♪ ♪ >> WHAT DO ACTOR MICHAEL J.

FOX, MAJOR LEAGUE BASEBALL PLAYER BEN PETRICK, NBA PLAYER BRIAN GRANT AND SINGER OZZY OSBOURNE HAVE IN COMMON?

THEY ALL HAVE PARKINSON'S DISEASE.

STAY WITH US AS WE TALK WITH Dr. ZAIN GUDURU ABOUT PARKINSON'S DISEASE.

NEXT ON "KENTUCKY HEALTH."

♪ S >> WHEN WE HEAR THE WORDS PARKINSON'S DISEASE, WE IMAGINE A PERSON WITH TREMORS AND SHAKES.

HOWEVER, THERE IS PERHAPS NO GREATER IMAGE THAN THAT OF THE BOXER AND HUMANITARIAN MUHAMMAD ALI RAISING HIS TORCH TO LIGHT THE OLYMPIC FLAME.

MOST PEOPLE DIAGNOSED WITH PARKINSON'S ARE OVER 60.

HOWEVER IN SOME CASES, THE SYMPTOMS OF THE DISEASE MAY HAVE BEEN PRESENT 10 TO 20 YEARS PRIOR TO THE DIAGNOSIS BEING MADE.

THE MOST COMMON SYMPTOMS ASSOCIATED WITH PARKINSON'S DISEASE ARE RELATED TO MOVEMENT, PATIENTS CAN OFTEN COMPLAIN OF SLEEP DISTURBANCES AND LOSS OF SMELL.

PERHAPS ONE OF THE MOST INSIDIOUS COMPLICATIONS OF PARKINSON'S DISEASE ARE COGNITIVE CHANGES INCLUDING LOSS OF MEMORY, CHANGE IN ATTENTION AND THE INABILITY TO ACCOMPLISH SPECIFIC TASKS.

TO DISCUSS THE CAUSES, SYMPTOMS, DIAGNOSIS AND RELATED TREATMENTS OF PARKINSON'S DISEASE, WE HAVE OUR GUEST Dr. ZAIN GUDURU.

Dr. ZAIN GUDURU IS A GRADUATE OF THE RANGARI MEDICAL COLLEGE IN INDIA, COMPLETED A RESIDENCY IN NEUROLOGY AT ALLEGANY HOSPITAL AND FOLLOWED BY A FELLOWSHIP FOR MOVEMENT DISORDERS IN AUGUSTA GEORGE.

HE IS AN ASSOCIATE PROFESSOR AT THE DEPARTMENT OF NEUROLOGY COLLEGE OF UNIVERSITY OF KENTUCKY AND STAFF OF NEUROSCIENCES INSTITUTE.

THANK YOU FOR BEING WITH US.

>> THANK YOU FOR HAVING ME IN THE STUDIO.

>> I HOPE IT'S NOT A SIGN OF PARKINSON'S BUT I FEAR I DID NOT DO JUSTICE TO THE NAME OF YOUR MEDICAL SCHOOL.

>> THAT'S OKAY.

>> HOW IS IT PROPERLY SAID.

>> IT'S CALL RANGARIA.

>> WHEN WE TALK ABOUT PARKINSON'S, IS THAT A DISEASE ENTITY BY ITSELF?

OR IS IT A PART OF A CONSTELLATION OF PROBLEMS?

>> RIGHT.

SO PARKINSON'S DISEASE, WE THINK THAT PROBABLY THE WORD DISEASE IS A MISNOMER.

THE BIGGER PICTURE, IT IS A SYNDROME WHERE THERE ARE MULTIPLE SYMPTOMS, WHICH CAN COME UNDER THAT UMBRELLA IN MULTIPLE DIFFERENT AREAS OF THE NERVOUS SYSTEM CAN BE AFFECTED AND EVERY PERSON MANIFESTS DIFFERENTLY WITH THE SYMPTOMS AND PROGRESS DIFFERENTLY.

I THINK IT'S A BIGGER UMBRELLA TERM, PARKINSON'S SYNDROME PROBABLY WOULD HAVE BEEN THE BETTER TERM.

>> WHAT ARE SOME OF THE OTHER THINGS THAT COME UNDER THIS BROAD SPECTRUM OF SYMPTOMS?

>> SO IS AWE JUST MENTIONED, THE COMMON SYMPTOMS, WHICH COME WITH PARKINSON'S, MOTOR SYMPTOMS LIKE SHAKING, TREMOR, SLOWNESS IN MOVEMENTS, WALKING, STIFFNESS OF MUSCLES AND OVER TIME, THEY CAN HAVE BALANCE PROBLEM WHEN THEY'RE WALKING.

