can from the failures to increase our chances of success. A vital lesson to learn from the Alzheimer’s world, is that established disease is likely to be a case of “too little, too late”. 


Alzheimer's disease research: the future of BACE inhibitors
Talha Burki

Tuesday, June 12, 2018

Image of the Day: Memory Jogger

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Image of the Day: Memory Jogger

Scientists can livestream how the mouse brain’s hippocampus maps the physical world and accesses those memories.  
By Sukanya Charuchandra | June 12, 2018
The mouse moves through the virtual world of a video game with the help of a Styrofoam ball that floats on compressed air.THOMAS HAINMÜLLER, MARLENE BARTOSResearchers looked into the brains of live mice experiencing a virtual environment to see how neurons were altered through the process of memory consolidation, according to research published June 6 in Nature.  
A look into memory: A video recording shows neurons begin to flash as soon as they are activated.THOMAS HAINMÜLLER, MARLENE BARTOS
“As the mouse is getting to know its environment, we use a special microscope to look from the outside into its brain and we record the activities of its nerve cells on video,” Thomas Hainmüller, a coauthor on the study, says in a statement. He and his colleague found that the mouse’s location within the game would trigger specific neurons among a group of cells that was engineered to light up when activated. The resulting neural map reflected memories of different areas within the virtual environment.

See “Virtual Reality May Revolutionize Brain Science

T. Hainmueller, M. Bartos, “Parallel emergence of stable and dynamic memory engrams in the hippocampus,” Nature, doi:10.1038/s41586-018-0191-2, 2018.

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Friday, June 8, 2018

Traditional May Day Celebrations at McDougall Cottage

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Traditional May Day Celebrations at McDougall Cottage


Event Details

The Gaelic May Day (also known as the fire festival, Beltane) traditionally marked the peak of spring and the beginning of summer. Join us as we celebrate May Day with music, crafts for kids, Morris dancing and Maypolefestivities. Musical group Hunter’s Corners (Brad McEwen and Bill Nesbitt) and Friends, along with the Orange Peel and Forest City Morris dance troupes will be on hand to help us usher in the summer in a most traditional manner. 

Friday, May 25, 2018

Blind women lend a hand for early detection of breast cancer

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Blind women lend a hand for early detection of breast cancer


The enhanced tactile sensitivity of blind and visually impaired women might make them especially suitable for breast examination, according to a visionary German gynaecologist. If it’s true that mammography is an effective breast cancer screening method until now, it’s costly and often not available for free, especially in low income level countries with a low level of health infrastructure.
(From the website
That’s why Frank Hoffmann first thought in 2006 of training blind and visually impaired people to work in breast cancer prevention, taking advantage of their highly developed aesthetic capabilities. The German resident gynecologist from Mülheim an der Ruhr launched in 2010 a social enterprise named “Discovering hands” with the added goal of creating a new field of employment for blind and visually impaired people, by turning their disability into a special skill.
His “Medical Tactile Examiners” (MTEs) are trained for nine months to carry out physical breast examinations in medical practices and to use a standard diagnostic method for examining the female breast based on custom-developed Braille orientation strips for the detection. The MTEs never diagnose directly: they assist the doctors by lending them their “discovering hands”.
Usually, a breast examination performed by a gynecologist takes a few minutes. A tactile examiner spends at least 30 minutes for each session, not only by looking at the breast but also by educating patients about how to deal with the risk of breast cancer. Preliminary results of a still-unpublished small trial carried on at the University of Erlangen (under the supervision of Professor Matthias Beckmann) indicate that MTEs detect significantly more chest tissue changes than doctors, also because they notice them when they are smaller.
Currently, more than 35 gynecological practices and hospitals across germany employ MTEs trained by the programme; more than 12.000 examinations have been carried out to date. According to “Discovering hands”, the model has expanded in Austria, runs pilot projects in both India and Colombia while more than 25 organizations from different countries have shown interest in it.

