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Explanation, please?

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Hi Barb,

Were you able to figure out what these things mean from the stuff I

posted yesterday?

Autonomic dysfunction is essentially orthostatic hypotension and bladder

problems. Extrapyramidal deficits lead to Parkinson's-like symptoms.

Cerebellar deficits lead to ataxia and balance symptoms.

For a diagnosis of " probable MSA " you need to show

autonomic + cerebellar OR

autonomic + extrapyramidal OR

autonomic + cerebellar + extrapyramidal

I posted some new research the other day by Dr. Kaufmann that talked

about the possibility that Pure Autonomic Failure, MSA and Parkinson's

are all variations of the same underlying disease process. I thought

that was quite an interesting concept and if it's proven right it would

mean that people with MSA actually belong under the Parkinson's

umbrella. Things seem to be moving more rapidly now on the research

front as they are making new discoveries every day. We already had

heard recently that people with Parkinson's, MSA and Lewy Body Disease

all have a protein called alpha-synuclein in their brain cells and

researchers were now lumping these disorders together and calling them

Synucleinopathies.

We should all support basic brain research because the breakthrough lies

there at the cellular level as researchers uncover the chemical

processes that regulate brain cell functions.

Hugs,

Pam

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Pam,

How realistic is the theory that SDS and Parkinson's might come under the Parkinson umbrella and is there any info indicating that treatment for Parkinson's might help with SDS? I know you're not a doctor and you've been on this site a long time as have I since Sylvia started it. I don't write much but I do observe letters that relate to the disease rather than personal and difficult experiences. I leave that to those who have the need greater than i. I just pass info on to my sister who is the caretaker for her husband who has been to Vanderbilt and has had the disease for 8 or 9 years now. Not getting any better at all, just a slow constant degradation in his health. You are really to be commended for doing what you are. Must be very time consuming.

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Pam,

Yes, I received your ex's and thank you so much. Haven't had time today to really sit down and digest them. I've been deluged with voting jokes from Florida and I'm going in for a sleep study tonight.

I'll get back to you in a few days if I need further help. Barb P (VA)

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,

I think Pam is referring to recent studies implicating a certain protein

which seems to attack different brain cells. From what I read it seems to

kill the cell much like ivy attacks and kills a tree. Sorry, I can not remember

the exact spelling, but it is something like syn-nuclean. In Parkinson's

it would attack the dopamine producing neurons and in MSA (SDS) it seems

to attack the glial cells. This may not be the final answer in either disorder,

but the research is vital to a cure.

Take care, Bill and Charlotte Werre

----------------------------------------------------------------------------------------------

alconjohn@... wrote:

Pam,

How realistic is the theory that SDS and Parkinson's might come under the Parkinson umbrella and is there any info indicating that treatment for Parkinson's might help with SDS? I know you're not a doctor and you've been on this site a long time as have I since Sylvia started it. I don't write much but I do observe letters that relate to the disease rather than personal and difficult experiences. I leave that to those who have the need greater than i. I just pass info on to my sister who is the caretaker for her husband who has been to Vanderbilt and has had the disease for 8 or 9 years now. Not getting any better at all, just a slow constant degradation in his health. You are really to be commended for doing what you are. Must be very time consuming.

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I agree with his compliments.

Marilyn in TN

----------

From: alconjohn@...

To: shydrageregroups

Subject: Re: re: Explanation, please?

Date: Mon, Nov 20, 2000, 5:15 PM

Pam,

How realistic is the theory that SDS and Parkinson's might come under the

Parkinson umbrella and is there any info indicating that treatment for

Parkinson's might help with SDS? I know you're not a doctor and you've been

on this site a long time as have I since Sylvia started it. I don't write

much but I do observe letters that relate to the disease rather than personal

and difficult experiences. I leave that to those who have the need greater

than i. I just pass info on to my sister who is the caretaker for her

husband who has been to Vanderbilt and has had the disease for 8 or 9 years

now. Not getting any better at all, just a slow constant degradation in his

health. You are really to be commended for doing what you are. Must be very

time consuming.

Legge

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Sorry , I totally missed it when you sent this note and I don't see

it in the archives. Very strange.

From what I've been reading lately about alpha-synuclein it seems researchers

are excited that it might hold a key to Alzheimer's, Parkinson's, Diffuse

Lewy Body Disease and MSA. In the MSA newsletter that Don and Sylvia

put out recently, Dr. on at Vanderbilt said:

RESEARCH REPORT

By Dr. on

Multiple System Atrophy: Now a Major Research Priority

For many years, only a few physicians were working to discover the cause

and treatment of multiple system

atrophy. This changed perceptibly in the 1990s as Physicians interested

in the autonomic nervous system

organized the American Autonomic Society. At the same time, neurologists

interested in Parkinson’s disease

began taking a greater interest in MSA. Now for the first time in history

there is a critical mass of physicians and

scientists whose major interest is in understanding and curing this

disease.

