- [Announcer] "Your Fantastic Mind," brought to you in part by Sarah and Jim Kennedy.

(intriguing synth music) (intriguing synth music continues) - Welcome to "Your Fantastic Mind."

I'm Jaye Watson.

Tonight's episode is about Parkinson's Disease and we're taking you to our collaborators at the University of Georgia where a leading Parkinson's researcher and his team have come up with a skin test for Parkinson's and a probiotic that releases L-Dopa.

Plus, we are following a woman who credits ping pong with slowing the decline of her Parkinson's, and you will wanna be there as we follow her to the National Table Tennis Championships in Alabama.

But first up tonight, the disease that impacts over 10 million people worldwide: Parkinson's disease, a progressive neurological disease that robs people of movement, independence, and quality of life.

90,000 cases are diagnosed in the US each year.

Tonight we take you inside research tackling one of Parkinson's most common and debilitating symptoms, freezing of gait, a sudden inability to walk that can lead to dangerous falls.

Emory researchers are examining a biomarker that may point to a possible cause.

- I was in the military for 27 years.

So I got plenty of shots.

- [Doctor] Here we go.

- [Jaye] Retired Marine Lieutenant Colonel Kent Morrison was a long-time leader who is now many years into Parkinson's disease.

- Seven, eight.

- How are you?

- [Jaye] He is still serving his fellow man- - [Doctor] Stand up if you can.

- [Jaye] by driving three hours from his home in South Georgia to take part in a clinical trial at Emory University in Atlanta.

There are dozens of symptoms associated with Parkinson's, and this trial is to investigate one of them.

- Go ahead and have a seat.

- Freezing of gait.

- And let me do some calibration work here.

- My, my, my, my brain, my, my, says it's time to take a step, time to m-move forward.

The feet will not, will not, will not comply.

They, they lock...

I mean, it's, it's, it's, it's like, it's like they're glued to the ground.

They lock up hard.

So the body's saying, "Let's go."

And everything wants to go to the feet.

So then I have the tendency to fall if I'm not, not careful.

But that's as simple as it is.

They just, they just, they just stopped working.

The brain and the feet can-cannot talk anymore.

- Okay, good.

Now do this.

(foot stomping firmly) It's one of the big unmet needs for Parkinson's.

We don't understand it.

It causes falls, injuries, and as the disease progresses, it gets worse and we don't have anything for him to help him.

- [Jaye] Neurologist Stewart Factor is the Director of the Movement Disorder program at Emory.

- [Dr.

Factor] This is where we just look at your balance.

So you just stand.

- [Jaye] In a career that has included 50 studies and more than 300 published papers, Factor's focus right now is on freezing of gait.

- We found what we think is a biomarker for freezing, to actually possibly predict freezing.

(melancholic music) - [Jaye] That biomarker is amyloid.

A protein that can misfold and clump together, forming plaques in the brain.

Amyloid clumping is a hallmark of Alzheimer's disease, disrupting brain cell function and causing memory loss and cognitive decline.

Amyloid changes are also present in other diseases like Parkinson's.

- We did spinal taps on a portion of our freezing patients to look at markers and what we found was that amyloid in Parkinson patients with freezing goes up, and in Parkinson patients without freezing goes down.

And there was a big difference.

It wasn't like a close difference between the groups.

- Yeah, so you're kind of tapering off.

And then the... - Yeah, yeah.

- [Jaye] Working with J. Lucas McKay, a Georgia Tech electrical engineer who is now the Data Science Director of the Emory Brain Health Center Motion Analysis Laboratory.

- We can make the computer do that.

- [Jaye] The two have combined their expertise to take research to the next level.

- He was able to do a lot of the statistical work that we needed.

One of the hardest parts about freezing is it's unpredictable.

So when you try to measure it, it's really hard to measure.

And you really need technology like this to measure it.

- [Jaye] McKay is the co-director of the motion analysis lab.

- We like to say it is a full body behavioral testing facility.

