Discover and read the best of Twitter Threads about #parkinsons

Most recents (24)

Sometimes, we doctors need to go beyond our duty of writing medicines

1. 75-year old Mr Reddy: "Dr, we just returned from Char Dham Yatra yesterday and we wish to thank you for enabling us do this Yatra, what seemed impossible for past 4 years. Here is some "prasadam" for you." twitter.com/i/web/status/1…
2. Mr Reddy had been consulting for #Parkinsons disease (PD) for the past 8 years. He was doing fairly well, however, his motor symptoms had worsened for the past 2 years. He walked slowly and tended to lose balance especially while turning. He had fallen twice in past 6 months.
3. Reddy couple had shared about their wish to undertake Char Dham Yatra in the past few clinic visits.
I had suggested that we adjust the medications and take help of physiotherapist (to improve balance, gait & strength).
About three months back, I had given the green signal.
Read 7 tweets
Shaking of hands: Essential tremor (ET) or Parkinson's disease (PD)

1. Shaking of hands (tremors) are common. The usual question among patients (and doctors) is what is the root cause- ET or PD?
Here I would highlight the clinical differences between the two.
#MedTwitter
2. ET affects both hands, whereas PD affects one hand (asymmetric ET- one hand more affected than other & unilateral ET- affecting only one hand can rarely occur).
If tremors remain confined to one hand for >3 years, one should look for structural brain disease (unusual for PD).
3. Tremor in ET is brought on by doing an activity (holding a cup of coffee or writing), whereas people with PD have resting tremors.
Tremors in ET can be better seen with outstretched arms and hands.
Tremors in PD can be better seen by distracting the patient (and observing).
Read 10 tweets
The “cure” not to die during acute phase SARS infection, is to have either full blown AIDS or already be persistent infected with SARS (both acquired lymphocytopenia)
There’s still going to be an accelerated aging of the immune system (immunosenescence) but death will be “WITH” mysterious and spontaneous LongSARS/#PASC and not death “FROM” SARS.
We discovered survivors of SARS infection had persistent infection well too late to really help improve their health and reverse immunity damage being caused by persistently infected renal epithelium cells.
Read 21 tweets
Have you ever heard of glutamate excitotoxicity? No? Well, settle in for a thread. You're going to need to know about this fascinating (and slightly scary) topic that's essential to understanding brain health. 🧵 (1/30)
Glutamate is an excitatory neurotransmitter. You need some constantly being released and taken up by neurons to keep the brain functioning. It is critical to properly function several brain pathways essential for mood and cognitive function. (2/30)
In the prefrontal cortex, glutamate signaling is necessary for executive functions like decision-making, working memory, and attention. When glutamate signaling is functioning properly, it's a very good thing! (3/30)
Read 30 tweets
Some of you are beginning to understand that to have a healthy brain that allows a good mood and rockin' cognitive function, you need to focus on mitochondrial function. Am I right? 🧵 (1/25)
Some pathways maintaining mitochondrial health include mitochondrial biogenesis, mitochondrial dynamics (fusion and fission process shaping mitochondrial morphology), and mitophagy—the process in charge of removing mitochondria through autophagy. (2/25)
Let's discuss the pathways that maintain mitochondrial health and then look at how ketogenic diets might influence those pathways to help you feel better. Shall we begin? (3/25)
Read 24 tweets
@MadhavThambiset was the voice of reason at the #AANAM. He delivered a Neurology Year in Review Plenary about the dubious record of the anti-proteinopathy framework inspiring therapies in #Alzheimers, #Parkinsons, and #ALS --Some highlights (1/4) Image
(2/4) Unblinding due to infusion-related reactions or ARIA-H was not accounted for in the sensitivity analysis of the #lecanemab trial. This and other issues have led to an inflated sense of efficacy and underestimated risk for anti-amyloid therapies. ImageImageImage
(3/4) What's the magnitude of brain loss induced by lecanemab over the course of the trial? 3 fewer "teaspoons" of brain lost at the highest ('therapeutic') dose of lecanemab. ImageImage
Read 4 tweets
Cognitive heterogeneity in Parkinson’s disease: A mechanistic view cell.com/neuron/fulltex…