My introduction to LazyLegz

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Just met LazyLegz at the discussion group at
where he said
"When I dance I forget I have crutches"

No excuses, no limits for Canadian dance ambassador Luca 'Lazylegz' Patuelli

Montrealer Luca "Lazylegz" Patuelli is this year's Canadian dance ambassador for International Dance Day, April 29. He walks with crutches. He dances like a star.
"When I'm performing or teaching or speaking, I experience a constant adrenalin rush," Luca "Lazylegz" Patuelli explains. "I love what I do. But when I step away from the arena, the fatigue takes over." Here he is showing us some of his moves. PIERRE OBENDRAUF /MONTREAL GAZETTE
Luca “Lazylegz” Patuelli  is this year’s Canadian dance ambassador for International Dance Day, April 29.
The Montreal breakdancer, a.k.a. b-boy, was selected by the Canadian Dance Assembly, an arts organization which promotes and supports Canadian dance. Patuelli wrote a message and is featured in a video posted on the CDA website and has been invited to be keynote speaker at the CDA National Conference in Toronto in September.
“I was overwhelmed when they contacted me,” Patuelli said. “This year (the CDA) wanted to highlight inclusiveness and accessibility to dance. When I sat down to write my dance message, it just flowed.”
Patuelli talked to the Montreal Gazette about dance and life and challenges in the conference room of his office in the Belgo Building on Ste-Catherine St. W. while wife Melissa Emblin-Patuelli, a dancer and occupational therapist, worked on their Project RAD initiative in the adjacent office. Project RAD trains urban-dance teachers how to work with children with physical and intellectual challenges in the dance studio.
Dominating the office space is a black wall emblazoned with the graffiti-styled slogan No Excuses No Limits — words that define Patuelli’s strength of spirit and body.
Patuelli was born with a condition called arthrogyprosis, which limited muscle and joint growth in his legs. At 8, he was diagnosed with scoliosis, a condition which leads to curvature of the spine. He underwent 16 surgeries between the age of seven months and 17 – and walks with crutches.
Patuelli was also born a determined optimist, with the ability to light up a room with a smile and handshake. Born in Montreal and raised in Bethesda, Md., he learned to skateboard, swim, ski, dive and sail — adapting each sport to his abilities. A knee operation ended his skateboarding when he was 15, so a friend introduced him to dance. It was all good until his senior year at high school when he broke a leg during an urban-dance competition, a.k.a. “dance battle.” The dancing stopped.
At 18, Patuelli moved back to Montreal to study economics and then marketing at Concordia University. He’d left a supportive group of buddies back in Maryland and knew that the best way to forge another group of close friends was to start dancing again. That was 2002. He hasn’t stopped since.
Patuelli’s impressive upper-body strength and ability to manoeuvre with innovative grace, using his crutches as an extension of his arms, garnered him praise in the international dance community.
He co-directed and headlined the opening ceremonies of the 2010 Paralympics in Vancouver, made it to finals week on Season 3 of the now-defunct CTV dance competition So You Think You Can Dance Canada, and has competed in and judged dance battles all over the world.
As a sought-after motivational speaker he does, on average, one talk and dance demonstration a week at schools, conferences and universities. He talks about his life and Project RAD – and he talks about his dance company ILL-Abilities. ILL, or “sick,” in this context means “very cool.” All five dancers have physical disabilities.
ILL-Abilities was nominated for an Olivier Award for excellence in theatre in the U.K. in 2013. The company didn’t win, but the attention landed it a 22-city U.K. tour in 2014. Patuelli tells a great story about company members walking the red carpet. The cheering from the crowd was deafening. They were tickled at being recognized until he looked back and saw that the outpouring of public affection was directed at Harry Potter star Daniel Radcliffe, walking right behind them.
The motivational speaking — which Patuelli can do in fluent French, English, Italian or Spanish — keeps him on the road a fair bit, but that will have to slow down at the end of this summer because the couple’s first baby, a girl, is due at the end of August.
Slowing down might not be such a bad thing. Performing has taken its toll. The dancer has chronic tendinitis in both elbows and his left shoulder and wrist. (He takes the full brunt of weight in his left arm when executing b-boy floor rotations.)
“When I’m performing or teaching or speaking, I experience a constant adrenalin rush,” Patuelli said. “I love what I do. But when I step away from the arena, the fatigue takes over.”
Patuelli and Emblin-Patuelli, both 30, are inseparable. They met in 2008 when Patuelli was asked to speak at McGill University and it was love at first sight.
“My heart was beating fast the minute he began to talk,” Emblin-Patuelli said. “And I hadn’t even seen him dance.”
She scrambled to come up with a question to ask him after the talk. He asked her out and the rest, as they say …
The two unwind in their loft in Hochelaga-Maisonneuve by cooking together and then collapsing on the couch to watch something on Netflix. Patuelli loves political intrigue, so they’ve been watching Season 3 of House of Cards.
The couple, along with teacher, dancer and choreographer Marie-Élaine Patenaude,  launched Project RAD in 2012 at the Rebelles et Vagabonds studio in Laval. They had five students.
Project RAD is now in five dance studios in Montreal, with a pilot project at one studio in Quebec City, has 18 certified teachers and 80 students.
“It’s about making dance inclusive and making dance studios physically accessible — like having bars installed in the bathrooms,” Patuelli said. “What impresses me is to see the change in the (Project RAD) dance students, how their confidence and levels of independence increases. They start to make friends. And because they are in a dance studio, they come in contact with professional dancers and those professional dancers, in turn, are inspired by what they see.”
Project RAD and ILL-Abilities caught the eye of talk-show host Ellen DeGeneres and Patuelli was invited to perform on her syndicated talk show in December 2013. His performance brought the studio audience to its feet.
How nervous was he?
“On a scale of 1 to 10, I was a 50,” he said. “I didn’t sleep the night before. I told Ellen it was like Christmas and my birthday and final exams all wrapped up into one because I was excited, but I was also nervous — like for a final exam — because of the pressure to perform.”
Patuelli graduated with a marketing degree from Concordia’s John Molson School of Business in 2009. It took seven years to complete the degree because he was juggling his dance career with the academics. His professors graciously adjusted deadlines and exam schedules as best they could to accommodate his demanding touring itinerary which would sometimes involve his flying somewhere to perform then catching the red-eye special home only to head directly to class at university.
“I remember taking 36 airplanes in one month,” Patuelli said with a laugh.
Last summer Patuelli took on another challenge, training hard to participate in the I Can Je Peux walk for people with physical disabilities, held in the Old Port. He completed the 2.5 kilometres from the Clock Tower to the Montreal Science Centre without his crutches.
“I trained by using a lot of visualization techniques, standing without my crutches for as long as I could and learning how to take steps by lifting my knees,” he said.
International Dance Day was introduced in 1982 by the International Dance Council, a UNESCO NGO, to promote dance worldwide. Dozens of countries participate in the annual event by organizing public performances or promoting dance with the help of ambassadors like Patuelli.
The Regroupement québécois de la danse has organized a 10-day event with dozens of dance activities designed to give a wider public an idea about what the dance industry in Quebec is doing. Événement Québec Danse began April 24 and runs until May 3. For program details, visit