I think it is the only one of its kind in the United States that we use for clinical purposes.

- Goes right down kind of by your brow.

- [Jaye] This pilot study is called Flicker and plans for 24 participants.

Half of the participants will receive the real thing and the other half will receive a placebo.

They will use it every day for six months.

- [Dr.

Factor] They wear headphones and they wear these glasses and within the glasses, the light flickers at 40 hertz and there's clicking in the headphones at 40 hertz.

- [Jaye] Animal studies have found that being exposed to this light and sound reduces levels of amyloid in the brain.

- [Dr.

Factor] We have them put on the device and they go get an EEG and we look to see that the 40 hertz that they're exposed to is actually entering in their brainwaves so that their brain is affected by that, and then they wear the device for one hour a day.

- Good morning.

- Hello.

How are you?

- [Jaye] At the beginning and end of the study, participants do blood work.

- Of course.

- Yes.

- [Jaye] Cognitive testing.

- [Dr.

Factor] Let see you turn in a circle.

- [Jaye] Clinical exams with Dr.

Factor.

- I'm gonna measure again, make sure we're at the right spot.

- [Jaye] And receive EEGs.

- [J. Lucas] We instrument folks like a Christmas tree.

They're called retro-reflective markers.

- [Jaye] They also spend time in the motion analysis lab- - [J. Lucas] 12 motion capture cameras and three simultaneous wide view video cameras.

- [Jaye] Doing a series of evaluations or examinations that are measured in a way that is far more precise than the human eye.

- Basically there's little spheres covered with 3M reflective tape.

We put them all over the body.

There's cameras all over the room that project a very specific frequency of light that reflects back into the cameras and then the software, it triangulates the positions of the markers.

And we use the positions of the markers to estimate where the body is in 3D space.

It's the gold standard of accuracy.

Okay, go ahead.

(gentle music) - [Jaye] The goal of the Flicker study is to see if it affects freezing or the levels of amyloid.

The hope is that both are decreased.

- I, I, I loved being a Marine.

I-I just loved, I, I, I joined the Marines when I was 17-years old.

Miss it every day.

I, I was very fortunate.

You know, I, I didn't, I didn't, I didn't have to kill and hurt people, and you know, I I, I did humanitarian, humanitarian missions.

- [Jaye] Kent and his wife Christine met in college and have three sons.

He was serving as the executive director of the Marine Corps logistics base in Albany, Georgia when symptoms began in 2015, - Mainly was just his flat affect.

He didn't have a big smile like he always had and his face just didn't have that expression.

- And I started stuttering.

I mean, I used to give speeches all, all, all over.

You know, suddenly I started to speak and I started drooling.

Very embarrassing.

- [Jaye] While Kent's Parkinson's has advanced- (drums thumping rhythmically) he still plays his drums and travels to see his children and volunteers for research.

- But I, I've been given so much, therefore I want, you know, I wanna give back to help mankind.

- You feel anything?

- No, sir.

- [Doctor] Okay, I'm gonna start.

- [Jaye] Kent volunteered to undergo lumbar punctures at the beginning and end of the study.

This is when CSF, cerebral spinal fluid is collected.

- About 20 ccs.

- [Jaye] Kent's amyloid levels before and after will be measured.

- [Doctor] Didn't feel a thing, right?

- [Jaye] And so will a related neurotransmitter, norepinephrine.

- [Dr.

Factor] What we found was the people with the highest amyloid had the lowest norepinephrine.

- [Jaye] In Alzheimer's disease, Norepinephrine drops, and amyloid goes up in the brain.

The hope is to create or use existing drugs to boost levels of norepinephrine.

- [Test Conductor] So I am just gonna push these electrodes into the little cap.

- [Jaye] This is the end of the study for Kent.

Since he doesn't know if he had the real Flicker or the placebo, he will go home with the real one and use it for several months.

- [Automated Voice] Capture started.