Our thoughts on #synuclein strains, #Alzheimer pathology, and individual genetic and biomarker characteristics in why individuals with #Parkinson disease manifest so differently. 1/n
We review how cognition looks in #Parkinsons (short answer: lots of different ways in different people). We review treatment options for cognitive impairment in PD (short answer: not many). We argue that mechanistic focus is needed for better treatment options to emerge. 2/n
Mechanistically, we focus on cell-to-cell spread of pathological #synuclein (aSyn). We think evidence for aSyn spreading and for strains (conformations) of aSyn w different biological behaviors and subsequent cognitive consequences in aSyn diseases is strong. 3/n
Read 7 tweets
The blood-brain barrier (BBB) is a crucial defense mechanism for the brain, regulating the exchange of molecules between the bloodstream and the brain. When the BBB is disrupted, it can have severe consequences for brain health. (1/12)
Alzheimer's disease is one example of a condition that is exacerbated by BBB disruption. When the BBB is compromised, amyloid beta-peptide deposits can accumulate, leading to #inflammation and disruption of neuronal function. (2/12)
A disrupted BBB in #Alzheimers means astrocyte and microglia inflammation, disruption of synaptic transmission, and myelin destruction. (3/12)
Read 12 tweets
When cheque bounced due to signature mismatch

1. 48-yr old Venky was surprised when two of the cheques issued by him bounced due to signature mismatch. On enquiry with bank staff, he was shown his original signature, which did not match with the current one.
#MedTwitter
2. It was noted that letters in the later half of his signature had reduced in height (as compared to height in his original signature). The legibility of his writing too had reduced. He tried writing at home & similar thing happened- letters became smaller as he wrote sentences.
3. Venky decided to consult a Neurologist for evaluation. I reviewed his history.
He showed me his writing. Attached below are the samples- (above is normal, the one below is what his writing looked like).
I also observed mild shivering of his right hand, while he spoke to me. Image
Read 11 tweets
#COVID19 #CVD #MetabolicDisorder and #FlushNiacin (will need equimolar Glutamine w/ it) per Double-Blinded Randomized Placebo-Controlled Clinical Trials Evidence in Humans:

“This meta-analysis involved 2,110 patients with T2DM from 8 RCTs across a wide range of patients’… twitter.com/i/web/status/1…
^ High triglyceride to HDL-cholesterol ratio as a biochemical marker of severe outcomes in COVID-19 patients
clinicalnutritionespen.com/article/S2405-…

Low HDL and high triglycerides predict COVID-19 severity
nature.com/articles/s4159…

Triglyceride/High-Density Lipoprotein Cholesterol Ratio is… twitter.com/i/web/status/1…
^ "In our study, high niacin intake during lifestyle intervention was associated with a larger reduction of liver fat content without affecting insulin sensitivity"

“Among 58 subjects with nonalcoholic fatty liver disease (NAFLD) at baseline, NAFLD resolved in 23 subjects during… twitter.com/i/web/status/1…
Read 15 tweets
Thread Alert 🧵: Let's talk about Parkinson's Disease 1/25 #Parkinsons #neurotwitter
In 2005 there was this study that, although very small, showed benefits. "Unified Parkinson’s Disease Rating Scale scores improved in all five during hyperketonemia" 2/25
n.neurology.org/content/64/4/7…
It wasn't designed to rule out a placebo effect. But the result should have resulted in excitement and further studies being done. 3/25
Read 25 tweets
"Many neurological diseases, such as Alzheimer’s disease, Parkinson’s disease, epilepsy, bipolar disorder, schizophrenia, and major depressive disorder are characterized by cerebral glucose hypometabolism, 🧵
insulin resistance, neurotransmitter imbalances, mitochondrial dysfunction, oxidative stress, and inflammation as potential causative factors."
#Alzheimers #Parkinsons #epilepsy #Bipolar #Schizophrenia #depression
Read 4 tweets
A #runner who would #swing his left arm more than the right
1. I have been running outdoors for two years. Over a period of time, one gets familiar with fellow runners- specially their style, pace & endurance. This post is about one of those runners, who was a regular (like me)😆
2. He had one odd style- he would swing his right arm lesser than the left while #running or #walking.
He would continue in the same style for about 60-70 minutes of his #RUN.
His #pace was excellent- 60 minutes for a 10 km run.
#MedTwitter #neurotwitter
3. Our interaction was limited to "Good mornings".
Six months had passed since I first saw him. At this point, I noted that I could outpace him on a few occasions (I was much slower than him to start with).
I had started to think about possibility of a #neurological #disease.
Read 11 tweets
I’ve just finished reading “Just Wobbling Along: My First Five Years with Parkinson’s Disease” by @HMellorMac and can highly recommend it for all, especially healthcare professionals. #MedTwitter

