After SPECT scans, PPFG diagnosis changed to PSP or CBD

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In this recently published Italian paper, the imaging records of 13 patients diagnosed with PPFG (primary progressive freezing gait) were evaluated. Four of the patients had their diagnosis changed to PSP after the SPECT imaging scan (using a dopamine transporter) was found to be “abnormal,” and two patients with a “normal” scan had their diagnosis changed to CBD. In the US, SPECT scans are not widely available.
The abstract is below.
Robin

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Parkinsonism & Related Disorders. 2012 Mar 27. [Epub ahead of print]

Nigro-striatal involvement in primary progressive freezing gait:
Insights into a heterogeneous pathogenesis.

Fasano A, Baldari S, Di Giuda D, Paratore R, Piano C, Bentivoglio AR,
Girlanda P, Morgante F.
Istituto di Neurologia, Università Cattolica del Sacro Cuore, Roma,
Italy; Department of Neuroscience, AFaR-Fatebenefratelli Association
for Biomedical Research, “San Giovanni Calibita-Fatebenefratelli”
Hospital, Isola Tiberina, Rome, Italy.

Abstract
Primary progressive freezing gait (PPFG) is a clinical syndrome
underlain by diverse neurodegenerative diseases and characterized by
early occurrence of gait freezing. Either degeneration or integrity of
the nigrostriatal terminals have been found by SPECT and PET studies.

In this retrospective study, we evaluated (123)I-FP-CIT SPECT findings
in a consecutive series of 13 PPFG patients with detailed clinical
evaluation over time (mean follow-up duration: 3.1 ± 1.2 years). In
all patients, (123)I-FP-CIT SPECT has been performed at the time of
first clinical evaluation (1.7 ± 1.4 years after disease onset) and
was compared with data from 23 age- and sex-matched healthy subjects.
PPFG patients were categorized as having abnormal (n = 8) or normal (n
= 5) SPECT.

At disease onset, PPFG with abnormal SPECT had more frequent
hypophonia, higher UPDRS-III scores and partial levodopa
responsiveness. By contrast, PPFG with normal SPECT had more frequent
bilateral plantar responses and no response to levodopa.

At latest follow-up, initial diagnosis in the abnormal SPECT group was
revised (n = 5) to progressive supranuclear palsy (n = 4) and pure
akinesia with gait freezing (n = 1).

Among the five patients with normal SPECT, follow-up evaluation
disclosed corticobasal syndrome (n = 2) and primary lateral sclerosis
(n = 1). Dopamine transporter imaging can capture the clinical
heterogeneity of PPFG and might have a value to predict possible
disease progression.

Copyright © 2012 Elsevier Ltd. All rights reserved.

PubMed ID#: 22459564 (see pubmed.gov for the abstract only)

Study Says DNA’s Power to Predict Illness Is Limited

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This interesting article in today’s New York Times says that a recent study of twins indicates that knowledge of a “every aspect of a person’s DNA” cannot predict the diseases in that person’s future nor could that knowledge “forestall the otherwise inevitable.”

See:

www.nytimes.com/2012/04/03/health/research/dnas-power-to-predict-is-limited-study-finds.html

Study Says DNA’s Power to Predict Illness Is Limited
New York Times
By Gina Kolata
April 2, 2012

Robin

Using bidet toilets or seats for older people (NYT)

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The New York Times has a blog called “New Old Age.”  In a recent blog
post, the author mentions the use of bidet toilets “as a safer and more
effective way for the elderly to clean themselves.”

The author notes that the idea is to use a “bidet toilet” rather than a
free-standing bidet.  Here’s the description:
“A bidet toilet has a wand under the seat that moves into
position and sprays warmed water over the perineal area;
some also come equipped with warm-air dryers. More practically,
for those not interested in major plumbing investments, bidet
seats can be installed atop existing toilets.”

A variety of possible benefits are mentioned.  The author notes that
nothing has been proven.

Here’s a link to the blog post:

newoldage.blogs.nytimes.com/2012/03/27/begin-the-bidet

Begin the Bidet
New York Times
By Paula Span
March 27, 2012, 3:32 pm

Robin

“When Medicine Gets Personal: The DIY Clinical Trial”

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This is an interesting post to the Health Blog of the Wall Street Journal (wsj.com).  It’s about an article in the journal Personalized Medicine about the do-it-yourself (DIY) science movement.  The journal article, written by Melanie Swan (melanieswan.com), lays out seven steps to “accelerating the professionalization” of do-it-yourself studies by laypeople.

Here’s a link to the WSJ blog post:

blogs.wsj.com/health/2012/03/30/when-medicine-really-gets-personal-the-diy-clinical-trial/

Health Blog/WSJ
When Medicine Really Gets Personal: The DIY Clinical Trial
By Amy Dockser Marcus
March 30, 2012, 3:38 PM

And here’s a link to the article in Personalized Medicine:

www.futuremedicine.com/doi/abs/10.2217/pme.11.97

Good luck to all your lay researchers!

“You’re Looking at Me Like I Live Here and I Don’t” – New film

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The New York Times has a blog called “New Old Age.”  In a recent blog post, a new film
titled “You’re Looking at Me Like I Live Here and I Don’t” is described.

The film, shot in April 2009, stars Mrs. Lee Gorewitz, who lives in a dementia unit
at a care facility in Danville, CA.  The film is basically a picture of dementia from
the inside out.  It will air on PBS stations tonight (March 29) in San Francisco.

The blog post notes:

“Mostly, the camera follows her wanderings through the unit, her
interactions with other residents and staff, her sudden swings from
conviviality to despair to anger. We hear the background noise and
conversation, if you can call it that, of residents and aides. Family
members are never in the frame. We are there only to the extent Mrs.
Gorewitz is. What she cannot tell us, we don’t know. … The title of the
film is simply something Mrs. Gorewitz said one day, sitting at the
edge of her bed, not far from tears and playing with a bunch of small
stuffed animals.”

Here’s a link to the blog post:

http://newoldage.blogs.nytimes.com/2012/03/28/dementia-from-the-inside

Dementia, From the Inside
New York Times
By Jane Gross, Founding Blogger
March 28, 2012, 8:19 am

Sounds like a very powerful movie….

Robin