- [Jaye] What researchers are discovering in this cutting edge motion lab is the most precise way developed to measure human movement, a remarkable blend of clinical expertise, advanced technology, digital innovation, and AI.

- What gets me going is the idea of using machine learning and things like that to replicate what they do.

And I'd really like to take the measurements that we use in the lab and translate them to something you could do in sort of like with a mobile phone.

(gentle music) - [Jaye] The goal is to create an app that could be used by physicians who could record their patients, - Or the primary doctor could even do a video of the walking.

- [Jaye] Right now, neurologists do clinical exams using the unified Parkinson's Disease Rating Scale.

The exam covers symptoms like tremor, stiffness and walking, daily living skills like dressing and eating, and issues like mood or sleep problems.

Each symptom is rated zero to four and the scores are totaled to track the progression of the disease over time.

- What we'd like to do with the data in the lab is to look at one domain at a time and measure it very precisely and then train a computer to look at it.

We can use AI ML to basically take a recording like we have in the lab and turn it into one of those scores that the neurologist does.

- [Jaye] Kent Morrison is living with a disease that is a relentless thief, but he doesn't see it that way.

This was his answer when we asked him how his life is today.

- It, it, it is perfect because I, I tell myself it's perfect.

I, I, I make it perfect.

You know?

Your mind is your best medicine.

So I tell myself... People say "How are you?"

and I'll say, "I'm, I'm doing great."

(gentle music) - From Emory in Atlanta to our neighbor and research collaborator in Athens, the University of Georgia.

Researchers there are developing a new way to make diagnosing Parkinson's easier and to make dosing medication more seamless.

(intriguing music) (bus droning) In a lab filled with PhD students- - We are trying to mimic what's happening in the brain.

- [Jaye] And neuroscientists.

- [Neuroscientist] That's what spreads the disease.

- [Jaye] Research is underway that could have a profound impact on Parkinson's patients when it comes to diagnosis and treatment.

- That'll be a big challenge when it comes to biopsies.

- So that's why these students are reproducing that in the lab.

- [Jaye] An internationally renowned Parkinson's researcher, Anumantha Kanthsamy was recruited to the University of Georgia in 2021- - So that kind of intrigued me.

- [Jaye] to establish and lead the Isaacson Center for Neurological Disease Research named for the late Georgia Senator Johnny Isaacson, who was diagnosed in 2015.

- The L-Dopa, is a gold standard treatment.

It was discovered 1960s.

(gentle synth music) - [Jaye] In Parkinson's the brain slowly loses dopamine producing cells.

Dopamine is what helps control smooth, coordinated movement.

Its loss leads to symptoms like tremors, stiffness, and slow movement.

The medication levodopa, also known as L-Dopa, replaces dopamine lost in Parkinson's disease.

It is taken multiple times a day and usually works well for several years.

- The challenge with the drug is very, what we call is the, the half-life is very short.

- So it's short acting?

- Yeah, short acting.

And the DK is fast.

You know, the dose goes away quickly within three to four hours.

- [Jaye] Kanthsamy and his team tackled a very real issue in the Parkinson's community - And then they just go for grinding.

- [Jaye] What happens after several years when L-Dopa is not as effective?

- Every time you take a dose, plasma level, brain level goes up, comes down.

Then again take another one, goes down, comes down.

The brain wants everything in homeostasis.

- [Jaye] Parkinson's disease continues to damage dopamine producing cells in the brain, so that years into the disease, there are fewer cells to convert levodopa into dopamine and store it for release.

In addition, the effects of levodopa aren't lasting as long, requiring more frequent doses.

Off times happen when symptoms return before the next dose kicks in.

There can be increases in involuntary movements called dyskinesia, and freezing episodes.

- Our goal is to make an engineered live biotherapeutic product that's essentially like a microbiome, like a bacteria, a probiotic that has been engineered to produce a drug molecule.