Buckle up, cos it’s time for a book review! (1/11)

amazon.co.uk/JUST-WOBBLING-…
I’m going to reflect on the key themes that struck me on reading Helga’s account of her first 5 years with #Parkinsons. While not wishing to distract from the Parkinson’s context, I suspect some themes will strike a chord with people who live with other chronic conditions. (2/11)
Knowing something’s wrong; needing a diagnosis:

The journey through various suggested diagnoses. Depression. Functional Tremor. A growing sense that Functional Tremor doesn’t explain things. (It’s notable how many people with chronic conditions have a journey like that.) (3/11)
Read 11 tweets
A bipartisan bill that the @MichaelJFoxOrg is calling “the first-ever legislation solely devoted to ending #Parkinsons disease” has been introduced in the House by @RepPaulTonko and @RepGusBilirakis.
mcknightsseniorliving.com/home/news/firs…
The National Plan to End Parkinson’s Act (H.R. 8585) calls for the secretary of @HHSGov to carry out a national project to prevent and cure #Parkinsons, to be known as the National Parkinson’s Project. mcknightsseniorliving.com/home/news/firs…
If the National Plan to End Parkinson’s Act passes, @HHSGov would create a public-private advisory council that would report every year to Congress on its progress and impact on ending #Parkinsons.
mcknightsseniorliving.com/home/news/firs…
Read 5 tweets
Beyond ecstatic to share that our paper is finally out @CellCellPress!
It's been a while since I lastly highlighted the main findings, so here's a refresher for new and old readers with some new data added during the peer-review process (-18)
doi.org/10.1016/j.cell…
The background: roughly one base out of 3 in our genomes belongs to either an Alu or L1 repeat element. These are retrotransposons involved in a lot of cool things, here's an excellent primer if you want to know more about transposable elements (-17)
doi.org/10.1186/s13059…
However, our relationship with Alu and L1 is...well, complicated. For example, due to high identity of millions of copies, they can "confuse" the homology-based repair mechanism that fixes DNA double-strand breaks (DSBs) and cause non-allelic homologous recombination (NAHR) (-16)
Read 20 tweets
"I am Jamie Bryson, I just turned 40 years old in April of this year. In April of 2021, I was diagnosed with #YoungOnsetParkinsonsDisease (#YOPD). I am an endurance athlete. I regularly compete in #Ironman and other triathlon events, road cycling events, & mountain biking events.
I live in the Dallas area w/ my wife, 3 boys (ages 12, 9, and 4), and 2 dogs. In November 2021, shortly after my YOPD diagnosis, I also discovered that I had a mass on my kidney and underwent surgery to have it removed in December.
The mass was in fact cancer, but it was caught super early (by accident) so I did not need any further treatment beyond surgery, although I did have to return to the hospital a couple of weeks later with an internal bleed and had COVID at the same time.
Read 22 tweets
#2 B-COMPLEX/MULTI VITAMIN. Buy a liposomal or other form that increases bio-availability. Take 1 capsule w/Breakfast and Lunch. If you have stomach upset, try sublingual (under tongue) EZ Melt B-Complex in AM & Multi w/iron for Dinner. amazon.com/Liposomal-Meth…
#3 OMEGA 3s. Fish Oil, Krill Oil, Algae Oil are all good sources of Omega 3. Be careful the EPA/DHA ratio. EPA helps with inflammation/DHA helps with cognition. You need both! Opt for a 1:1 or 2:1 ratio of DHA to EPA (2:1 ratio eg. 800 DHA/400EPA) amazon.com/3Care-Concentr…
Read 93 tweets
Drug discovery for complex diseases like #Parkinsons (#PD) is challenging - we need screenable cellular phenotypes to move faster. Today in @NatureComms, we present an #AI-driven phenotyping platform that identifies #PD hallmarks in patient cells: nature.com/articles/s4146… 🧵(1/11)
By combining our cell culture #automation, #CellPainting, high-content imaging, and #DeepLearning methods, we built a robust platform for phenotypic profiling and collaborated with @GoogleAI to screen fibroblasts from 91 #Parkinsons patients and matched healthy controls (2/11)
We profiled images of nearly 6 million fibroblasts, creating the largest publicly available #CellPainting dataset to date at 48 terabytes (3/11)
Read 11 tweets
As some of you know im suffering weird #neurological symptoms atm. The last week has been pretty awful. One of the weirder symptoms is called micrographia: writing getting smaller and smaller.
↙️ My writing on Tuesday (bad not awful day)
My writing on Wednesday (awful day) ↘️ The words: corporate → research & development Location: coThe words: brief [blanked out] on extension Written in small
Micrographia in itself *can* be an early sign of conditions like #Parkinsons