IN ADDITION TO THIS, THEIR AUTONOMIC NERVOUS SYSTEM CAN BE AFFECTED WHICH CAN LEAD TO DIZZINESS, LIGHTNESS, CONSTIPATION OR URINARY PROBLEMS, SWELLING.

COGNITION CAN BE AFFECTED.

SOME PEOPLE MIGHT PROGRESS INTO COGNITIVE IMPAIRMENT OR DEMENTIA IN ADDITION, SOME PEOPLE CAN HAVE HALLUCINATIONS OR DELUSIONS WHICH WE CALL PSYCHOSIS.

AGAIN, ONE POINT I WANT YOU TO REMEMBER HERE IS EVERY PERSON MANIFESTS DIFFERENTLY.

NOT EVERY PERSON WILL PROGRESS TO HAVE ALL THESE, WHICH I JUST MENTIONED.

>> I'M GOING TO GO BACK JUST A BIT.

TREMORS IS A SIGNIFICANT PART OF PARKINSON'S, BUT DISEVERYONE WHO HAVE TREMORS HAVE PARKINSON'S AND IF NOT, WHAT ARE SOME OF THE OTHER CONDITIONS?

>> RIGHT.

SO TREMOR IS THE MOST COMMON PRESENTING SYMPTOM BY THE PEOPLE WHEN THEY COME TO THE NEUROLOGIST.

AND OUR HISTORY AND EXAM WILL HELP US DIFFERENTIATE WHAT EXACTLY IT IS.

THE TREMOR, WHICH HAPPENS IN PARKINSON'S IS USUALLY A RESTING TREMOR.

THAT MEANS A SHAKING THAT HAPPENS ESPECIALLY IN THE HANDS OR LEGS WHEN THEY'RE NOT DOING ANYTHING.

IN CONTRAST,A LITTLE MORE COMMON THAN THIS IS ACTION TREMOR.

THAT MEANS SHAKING THAT HAPPENS WHEN YOU ARE HOLDING A CUP OR HOLDING A PEN.

IF THAT KIND OF SHAKING IS A PRESENTING SYMPTOM, USUALLY IT FALLS UNDER A COMMON CONDITION CALLED ESSENTIAL TREMOR.

THAT SAID, THIS IS ONE OF THE IMPORTANT REASONS FOR REFERRAL FOR THE NEUROLOGIST OR MOVEMENT SPECIALIST TO TEASE THOSE APART AND COME UP WITH RIGHT CLINICAL DIAGNOSIS AND THE TREATMENTS ARE ABSOLUTELY DIFFERENT.

THE PROGRESS IS DIFFERENT.

NOW ONCE YOU COME TO A CONCLUSION THAT THIS IS PROBABLY PARKINSON'S, BASED ON SHAKING, WHICH IS HAPPENING AT REST AND SLOWNESS WHICH YOU NOTICE ON EXAM, THEN IT'S ALSO OUR JOB TO FIGURE OUT IS THIS IDIOPATHIC PARKINSON'S OR PRIMARY PARKINSON'S DISEASE IS IT BEING CAUSED BY SOMETHING ELSE; FOR EXAMPLE, A PERSON WHO IS ON ANTIPSYCHOTIC MEDICATIONS, THOSE CAN CAUSE A PICTURE WHICH LOOKS LIKE PARKINSON'S, AND WE CALL IT AS DRUG INDUCED PARKINSONISM.

I'M ESPECIALLY QUOTING THIS EXAMPLE BECAUSE THIS IS A TREATABLE CONDITION.

IDENTIFYING THIS AND IDENTIFYING THE CULPRIT MEDICATION AND WORKING WITH PSYCHIATRIST AND REMOVING THAT MEDICATION WITHIN THREE MONTHS THEY COME BACK TO THEIR BASELINE, HOW THEY WERE.

RIGHT?

SO WE SHOULD NEVER MEET THESE TREATABLE CONDITIONS.

THAT'S JUST ONE EXAMPLE.

SOMETIMES THE SECONDARY CAUSES CAN BE ENDOCRINE CAUSES, SOMEONE MAYBE HAD A STROKE IN THE PAST THAT CAN CAUSE PARKINSON'S-LIKE PICTURE.

THE PHYSICIAN IS THINKING ALL THESE IN THE BACKGROUND.

IS THIS PARKINSON'S-LIKE?

IT IS PARKINSON'S-LIKE, IS IT PARKINSON'S DISEASE OR A LOOK ALIKE CONDITION.