- [Jaye] Kanthsamy and his team have created a levodopa-producing probiotic- - [Piyush Padhi] And in this plate we have streaked bacteria onto it.

- [Jaye] that would be taken once a day and would provide a steady release of L-Dopa.

Using E. coli nissle, a beneficial bacterial strain known for its probiotic properties and often used in supplements and treatments for gut health.

The team created the L-Dopa-producing probiotic.

- [Anumantha Kanthsamy] And put a gene that makes the L-Dopa.

So we inserted into the bacterias gene that won't recognize them as a foreign gene.

- [Piyush Padhi] And from one single colony, we're able to get a nice, dense culture.

'Cause the cells multiply, they replicate.

This bioreactor, essentially it makes cells.

We can grow up to 10 liters at a time and we let it grow, let it ferment inside of it for up to 12 hours.

- [Jaye] Tucked inside the probiotic, once digested, L-Dopa is released from the gut for 24 hours at a continuous, steady rate.

- At our surprise, it worked.

Worked really well, better than we thought.

- [Researcher] This test is called the balance beam test.

- [Jaye] Right now the research is in animal models and the results are stunning.

- This is constantly producing L-Dopa, but when we give it to the mice, these cells will continuously produce the L-Dopa.

So the animals get the sort of anti Parkinsonian benefit and they are essentially back to almost like close to being as normal as possible.

- [Jaye] Here's a mouse with severe Parkinson's symptoms.

- [Piyush Padhi] They have like slight gait issues, they're walking slower, they don't know what to do.

And that is all part of the dopamine process.

This is a healthy mouse.

- [Jaye] And here's a mouse who has received the probiotic.

The researchers precisely measure every step.

- [Piyush Padhi] So you can see that the animals, as they're walking across, it's picking up each of the paw prints, which we have classified.

And we can obviously control the speed here so the animals can walk at a normal pace.

And you can see that, you can see his circumference.

- [Jaye] So when could this probiotic be used by Parkinson's patients?

- I think we'd like to see at least next five years.

- [Jaye] One of the other areas of research for Kanthsamy's team, they are creating a skin test for Parkinson's disease.

- Basic idea of the assay is to be able to differentiate between Parkinson's disease and control.

- [Jaye] Right now, neurologists diagnose it by doing a clinical exam and sometimes brain imaging.

A skin test would be a game changer.

- So we take a small punch.

It's kind of when you go to a dermatologist, normally take a small punch.

It's a three millimeter punch, a biopsy.

So you take that and we can test them in our lab and then identify the protein using some seeding activity assay that we developed.

(gentle synth music) - [Jaye] Emory University is part of the Michael J.

Fox Foundation's Parkinson's Progression Markers Initiative, a biomarker study that began in 2010.

In 2023, the Fox Foundation announced a huge breakthrough, that a protein called alpha-synuclein could be identified by examining spinal fluid in patients.

In people with Parkinson's, this protein can misfold and clump together abnormally in the brain where it can accumulate not only in spinal fluid, but it can also build up in skin cells.

- That accelerates the protein aggregation that happens in the misfolded alpha-synuclein.

- [Jaye] Skin tests done by Kanthsamy's team from autopsy showed 93% accuracy in predicting if that person had had Parkinson's disease.

Skin tests in living patients have a slightly lower accuracy rate.

- Currently about 80% accuracy, so we wanna get up at 90%.

- So that's what the reader... - [Jaye] By looking for abnormal alpha synuclein protein in skin cells, these tests offer a simple, non-invasive way to detect Parkinson's early, even before symptoms appear.

Kanthsamy hopes it's in wide use within five years.

- Sometimes it's out of the box idea that works.

That's what makes a great science and discovery.

That's why this job is so exciting.

It's stressful, but at the same time, a good way, a good stress.

- [Jaye] Kanthsamy and his team are collaborating with Emory on this research, including the creation of a probiotic for people with Alzheimer's disease.

Instead of bacteria producing L-Dopa, bacteria would be producing norepinephrine, a neurotransmitter whose levels drop in Alzheimer's disease.

