Practice Parameter: Neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review)

[Farooqji]

Results and conclusions: 1. Levodopa does not appear to accelerate disease progression. 2. No treatment has been shown to be neuroprotective. 3. There is no evidence that vitamin or food additives can improve motor function in PD. 4. Exercise may be helpful in improving motor function. 5. Speech therapy may be helpful in improving speech volume. 6. No manual therapy has been shown to be helpful in the treatment of motor symptoms, although studies in this area are limited. Further studies using a rigorous scientific method are needed to determine efficacy of alternative therapies.

n.neurology.org/content/66/...

[WinnieThePoo]

Interesting. Very much a hard line conventional take on evidence and proof, but probably confirming my thoughts about a lot of anecdotal therapies. It emphasises the high-bar set for new drug therapies, and reinforces my concern that the conventional assessment techniques are not appropriate to a complex condition with multiple symptomatic variations, and possibly multiple causes. The likes of Exanatide should probably be making it through to clinical practice.

For things like B1, and microbiome change (which it didn't really detect) it doesn't mean the treatment doesn't work, it just means no proper study has been carried out which demonstrates, according to conventional medical trial standards that it works. The same could be said of Captain Cooks innovation of giving his sailors limes to prevent scurvey. For over 200 years there was no medical trial (or proper scientific explanation) which meant the "alternative therapy" was "unproven". But for 200 years sailors stopped dying of scurvey (which is leaky blood vessels due to vitamin C deficiency)

However, I still feel a lot of "alt" is probably due to (a very real) placebo effect. Whilst many helpful ideas are presented, nothing is fundamentally changing the pathology of PD over the long term

(Ducks behind sofa, as Roy, Art and the rest of the B1 gang swing into action)

[GymBag]

YEP that looks about right.

I have no ducks behind my sofa . There is a chipmunk that gets into the drawer where we keep the peanuts and a pair of Black Birds nesting in the attic but no ducks .

[MBAnderson]

WARNING! You have much better things to do than to read this. For example, you might pick lent out of your navel. (Even if it wasn't from 2006 and even if any of their conclusions weren't based on an insignificant number of abstracts, in some cases 1 or 2, the thing is rife with ignorant statements.)

[WinnieThePoo in reply to MBAnderson]

Good spot on the 2006. RTFQ Winnie, RTFQ.

[MBAnderson in reply to WinnieThePoo]

I'm dying to know -- what is RTFQ?

[WinnieThePoo in reply to MBAnderson]

It's the exam mantra I drilled into my kids. It stands for "Read the F***ing Question"

[Icequeen10 in reply to WinnieThePoo]

This the best ever!

[park_bear in reply to MBAnderson]

Thank you for saving me the time!

[MBAnderson]

Ha. Only another professor would know that.

[Gioc]

ha ha Very interesting Iqbal, a little mischievous of you to publish an article of April 2006 in April 2019. 😊

Much has been written since then on vitamins, not only on b1 but also on B3 and D3 that are not taken into consideration. However I find worrying that after 13 years of not having a precise biomarker of PD progression that I would find immensely useful both in research and in early diagnosis. Interesting the answer to question n. 1 in which it would seem that even the datscan is valid only in diagnostic terms, but unreliable as a measurement of progression, if I understand correctly. The rest is negligible.

[MBAnderson in reply to Gioc]

Iqbal just posted that as a test -- to see who's sleeping.

[Farooqji in reply to MBAnderson]

I knew that the article is old , but it's worth reading (whether you agree or disagree ) . Science and research do not get old. I have read about some stuff that was quite old and rejected by the then scientific community, but got acknowledged after decades and even centuries. I had picked the link from yoga international website where they had referred to it to strengthen their point of view regarding alternative therapies

yogainternational.com/artic...

[MBAnderson in reply to Farooqji]

Iqbal, you post a ton of really valuable information all the time and I for one really appreciate your effort. I am healthier because of information you provided.

As far as "science and research not getting old" I'm certain you would agree that conventional scientific wisdom is altered and reversed all the time and I think over the past 13 years there has been a fair amount of new knowledge regarding alternative and complementary therapies.

The author of the study concludes, "Alternative therapies are widely used by patients in PD treatment. Few studies are available to demonstrate safety or effectiveness of these treatments, exposing patients to the possibility of ineffective or possibly harmful treatments." which I believe you would agree is false. Everything a PWP does or takes to reduce inflammation is beneficial.

Apparently, the author of the study, and every other scientist involved, except one, take money from the pharmaceutical industry.

"Disclosure.

Dr. Suchowersky has received consulting fees from Teva, speaker fees from GlaxoSmithKline, and research funds from Boehringer Ingelheim, Kyowa, Merck, Amarin, Cephalon, Swartz-Pharma, and Solstice Neuroscience. Dr. Reich has received research funds from Guilford Pharmaceuticals and Cephalon. Dr. Perlmutter has received unrestricted educational funds from Medtronic. Dr. Zesiewicz has received consulting fees from UCB Pharma and Schwartz Pharma, speaker fees from Boehringer Ingelheim, GlaxoSmithKline, Novartis and Medtronic, and research funds from Boehringer Ingelheim, GlaxoSmithKline, Novartis and Merck. Dr. Weiner is a consultant for Teva, a speaker for Boehringer Ingelheim, and has received research funds from Boehringer Ingelheim and Teva. Dr. Gronseth has nothing to disclose."

They drew their conclusions about question #1 based on 11 studies and question #2 was based on 22 studies and some sub-conclusions were based on 1 or 2 studies -- hardly a meta-analysis.

Again, thank you for all you do, but based on the age, the conflicts of interest and the skimpy data, this analysis has no value for me.

Marc

[Farooqji in reply to MBAnderson]

thanks for the detailed analysis. I agree that doctors and big pharma lay in same bed. Cannot deny that! !!

[kalyan48]

any review of qigong based protocols - like Howard Shiffke.s recipe for recovery or Bianca moley's ( sorry spelling ) methods or Dr.HADDOCK'S recovery project

[Despe]

"Based on one Class IV study, the benefit of chronic use of M pruriens cannot be determined. . ."

Sorry folks, no double-placebo study effects. . .only 3,000 years use and results.

[Hikoi]

Thanks Iqbal

Interesting and useful. It is a report by American Academy of Neurology. I wonder when/if it has been updated. I guess there is little change with no neuro protective substances yet available.

[Gioc]

This is the problem!