Extraordinary achievements have recently been made. At first the Shy-Drager

syndrome seemed like a

particularly severe form of Parkinson’s disease. Now the clinical differences

have begun to emerge. The poor

response to levodopa, the early autonomic involvement, the prominent

urinary tract symptoms, cerebella

involvement, apnea, emotional volatility and cranial nerve involvement

and peripheral neuropathy are

recognized as characteristic of MSA rather than Parkinson’s disease.

Differences in physical findings also

soon emerged: the cold hands of the MSA patient.

What is exciting to us now is the identification of significant functional

differences in MSA and Parkinson’s

disease. For example, we now understand that in Parkinson’s disease,

surprisingly, there is significant

involvement of the autonomic nerves in the heart, and many Parkinson’s

patients seem to lose almost all of their

cardiac sympathetic nervous system innervation. In MSA, normal levels

of sympathetic innervation of the heart

seem to be present. This is encouraging because it means that the nerves

are still there if we can just learn to

control them properly.

The importance of this was made clear by recent studies using the drug

trimethaphan, which transiently shuts

down both parasympathetic and sympathetic activity. It was found that

in MSA patients, this drug greatly altered

blood pressure and heart rate, proving that even though the patients

had orthostatic hypotension, they still had

plenty of sympathetic control of their vessels. It is just that this

control could not be marshaled appropriately by

the brain to do the job it needed to do.

Yet, the most exciting new research is focusing on the similarities

emerging in many of the neurodegenerative

diseases such as MSA, Parkinson’s disease, and even Alzheimer’s disease.

Alpha-Synuclein has been identified in

tiny bodies in the brain cells of patients with MSA. These are called

glial cytoplasmic inclusions and while

structurally distinct from the Lewy bodies of Parkinson’s disease,

nevertheless, seem to have many of the same

components in them. The widespread presence of this alpha-synuclein

has encouraged some scientists in the past

few months to classify Parkinson’s disease and MSA by the new name

of "synucleinopathies." Alpha-synuclein is a

normal component of the human genome. Therefore, it obviously has some

important purpose although that

purpose is not now understood. Still, when it is present in such extraordinarily

high concentrations in the brain

cells of patients with MSA, that surely must be telling us something

about the cause of MSA. Alpha-synuclein does

not appear to be the culprit causing MSA but it may only be one or

two steps away. That offers much hope for

understanding MSA. In alpha-synuclein, we may not yet have discovered

the perpetrator, but at least we have

apprehended one of the accomplices. And we expect to learn a great

deal from this accomplice.

Clearly, we have made greater progress in understanding the cause of

MSA in the past three years than in the

previous 100 years. There is every reason to expect more progress in

the future. I have never been more

optimistic about discovery of the cause of MSA than I am in the millennial

year.

This is another quote from him in the USA Today article about ny

Cash:

http://www.usatoday.com/life/health/doctor/lhdoc023.htm

To find a cure(for MSA), the cause must first be identified. That is the

primary focus

for (Dr. ) on and his research team at Vanderbilt. Earlier

this year, they

made a promising discovery. "An important hint about the cause has been

the discovery of deposits of (the protein) synuclein in the brain," he

offers.

"If we can learn why this protein is laid down abnormally in MSA, we

will

probably uncover the cause of the disease."

on is optimistic. "There is enormous medical progress being made

in neurological diseases," he says. "Quite honestly, I think in five

years

we're going to know the cause of Shy-Drager(MSA), plus Alzheimer's, and

Parkinson's."

As he points out, uncovering the cause is close at hand and the cause

of MSA seems to be close to the same cause of Parkinson's. Parkinson's

and MSA have already been reclassified as "synucleinopathies", according

to him. Currently none of the available treatments for Parkinson's

though are nearly as effective for MSA. This seems to be because

slightly different areas of the brain are involved in Parkinson's versus

MSA.

At the Center for Neurodegenerative Research http://www.med.upenn.edu/cndr/overview.html

they are trying to uncover the causes of many similar disorders, including

MSA. So far they've figured out that they all have something in common

regarding protein interactions in the brain cells which form plaques or

inclusions which may be the cause of the cells dying. If this is

in fact the cause then logically it would seem that if they can figure

out a drug that would prevent or reverse the plaque formation they could

prevent or possibly improve upon the symptoms of these diseases.

How far away such a treatment might be is not clear.

I'll continue to watch the research developments about alpha-synuclein.

Hope this is helpful.

Regards,

Pam

and Marilyn wrote:

I agree with his compliments.

Marilyn in TN

----------

From: alconjohn@...

To: shydrageregroups

Subject: Re: re: Explanation, please?

Date: Mon, Nov 20, 2000, 5:15 PM

Pam,

How realistic is the theory that SDS and Parkinson's might come under

the

Parkinson umbrella and is there any info indicating that treatment

for

Parkinson's might help with SDS? I know you're not a doctor and

you've been

on this site a long time as have I since Sylvia started it. I

don't write

much but I do observe letters that relate to the disease rather than

personal

and difficult experiences. I leave that to those who have the

need greater

than i. I just pass info on to my sister who is the caretaker

for her

husband who has been to Vanderbilt and has had the disease for 8 or

9 years

now. Not getting any better at all, just a slow constant degradation

in his

health. You are really to be commended for doing what you are.

Must be very

time consuming.

Legge

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