In patients with Parkinsons, closing their eyes whilst writing can often help mitigate micrographia
(in my case the rapid onset followed by rapid improvement makes me think / hope its just whatever the fuck is going on with my neuro-immunology not a sign of whats to come...😬)
Read 5 tweets
"Knockdown of PTBP1 FAILS TO CONVERT brain astrocytes into neurons in vivo״ cell.com/cell/fulltext/…
Why is this negative finding of such interest? mainly because two recent high profile papers reported that PTBP1 knockdown converts glia to neurons to treat #Parkinsons Disease, see following links
Read 6 tweets
1) 🇬🇧 The 8 steps of UK #LongCovid prevalence research in a nutshell - By an upset parent.
1. Child suffers disabling symptoms for over 12 months
2. GP says it is health #anxiety and standard blood tests show nothing wrong, so there can not be anything wrong.
3. #Parent has been
2) using Zoe app, but gives up logging symptoms after x months as they can't see the point anymore. No one believes they are sick anyway
4. Child has disabling symptoms for over 12 months
5. GP says children don't get #longcovid as the @govuk has told them this
3) for the last 18 months. Parent and child both dismissed as "anxious". #Child never sees a #paediatrician as GP dismisses them & paediatricians, therefore, don't see many kids with #longcovid.
Read 7 tweets
$LOAC - SPAC for 4D Pharma (#DDDD) due diligence thread including:

✅Company overview
✅Product overview
✅Collaborations with major #pharma companies ( $MRK, $PFE, and Merck KGaA)
✅Key competitors
✅Pipeline and upcoming catalysts
𝘾𝙤𝙢𝙥𝙖𝙣𝙮 𝙤𝙫𝙚𝙧𝙫𝙞𝙚𝙬
4D Pharma (#DDDD) is a pharmaceutical company leading the development of a novel class of drugs derived from the microbiome (LBPs).🦠

Here is a quick overview of how 4D utilizes the microbiome for unique solutions. vimeo.com/249654919
#DDDD / $LOAC is leading the microbiome sector with:

✅More than 1,000 granted patents
✅Partnerships with several large biopharma companies (Merck, Pfizer, Merck KGaA) and in talks with others
✅Unique discovery platform of live biotherapeutic products (LBPs)
Read 35 tweets

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