Luca “Lazylegz” Patuelli’s message for International Dance Day:

“No matter what age, race, sex or ability one may have, everyone can dance. Dance is within all of us. Some choose to share it with others and some choose to keep it to themselves. Life is a dance whether we know it or not. We are constantly dancing with every movement we make, with every breath we take, and with every beat our hearts make, a rhythm is being created. It’s the slightest movements that make the greatest difference in a performance, just like in life it’s the little things that matter. Dance is the connection between you and the universe; while we are dancing we are developing ourselves based on the energy, the emotions, and the challenges we experience. It is up to us to determine how we want to communicate our dance to the world. Dance is the ultimate form of self-expression and it is the escape that always reminds us that everything is going to be OK. Dance challenges us to surpass our limitations by discovering strength within. So, live your life to the fullest and dance beautifully!”

Monday, April 30, 2018

Music Activates Regions of the Brain Spared by Alzheimer’s

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Summary: A new study reports Alzheimer’s disease does not appear to affect the salience network. Researchers found, when listening to music, the salience network along with other networks, show higher functional connectivity in Alzheimer’s patients.
Source: University of Utah Health.
Ever get chills listening to a particularly moving piece of music? You can thank the salience network of the brain for that emotional joint. Surprisingly, this region also remains an island of remembrance that is spared from the ravages of Alzheimer’s disease. Researchers at the University of Utah Health are looking to this region of the brain to develop music-based treatments to help alleviate anxiety in patients with dementia. Their research will appear in the April online issue of The Journal of Prevention of Alzheimer’s Disease.
“People with dementia are confronted by a world that is unfamiliar to them, which causes disorientation and anxiety” said Jeff Anderson, M.D., Ph.D., associate professor in Radiology at U of U Health and contributing author on the study. “We believe music will tap into the salience network of the brain that is still relatively functioning.”
Previous work demonstrated the effect of a personalized music program on mood for dementia patients. This study set out to examine a mechanism that activates the attentional network in the salience region of the brain. The results offer a new way to approach anxiety, depression and agitation in patients with dementia. Activation of neighboring regions of the brain may also offer opportunities to delay the continued decline caused by the disease.