SO IN THIS JOURNEY, CLINICAL DIAGNOSIS IS IMPORTANT.

SOMETIMES THE BLOOD TESTS AND THE BRAIN SCANS MIGHT BE HELPFUL.

>> I MUST ADMIT, JUST THE OTHER DAY I WENT TO SEE MY YOUNG LADY WHO CUTS MY HAIR, TAISHA.

I WAS LOOKING AT HER HANDS.

SHE IS VERY SKILLED.

BUT I WAS LOOKING AT HER HANDS BECAUSE I PREPARED FOR THIS, LOOKING TO SEE IF SHE HAD TREMORS.

SHE IS A YOUNG PERSON.

DO YOUNG PEOPLE GET PARKINSON'S DISEASE?

>> RIGHT, AGAIN IS PARKINSON'S DISEASE IS MORE COMMON ABOVE AGE 60.

WHENEVER YOU SEE A PERSON WITH THESE SYMPTOMS, THE SHAKING BELOW AGE 50, INSTEAD OF JUMPING TO THE DIAGNOSIS OF PARKINSON'S, HAVE YOU TO THINK ABOUT ALTERNATE DIAGNOSIS, TOO?

THAT'S WHERE THE HISTORY AND EXAM HELP.

ESSENTIAL TREMOR, WHICH IS A COMMON CONDITION IS STILL OUT THERE THAT WE HAVE TO THINK.

TO ANSWER YOUR QUESTION, DOES PARKINSON'S HAPPEN IN YOUNG INDIVIDUAL?

THE ANSWER IS YES, BUT NOT COMMON.

RIGHT?

JUST TO GIVE YOU AN EXAMPLE.

YOU MENTIONED EARLIER MICHAEL J.

FOX.

HE HAD PARKINSON'S DIAGNOSIS EARLY ON IN HIS LIFE.

AND THIS ESPECIALLY HAPPENS WHEN THERE IS A GENETIC COMPONENT.

GENETIC MUTATION.

VERY COMMON TO HAVE ONE GENE MUTATION RELATED TO PARKINSON'S DISEASE THAT MANIFEST SYMPTOMS BEFORE THE AGE OF 40 AND THAT IS CALLED YOUNG ONSET PARKINSON'S DISEASE.

>> SO THERE IS A GENETIC COMPONENT TO A PERSON HAVING-- WHAT OTHER RISK FACTORS ARE THERE FOR THE DEVELOPMENT OF PARKINSON'S?

>> AS OF NOW, YOU KNOW, PARKINSON'S IS THOUGHT TO BE IDIOPATHIC CONDITION.

WE DO NOT KNOW THE EXACT PATHOLOGY OF THIS.

THE POSSIBLE-- AND WE DON'T KNOW THE CAUSES LIKE EXPOSURE TO CHEMICALS CALLED MTPT OR PESTICIDES.

>> FARM WORKERS MAY BE EXPOSED?

>> OR CERTAIN WORKERS MANGANESE EXPOSURE.

IT CAN CAUSE PARKINSON'S PICTURE.

THOSE ARE EXAMPLES OF ELEMENTAL EXPOSURE.

I MENTIONED THE GENETIC COMPONENT, JUST TO GIVE YOU NUMBERS ROUGHLY ABOUT 10 TO 20% OF THE PEOPLE CAN HAVE FAMILY HISTORY WITH POSITIVE GENETIC TESTING.

AND THE THIRD ONE, AS I MENTIONED, AGE IS ALSO ONE OF THE RISK FACTORS, USUALLY THE SYMPTOM MANIFESTATION OF ABOVE 860 AND THE INCIDENTS AND THE PREVIOUS DENSE INCREASES AS YOU ADVANCE WITH AGE.

>> WITH ALL THE ATTENTION BEING PAID TO CONCUSSIONS AND MULTIPLE BLOWS TO THE HEAD, IS BOXING AND FOOTBALL, ARE THESE AT RISK FOR DEVELOPMENT OF PARKINSON'S DOWN THE ROAD OR DO YOU SEE OTHER TYPES OF NEUROLOGICAL PROBLEMS.

>> MULTIPLE PAL CONCUSSIONS OR SOMEONE WHO HAS MULTIPLE BLOOD ACCUMULATED ON THE SURFACE OF THE BRAIN IN MULTIPLE REGIONS, THEY CAN CAUSE A PICTURE WHICH LOOKS LIKE PARKINSON'S AND CONCUSSIONS CAN ALSO BE A RISK FACTOR FOR PARKINSON'S DISEASE, TOO.