When norepinephrine goes down, amyloid levels go up.

The hope is that boosting norepinephrine could decrease amyloid levels.

- I grew up in a agriculture family, so I work with a lot of chemicals and pesticides and just kind of passionate about, you know, how chemical affects human life.

- [Jaye] From the time he learned how pesticides and chemicals could increase the risk of developing Parkinson's disease, this has been Kanthsamy's passion, first as a neurotoxicologist understanding how external environmental chemicals affect the brain, and now as a Parkinson's researcher, figuring out what he can do about it.

- Some people think that, you know, it's an idea that's not gonna work.

We ask the question, "Unless you test it how do you know?"

(gentle synth music) - And now to our final story.

Exercise is very beneficial for people with Parkinson's.

But in the case of one woman, (ping pong ball tapping) ping pong has been much more than that.

It's a community that has carried her to the National Championships.

(intriguing music) (knife scoring) (knife knocking) - [Linda] Always tried to kind of eat healthy anyway.

- [Jaye] A health conscious, lifelong athlete- - It's basically like a Mediterranean diet.

- [Jaye] Linda Bramhall remembers how her Parkinson's symptoms began.

- Probably the tremors.

That's probably the classic symptom.

I had tremors in my leg and then in my hand and arm.

Another thing that I have is they call dystonia and it's like a tightness of the muscle and I have that in the left arm and hand, and it just kind of, it's just like if you get in a real tight grip and you can't let it go.

Sometimes it can be, you know, almost like a violent kind of a shake.

- [Jaye] At 67, six years into the disease, medication controls her tremors.

She's doing well and she also gives credit to a video she watched one year into her diagnosis.

- My name is Nenad Bach.

- That's how I found out was from watching one of his videos.

(upbeat acoustic music) ♪ If I had another life ♪ - [Jaye] Nenad Bach, a Croatian musician diagnosed with Parkinson's, had found something that helped him.

- He had Parkinson's and he had not been able to pick up his guitar and play again or perform.

Probably after maybe a year or I think is what he said of playing table tennis, he started being able to perform again.

(bat and ball tapping) - [Jaye] Bach helped to found Ping Pong Parkinson, a nonprofit to help people with Parkinson's through ping pong.

There are chapters around the world, including nine states in the US.

And Linda Bramhall plays at the only ping pong Parkinson chapter in Georgia, the Atlanta Georgia Table Tennis Association at Lucky Shoals Park in Norcross.

- If I hadn't seen his video, I would not be here, probably.

It has helped me to stay more mobile.

It's helped with balance, coordination, reflexes, just a general overall sense of vitality, I think.

When you have Parkinson's and you, especially if you look at people with Parkinson's, you feel frail and you can feel, weak, I guess.

But playing ping pong, or table tennis is what a lot of people call it, it's kinda the exact opposite of being frail and weak.

- [Jaye] 17-year-old Ryan Dong and a friend whose grandmother was diagnosed with Parkinson's approached the head of Atlanta, Georgia Table Tennis, Brian Crisp, to ask if he could host a chapter for Ping Pong Parkinson.

- We started the organization and we obviously came to Brian hoping for a ping pong facility place and he graciously allowed us to use his facility for no charge.

- [Brian] As you know, about two years ago, we started the Ping Pong Parkinson's Atlanta branch.

- [Jaye] It's a lively place.

- What the heck?!

(opponent laughs) - Anywhere from beginners up to about intermediate.

But over here you'll find very experienced players.

I've got people from France, Poland, and Russia.

- [Jaye] The two days a week the association rents the gym, it is packed!

- [Ryan] You make friends.

I've made a lot of friends in table tennis.

- I'm ready.

- [Ryan] It gets very competitive.

(ball smashes) - No!

- So when you tighten, your shoulder will go up.

You don't want that, you want to loosen, just elbow.