Wednesday, April 4, 2018

Using Smartphones and Machine Learning to Quantify Parkinson Disease Severity: The Mobile Parkinson Disease Score

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Using Smartphones and Machine Learning to Quantify Parkinson Disease Severity: The Mobile Parkinson Disease Score

Smart phone technology and app-based approaches for measuring PD symptoms and signs have been around for some time and there are seemingly innumerable companies and groups that all suggest that their approach is the best...

The results of this recent study published in JAMA Neurology do however look really impressive. I have always felt that given the heterogeneity of PD (motor and non-motor), a good measuring device will take account of multiple domains. This app measures voice, gait, balance, reaction time and finger tapping (which you might argue are exclusively motor)... but the results suggest that it does measure these really well. 

The hardest thing is to develop a tool that captures fluctuation well and objectively. Some purpose-built devices do (the PKG for example), but it is impressive to see these kind of results through utilisation of the standard hardware that comes with a smart phone. Furthermore the objective response to dopaminergic therapy is substantial and apparently clinically meaningful. 

Will we see this app used in clinical trials in the coming years... I expect we might!

- Alastair Noyce

JAMA Neurol. 2018 Mar 26. doi: 10.1001/jamaneurol.2018.0809. [Epub ahead of print]
Zhan A, Mohan S, Tarolli C, Schneider RB, Adams JL, Sharma S, Elson MJ, Spear KL, Glidden AM, Little MA, Terzis A, Dorsey ER, Saria S.

IMPORTANCE: Current Parkinson disease (PD) measures are subjective, rater-dependent, and assessed in clinic. Smartphones can measure PD features, yet no smartphone-derived rating score exists to assess motor symptom severity in real-world settings.

OBJECTIVES: To develop an objective measure of PD severity and test construct validity by evaluating the ability of the measure to capture intraday symptom fluctuations, correlate with current standard PD outcome measures, and respond to dopaminergic therapy.

DESIGN, SETTING, AND PARTICIPANTS: This observational study assessed individuals with PD who remotely completed 5 tasks (voice, finger tapping, gait, balance, and reaction time) on the smartphone application. We used a novel machine-learning-based approach to generate a mobile Parkinson disease score (mPDS) that objectively weighs features derived from each smartphone activity (eg, stride length from the gait activity) and is scaled from 0 to 100 (where higher scores indicate greater severity). Individuals with and without PD additionally completed standard in-person assessments of PD with smartphone assessments during a period of 6 months.

MAIN OUTCOMES AND MEASURES: Ability of the mPDS to detect intraday symptom fluctuations, the correlation between the mPDS and standard measures, and the ability of the mPDS to respond to dopaminergic medication.

RESULTS: The mPDS was derived from 6148 smartphone activity assessments from 129 individuals (mean [SD] age, 58.7 [8.6] years; 56 [43.4%] women). Gait features contributed most to the total mPDS (33.4%). In addition, 23 individuals with PD (mean [SD] age, 64.6 [11.5] years; 11 [48%] women) and 17 without PD (mean [SD] age 54.2 [16.5] years; 12 [71%] women) completed in-clinic assessments. The mPDS detected symptom fluctuations with a mean (SD) intraday change of 13.9 (10.3) points on a scale of 0 to 100. The measure correlated well with the Movement Disorder Society Unified Parkinson Disease's Rating Scale total (r = 0.81; P < .001) and part III only (r = 0.88; P < .001), the Timed Up and Go assessment (r = 0.72; P = .002), and the Hoehn and Yahr stage (r = 0.91; P < .001). The mPDS improved by a mean (SD) of 16.3 (5.6) points in response to dopaminergic therapy.

CONCLUSIONS AND RELEVANCE: Using a novel machine-learning approach, we created and demonstrated construct validity of an objective PD severity score derived from smartphone assessments. This score complements standard PD measures by providing frequent, objective, real-world assessments that could enhance clinical care and evaluation of novel therapeutics.