>> IS THERE A SEX PREDILECTION OR CERTAIN GROUPS.

>> SEX PREDILECTION HAVE BEEN CLEARLY DESCRIBED.

MEN ARE MORE AFFECTED THAN WOMEN WITH PARK PARKINSON'S DISEASE.

>> AGAIN, STILL THE SAME RISK FACTORS AND ALL THAT HOLDING TRUE?

>> THAT'S TRUE.

>> DIFFERENT ETHNIC GROUPS, NO DIFFERENCE THERE EITHER, I PRESUME?

>> I DON'T THINK THAT HAS BEEN STUDIED WELL YET.

>> YOU KEEP TALKING ABOUT THE HISTORY.

SO WHAT ARE YOU LOOKING FOR IN THE HISTORY?

IS IT SOMETHING THAT THE PATIENT TELLS YOU OR IS IT SOMETHING THAT FAMILY MEMBERS OR SOMEONE LIVING WITH THE PERSON TELLS YOU?

>> VERY GOOD QUESTION.

HERE, AS WE MENTIONED EARLIER, THERE CAN BE COGNITIVE PROBLEM.

IT IS VERY IMPORTANT THAT YOU OBTAIN HISTORY FROM THE FAMILY MEMBERS, TOO, BECAUSE THE PERSON MAY NOT HAVE NOTICED THAT SYMPTOM OR MAY NOT HAVE THOUGHT THAT THIS IS RELEVANT TO THE ONGOING PROBLEM.

SO THAT'S WHEN WE'LL HAVE TO EXTRACT THAT INFORMATION BY ASKING PERTINENT DETAILS.

NOW WHEN WE ARE TAKING THE HISTORY, IT'S IMPORTANT TO ASK ABOUT ALL THESE CARDINAL SYMPTOMS, AT THE SAME TIME ASKING WHICH SYMPTOM STARTED WHEN.

THAT WILL HELP US UNDERSTAND THE PROGRESSION OF THIS NEURODEGENERATIVE PROBLEM THAT WILL HELP US UNDERSTAND IF IT IS FITTING MORE INTO PARKINSON'S DISEASE OR A LOOK ALIKE CONDITION.

SO THAT PROGRESSION, FOR EXAMPLE, JUST TO GIVE YOU AN EXAMPLE, IF A PERSON HAS PARKINSON'S LIKE SYMPTOMS AT THE SAME TIME HAS GOT SIGNIFICANT COGNITIVE PROBLEM THAT STARTED EARLY ON IN THE DISEASE PROCESS AND THEY'RE PROGRESSING FASTER, PROBABLY THINKING ABOUT A LOOK ALIKE CONDITION CALLED LOUIE BODY DEMENTIA.

>> LOUIE BODY DEMENTIA.

>> THAT'S ONE EXAMPLE.

THAT HISTORY WILL HELP TEASE THIS APART.

>> GOTCHA.

WHAT DO YOU DO TO MAKE THE DIAGNOSIS?

IS THERE A SINGLE TEST OR SOMETHING YOU ARE LOOKING FOR, AHA, THIS IS PARKINSON'S?

>> UNFORTUNATELY THERE IS NO SUCH 100% SENSITIVE SPECIFIC TEST FOR THIS AND THAT'S WHERE, AGAIN, IT'S A CLINICAL DIAGNOSIS.

IF YOU NEED HELP OR ASSISTANCE, YOU MIGHT TAKE HELP OFF A SCAN CALLED DAT SCAN, WHICH CAN HELP IN THE RIGHT CONTEXT TO SEE IF IT FITS WITH PARKINSON PICTURE.

AGAIN, IT IS NOT 100% SENSITIVE OR SPECIFIC.

HAVE YOU TO USE IT IN THE RIGHT CONTEXT.

>> SO ONCE THE DIAGNOSIS IS MADE, WHAT IS THE GOAL?

IS THE GOAL TO CURE THE INDIVIDUAL OR ARE WE TREATING THE PERSON TO MAKE THEIR LIVES, THE QUALITY OF THEIR LIVES BETTER?

WHAT ARE YOU TRYING TO DO?

>> I FEEL THE FIRST IMPORTANT THING ONCE THE DIAGNOSIS IS MADE, SHOULD UNDERSTAND THAT ALL THE SYMPTOMS WHICH THEY'RE HAVING, THEY HAVE A NAME TO THAT.

THEY KNOW THAT THIS IS WHAT IS GOING ON.

THAT GETS A PEACE WITHIN OURSELVES RATHER THAN HUNTING FOR A PROBLEM.