- [Jaye] Linda plays with coaches and friends and other people with Parkinson's.

Ping pong is thought to be beneficial because it's a combination of aerobic exercise, hand-eye coordination, balance, cognitive stimulation and social interaction.

While exercise is recommended for Parkinson's patients, certain sports have grown in popularity, such as non-contact boxing and even dance.

- [Dance Instructor] Alright, everyone, when you get a chance, grab a partner and start dancing.

- [Jaye] We featured research about how learning tango is beneficial for Parkinson's patients.

- Am I messing up too much?

- No, we're doing great.

(light tango music) - [Linda] No, he's an exceptionally good player.

- [Jaye] Linda and her significant other Emil play in their basement.

- [Linda] He has played for, I believe 40 years.

He's done some coaching in the past so he knows how to teach.

(ball rattles) - [Jaye] She's worked tirelessly to improve her game.

- [Linda] I'm getting a lot of work on coordination, reflexes, balance.

- [Jaye] Back at the Atlanta Georgia Table Tennis Association- (PA booms) - Linda, Linda Bramhall.

Linda's going to be playing in the Parkinson's of America event at the US Nationals in Huntsville.

Next month.

(attendees applaud) And Linda, AGTTA is proud to sponsor you for your trip.

- [Jaye] Linda is heading to the USA Table Tennis Nationals in Huntsville, Alabama to compete in the Parkinson's of America Championship.

- She's got some tough competition.

I know several of the people that are in it and they're hard, they're hard players.

(ball patters rhythmically) - [Jaye] Linda didn't take up ping pong with thoughts of being a champion.

She did it to try to slow a progressive disease.

- There's no question I would probably have progressed with my disease a lot faster if it weren't for ping pong, table tennis.

(ball whacking rhythmically) - [Jaye] As for that tough competition awaiting her at nationals, Linda keeps playing the sport that has helped her, practicing in her basement and at the gym.

- You know what it's like, I guess being kind of a southern woman, you're supposed to be nice and not mean to people.

And it's kind of hard to make yourself be kind of aggressive and go for the kill shot.

So kind of had to gradually work my way up to being that kind of a player.

- [Jaye] Linda is playing Bob Bolander from Alabama.

He's a bit of a legend in the Parkinson's Division and Linda has never beat him.

- Your serve.

4-4.

- [Jaye] He beat her twice while using a walker.

(Emil talks quietly, indistinctly) - [Jaye] With Emile coaching, Linda gains momentum.

- [Umpire] 5-6.

- [Jaye] They're playing best of five games.

Whoever gets to 11 first by two points wins the game.

(ball pattering) - It hit me.

(spectators groan) - [Umpire] 11-9.

Game and match to Linda.

- [Jaye] For the first time, Linda beats Bob in four games.

Now to the final.

Linda plays John DiPasquale from Oregon whom she has never played before.

Six years into a diagnosis, five years into a sport she took up to help stave off decline- (spectators applauding) Linda wins, beating John in three games, becoming the Parkinson's Division Champion at Nationals.

- This is the first tournament I've ever seen you play in.

- [Jaye] Linda's daughter and her family are there.

- This is awesome.

I couldn't even sit down.

I was like stressed out.

- Aw, I appreciate it.

So... Well, all of your support meant a lot.

- [Jaye] She's the champion.

A humble one.

- I thought I would probably choke.

- [Jaye] We asked how it felt to win.

- (tearfully) I'm trying to figure that out.

(Linda sighs) It's not just a win for me.

I think it's a win for everybody who has Parkinson's.

I'm gonna tell you something, I do the ugly cry.

(both chuckling) So it's the, the win over the mind, I guess.

I'm just gonna keep on going, keep on playing.

(ball patters rhythmically) - And that's gonna do it for us this week.

See you next time on "Your Fantastic Mind."

(upbeat electronic music) (upbeat electronic music continues) - [Announcer] Your Fantastic Mind: brought to you in part by Sarah and Jim Kennedy.