HAVING A NAME WILL MAKE YOU UNDERSTAND WHAT ALL SHOULD YOU DO AT THE SAME TIME THINK ABOUT WHAT WHAT TO EXPECT AND WHAT IS THE PROGNOSIS GOING TO BE.

FROM PHYSICIAN AND PATIENT DISCUSSION STANDPOINT, THE MOST IMPORTANT THING WHICH WE TELL IS EXERCISE IS GOING TO HELP SLOW DOWN THE PROGRESSION.

>> EXERCISE.

>> EXERCISE IS GOING TO HELP SLOW DOWN THE PROGRESSION OF PARKINSON'S.

PARKINSON'S IS A SLOWLY PROGRESSIVE NEURODEGENERATIVE PROBLEM.

UNFORTUNATELY, WE DO NOT HAVE A MEDICAL OR A SURGICAL TREATMENT OPTION WHICH CAN STOP OR SLOW DOWN THE PROGRESSION OF DISEASE.

THE TREATMENTS WHICH WE HAVE AVAILABLE, WHICH INCLUDES MEDICATIONS, AND SURGICAL OPTIONS, ARE THERE TO HELP IMPROVE YOUR SYMPTOMS SO THAT YOU CAN HAVE BETTER QUALITY OF LIFE.

AGAIN, IN CONJUNCTION WITH THESE TREATMENT OPTIONS, YOU COMBINE THE REGULAR EXERCISE, IT IS GOING TO HELP YOU OVERALL OVER THE LONG RUN, TOO.

>> IF A PERSON COMES IN EARLIER RATHER THAN LATER-- WHEN I SAY EARLIER, WHEN THE SYMPTOMS ARE RATHER SUBTLE AND SOMEONE SKILLED SUCH AS YOURSELF OPPOSED TO LATER WHEN SOMEONE LIKE ME GOES AHA, THIS FITS PARKINSON'S.

IS THERE A DIFFERENCE IN WHAT YOU CAN DO, OR CAN YOU SLOW DOWN THE PROGRESSION OF THE DISEASE?

>> SO, AGAIN, UNFORTUNATELY WE DO NOT HAVE SUCH MEDICATION TO SLOW DOWN THE PROGRESSION.

THAT SAID, EARLY DIAGNOSIS IS IMPORTANT BECAUSE YOU KNOW, YOU CAN DO SOMETHING-- YOU CAN TAKE A MEDICATION.

YOU CAN INTERVENE AT THAT TIME SO THAT YOUR QUALITY OF LIFE IS GOOD.

YOU DO NOT HAVE TO SUFFER THROUGH THOSE SYMPTOMS.

AND IF YOU WAIT IN THE LONG RUN NOT GOING TO THE DOCTOR AND NOT GETTING THIS TREATED, YOU ARE BASICALLY LOSING THOSE IMPORTANT YEARS SO COULD YOU HAVE SPENT QUALITY OF LIFE, BETTER QUALITY OF LIFE AT THAT TIME.

THAT'S MY ANSWER AT THIS TIME.

HOPEFULLY IT WILL CHANGE IN THE NEAR FUTURE BECAUSE THERE IS A LOT OF RESEARCH GOING ON IN IDENTIFYING THE PEOPLE WHO MIGHT DEVELOP PARKINSON'S MOTOR SYMPTOMS IN THE NEAR FUTURE SO IDENTIFYING THEM EARLY ON, AND ALSO RESEARCH IS GOING ON HOW TO SLOW DOWN OR STOP THE PROGRESSION OF PARKINSON'S.

THERE IS A LOT GOING ON IN THIS SO HOPEFULLY WE'LL HAVE A GOOD TREATMENT, REVERSAL TREATMENTS IN THE NEAR FUTURE.

>> ARE THERE ANY MEDICATIONS THAT YOU BRING TO BEAR IN TREATING PATIENTS WITH PARKINSON'S DISEASE, EITHER, AGAIN, YOU SAID THERE IS NOTHING THAT IS GOING TO SLOW THINGS DOWN BUT WHAT ABOUT MANAGING SOME OF THE SYMPTOMS THE PATIENT HAS.

>> WHEN YOU TALK ABOUT SYMPTOMS, BROADLY, WE HAVE TO TALK ABOUT MOTOR SYMPTOMS AND NON-MOTOR SYMPTOMS, NOT RELATED TO MUSCLE OR MUSCLE ACTIVITY.

BOTH THESE SYMPTOMS, THE GOLD STANDARD TREATMENT AT THIS TIME EARLY ON IS MEDICATION CALLED CARDIDOPA.

IT CAME INTO THE MARKET IN 1967 AFTER EXTENSIVE RESEARCH.

>> YOU WEREN'T EVEN BORN THEN.

IT HAS REVOLUTIONIZED HOW WE TREAT.

THERE ARE MULTIPLE MEDICATIONS THAT WORK AROUND THE CHEMICAL IN THE BRAIN CALLED DOPAMINE.

DOPAMINE IS THE CHEMICAL PREDOM FAPTLY LOST, THE AUTO NEURONS ARE NOT PRODUCING THAT CHEMICAL IN THE BRAIN AND A LOT OF TREATMENT OPTIONS WHICH EITHER ARE INCREASING THE DOPAMINE LEVEL OR REPLACING THE DOPAMINE OR INCREASING THE BREAKDOWN OF THE DOPAMINE.

SO IN ADDITION TO THESE MEDICATION OPTIONS, RECENTLY THERE WAS A NEW DRUG WHICH WAS APPROVED, WHICH WORKED, ACTUALLY SIMILAR TO COFFEE.

>> REALLY?

>> YES.

IT'S ONE OF THE FDA APPROVED MEDICATIONS FOR PARKINSON'S, TOO I WAS TALKING ABOUT SURGICAL TREATMENT OPTION FDA APPROVED.

DEEP BRAIN STIMULATION SURGERY.

IT HAS BEEN FDA APPROVED SINCE 2002.

>> SO CAFFEINE MAY HAVE SOME BENEFITS, SO YOU CAN WRITE A PRESCRIPTION FOR SOMEONE TO GO TO THEIR LOCAL COFFEE SHOP TO GET A CUP OF JO AND THAT WILL MAKE THEM BETTER?

>> THE LITERATURE HAS CLEARLY SHOWN THAT CAFFEINE HAS BENEFITS WITH PARKINSON'S, AND THAT'S HOW-- THAT'S THE BACKGROUND BEHIND DESIGNING THE MEDICATION SO THAT WITH MEDICATION, YOU KNOW WHAT DOSE YOU SHOULD GIVE, WHAT TO EXPECT.

THAT'S THE BACKGROUND OF THE MEDICATION.

>> WHAT IS THE BACKGROUND OF THE MEDICATION BECAUSE IT'S NOT A ONE WAY STREET, IS IT?

>> SO VERY COMMON SIDE EFFECTS, WHICH WE EDUCATE THEM WHEN WE ARE PRESCRIBING THIS MEDICATION, ESPECIALLY I'M GOING TO TALK ABOUT CARBIDO.

IN THE IN I.R.S.

WEEK THEY COULD HAVE NAUSEA, VOM INTERESTING AND DIARRHEA.

THESE ARE SHORT LIVED SIDE EFFECTS.

AND IF THAT HAPPENS, WE TELL THEM TO TAKE THE MEDICATION WITH FOOD SO THAT THE CHANCE OF SIDE EFFECTS ARE LOWER, RIGHT?

IN ADDITION TO THIS ONE SIDE EFFECT WHICH IS CALLED DISKINEZIA.

THEY'RE DANCE TYPE MOVEMENTS THAT CAN HAPPEN AFTER YOU TAKE THE MEDICATION.

FOR EXAMPLE,YOU MIGHT HAVE SEEN MICHAEL J.

FOX, YOU KNOW, THERE ARE THESE EXTRA MOVEMENTS THAT ARE HAPPENING.

ONE POINT TO REMEMBER IS THIS PARTICULAR SIDE EFFECT, AS SOON AS YOU HAVE IT, YOU SHOULD NOT STOP THE MEDICATION.

YOU SHOULD NOT DECREASE THE MEDICATION BECAUSE THEY MIGHT BE MILD, OR THE PERSON WHO IS HAVING IT MAY NOT EVEN NOTICE THAT THAT IS HAPPENING UNLESS SOMEONE ELSE COMES AND TELLS THEM.

SO IT'S NOT ALWAYS BAD.

>> GOTCHA.

TELL ME THE CONVERSATION THAT YOU HAVE WITH THE PATIENT.

ONCE YOU MAKE THE DIAGNOSIS OF PARKINSON'S, WHAT DO YOU ADVISE LEM TO DO, DIETARY, EXERCISE OR WHAT THEIR LONG-TERM OUTCOME IS GOING TO BE?

WHAT IS THAT CONVERSATION LIKE?

>> RIGHT.

SO THERE ARE THREE THINGS WHICH WE FOCUS.

THE FIRST IS I START WITH REGULAR EXERCISE.

AND WHEN I SAY REGULAR EXERCISE, I'M TALKING ABOUT REGULAR WALKING, WHICH HAS PROVEN BENEFIT, BOXING, SWIMMING, ROCK STEADY BOXING AND RECOMMEND BIKING.

ALL THESE HAVE PROVEN BENEFIT.

SO THEY CAN CHOOSE ANY OF THESE AND DO IT REGULARLY.

2: FOR MEDICATIONS I JUST TALKED ABOUT, WE BRIEFLY INTRODUCED A CONCEPT OF SURGICAL TREATMENT OPTION.

IF NEEDED, WE'LL TALK ABOUT THAT IN THE FUTURE.

THE THIRD ASPECT IS TAKING HELP OF OUR COLLEAGUES, FOR EXAMPLE, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY.

THEY'RE SPECIALLY DESIGNED PHYSICAL THERAPY THERAPIES FOR PARKINSON'S, FOR EXAMPLE, THERE IS A THERAPY LSTB.

AND ANOTHER ONE CALLED POWER THERAPY.

THESE ARE DESIGNED FOR PEOPLE WITH PARKINSON'S.

WE LOOK FOR SUCH, YOU KNOW, THERAPISTS THAT ARE TRAINED IN THESE.

>> WHAT DO THEY DO?

>> BASIC CONCEPT IS IN PARKINSON'S YOU HAVE TO MAKE BIG AND WIDE MOVEMENTS.

IN THEM, THE TALK IS SLOWER WITH LOW VOLUME, LOW PITCH.

SO TRAINED TO TALK BIGGER, LOUDER THAN WHAT YOU NORMALLY TALK THAN THE NORMAL TALK COMES OUT.

THAT'S WHERE THE TRAINING IS.

AND THE THIRD ASPECT IS BALANCE TRAINING, TOO.

AS I TALKED, SOME PEOPLE CAN HAVE BALANCE PROBLEM.

THEY'RE GOING TO HELP YOU EDUCATE AND TRAIN YOU HOW TO PREVENT THOSE FALLS.

GOOD EXAMPLE FOR THAT IS MAKE WIDER TURNS WHEN YOU ARE TURNING AROUND.

DON'T TALK ON THE PHONE WHEN YOU ARE WALKING.

SO WE TAKE HELP OF OUR COLLEAGUES.

I THINK IT'S A COLLABORATIVE APPROACH WHERE WE HAVE TO WORK TOGETHER IN ADDRESSING THIS.

FINALLY, IN THE STATE OF KENTUCKY, THERE ARE MULTIPLE DIFFERENT REGIONS WHO OFFER SUPPORT GROUPS.

FOR EXAMPLE, IN LEXINGTON THERE IS BLUEGRASS PARKINSON'S ALLIANCE WHO RUNS A PARKINSON'S SUPPORT GROUP FOR FREE FOR PEOPLE FOR THE PEOPLE WITH PARKINSON'S AND THEIR FAMILIES.

THIS INCLUDES EDUCATION, THIS INCLUDES MULTIPLE EXERCISE SESSIONS, MUSIC THERAPIES, EVERYTHING IS OFFERED FOR FREE.

>> WHAT IS THE LONG-TERM LIFESPAN FOR PEOPLE WITH PARKINSON'S?

IS IT SHORTER THAN THE AVERAGE PERSON?

OR CAN THEY STILL LIVE A FULL ANTICIPATED LIFE?

>> NOW BEFORE I ANSWER THAT QUESTION, I WANT YOU TO THINK, YOU KNOW, IF A PERSON-- YOU MIGHT HAVE COMMONLY SEEN A PERSON DIAGNOSISSED WITH DIABETES.

THEY TAKE MEDICATIONS, LIVE HAPPY LIFE.

EVERYTHING IS GOING GOOD.

AS LONG AS YOU ARE TAKING THE TREATMENTS, YOU ARE HAVING BETTER-- SYMPTOMS ARE BETTER, BETTER QUALITY OF LIFE, THIS IS NOT GOING TO SHORTEN YOUR LIFE.

YES, THIS COMES IN SOME PEOPLE IT COMES WITH COGNITIVE PROBLEM OR PSYCHIATRIC SYMPTOMS.

BUT IT WILL NOT SUDDENLY, YOU KNOW, DEBILITATE YOU.

>> SO THERE IS NOTHING INHERENT WITHIN THE DIAGNOSIS ITSELF.

ARE YOU GUYS DOING ANYTHING SPECIAL DOWN AT U.K. WITH PARKINSON'S?

>> RIGHT, SO THERE IS A LOT OF RESEARCH, WHICH GOES ON AT UNIVERSITY OF ACCOUNT-- UNIVERSITY OF KENTUCKY, ONE THAT IS SURGICAL FOCUSED CALLED DB-PLUS.

WHEN WE ARE DOING THE SURGERY, WHERE WE PUT AN IMPLANT IN THE DEEP REGIONS OF THE BRAIN, RIGHT AROUND THAT TIME WE PUT A PERIPHERAL NERVE GRAFT IN THAT AREA OF THE BRAIN WHICH IS PRODUCING THOSE NEURONS.

AND THE IDEA IS IT RELEASES GROWTH FACTORS HELP PREVENT THE LOSS OF THOSE DOPAMINE NEURONS.

IN SUMMARY, THIS IS AN IDEA WHERE-- WHICH IS TO HELP SLOW DOWN THE PROGRESSION OF PARKINSON'S DISEASE.

IT'S ONE OF A KIND RESEARCH.

WHERE WE HAVE BEEN SUCCESSFUL WITH ANIMAL STUDIES, YOU KNOW, WITH HUMAN SUBJECTS, WE HAVE ENROLLED MORE THAN 80 PATIENTS AND WE ARE DOING GOOD WITH THAT.

THAT'S ONE.

SECOND, WE ARE ALSO DOING RESEARCH, WHERE WE ARE TRYING TO DO GENETIC TESTS FOR THOSE PEOPLE WHO ARE MANIFESTING WITH PREMOTOR PARKINSON'S SYMPTOMS, IDENTIFYING THEM EARLY ON OR PEOPLE WHO HAVE FAMILY POSITIVE FAMILY HISTORY AND IDENTIFYING THE GENES.

AND THE THIRD SET IS FOCUSING ON MEDICATION-RELATED RESEARCH PROJECTS, FOR EXAMPLE, WITH JUST DID A RESEARCH ON AN INFUSION WHERE THE SAME TABLET, IT CAN BE DELIVERED IN A DIFFERENT ROUTE.

AND THROUGH THE SUBCUTANEUS TISSUE, FOR EXAMPLE, YOU MIGHT HAVE SEEN INSULIN PUMP.

>> SAME KIND OF THING.

DOES IT LOOK LIKE IT MIGHT BE PROMISING?

>> IT IS AND JUST 10 DAYS AGO IT WAS FDA APPROVED, TOO.

>> SO THERE IS MORE THAN FOOTBALL GOING ON DOWN THERE AT THE UNIVERSITY OF KENTUCKY.

>> RIGHT.

>> I'M GLAD TO HEAR THAT.

THIS HAS BEEN VERY INTERESTING AND I APPRECIATE YOU COMING OUT AND TALKING ABOUT THIS BECAUSE PARKINSON'S DISEASE IS MISOOD BY A LOT OF US.

THANK YOU VERY MUCH FOR BEING WITH US AND THANK YOU FOR BEING WITH US TODAY.

WHILE PARKINSON'S DISEASE MAY BE A DIFFICULT SUBJECT TO DISCUSS, IT IS NONETHELESS AN IMPORTANT ONE TO UNDERSTAND.

WHILE THERE IS NO CURE AT THIS TIME, BUT AS WE HEARD THERE IS SOME GOOD RESEARCH GOING ON, WE MUST BE SENSITIVE TO THE SYMPTOMS AND SEEK OUT CARE AS SOON AS POSSIBLE SO THAT WE CAN PERHAPS SLOW THE PROGRESSION AND AFFORD THE BEST POSSIBLE QUALITY OF LIFE FOR THE PATIENT AND ALSO THE PATIENT'S FAMILY.

IF YOU WISH TO WATCH THIS SHOW AGAIN OR WATCH AN ARCHIVED VERSION OF PAST SHOWS, PLEASE GO TO WWW.ket.org/HEALTH.

IF YOU HAVE A QUESTION ABOUT THIS OR COMMENT ON OTHER SHOWS, WE CAN BE REACHED AT ket.org.

I LOOK FORWARD TO SEEING YOU ON THE NEXT "KENTUCKY HEALTH."

IF YOU HAVE QUESTIONS ABOUT SYMPTOMS, PLEASE SEE YOUR PRIMARY CARE PROVIDER AND REACH OUT TO YOUR NEUROLOGIST OR THE FOLKS AT UNIVERSITY OF KENTUCKY, KENTUCKY NEUROLOGY INSTITUTE.

THANK YOU.

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