Penn Neurologists Report on Promise of Statins, Estrogen and Telemedicine as Potential Targets and Interventions for …

PHILADELPHIA A trio of studies from the Perelman School of Medicine at the University of Pennsylvania demonstrate new approaches to understanding, treating and potentially staving off Parkinson's disease (PD). Studies show that factors such as estrogen exposure and statin use have an impact on the onset of Parkinson's disease. And a new look at telemedicine demonstrates feasibility in providing care for Parkinson's patients using remote video visits to expand access and center care around the needs of Parkinson's patients. These studies and more will be presented at the American Academy of Neurologys 66th Annual Meeting at Philadelphias Pennsylvania Convention Center from April 26 to May 3, 2014.

"Researchers at Penn Medicine are looking at Parkinson's disease from all angles - ways to improve treatment methods for those currently battling the disease, understanding the root causes of disease, and identifying potential interventions to delay the onset of disease," said Matthew Stern, MD, professor of Neurology in the Perelman School of Medicine at the University of Pennsylvania and director of Penn's Parkinson's Disease and Movement Disorders Center. "We are persistent and eager to find better targets and treatments to help patients with Parkinson's disease, which affects up to 1 million Americans and 10 million people globally." Dr. Stern is the current president of the International Parkinson and Movement Disorder Society.

Statins May Delay Onset of Parkinson's Disease Research presented by Yosef Berlyand, undergraduate in the laboratory of Alice Chen-Plotkin, MD, MSc assistant professor of Neurology, suggests that statins may be beneficial in Parkinson's disease. In collaboration with Roy Alcalay, MD and colleagues at Columbia University School of Medicine, members of Dr. Chen-Plotkin's research group demonstrated that blood levels of the protein Apolipoprotein A1 (ApoA1) are lower in people with Parkinson's disease than those without disease. PD patients taking statin medications, which can elevate levels of ApoA1, had an older age of disease onset, which appears to be driven by PD patients taking statins. Previous work led by Dr. Chen-Plotkin has suggested that ApoA1 levels may be a new biomarker for PD risk. The team is in the midst of a follow-up study on plasma ApoA1 and statins, evaluating participants in the Michael J. Fox Foundation's Parkinson's Progression Marker Initiative (PPMI) cohort, to confirm whether ApoA1 modifying drugs such as statins may be a promising neuroprotective therapy for Parkinson's disease.

Yosef Berlyand will present [P2.055] Statin Use, Apolipoprotein A1, and Parkinson's Disease on Tuesday, April 29, 2014 at 7:30 a.m., during P2: Poster Session II: Movement Disorders: Co-morbidities and Novel Care Models from 7:30 a.m. to 11 a.m. in Hall E.

Christine Swanson, MD, postdoctoral fellow in Neurology[S17.004] Apolipoprotein A1 Levels Are Associated with ApoA1 Promoter Variation and Influence Parkinson's Disease Riskon Tuesday, April 29, 2014 at 4:00 p.m., during S17: Scientific Session: Parkinson's Disease: Genetics and Epidemiology in Room 108 AB.

Estrogen Investigated for Protection from Parkinsons In another study, an analysis by Kara Smith, MD, a Movement Disorders fellow in Neurology at Penn's Perelman School of Medicine, and colleagues, investigated the role estrogen plays in decreasing lifetime risk of PD, in light of the fact that men have a relative risk of 1.5 of having Parkinson's disease compared to females. In a systemic review of studies using animal models of PD, the team found consistent evidence that 17b-estradiol, in particular, may play a key role in binding to the estrogen receptor and protecting cells from Parkinson's pathology. The team says further research needs to look at 17b-estradiol in more accurate animal models of PD, before results can be translated to clinical trials in people with Parkinson's.

Dr. Smith will present [P3.068] Neuroprotection by Sex Steroid Hormones in Parkinson's Disease on Tuesday, April 29, 2014 during P3: Poster Session III: Movement Disorders: Clinical Features of Parkinson's Disease from 3:00 p.m. to 6:30 p.m. in Hall E.

Telemedicine Improves Access to Specialty Parkinson's Care An additional Penn study being presented at the AAN meeting examined use of telemedicine visits to increase access to specialty care for Parkinson's patients, in an effort to help remove barriers to specialty care experienced by many patients who live far from care or have disabilities that make it difficult to travel. A Penn Medicine team led by Jayne Wilkinson, MD, and Meredith Spindler, MD, conducted a randomized controlled trial using video telemedicine in the patient's home or at a facility near the patient (in this case, Veterans Affairs Medical Centers), connecting them to a neurologist specializing in movement disorders and Parkinson's disease. Early results demonstrate that the process of using telemedicine for Parkinson's specialty care is feasible, provided similar quality of life, care and communication, and significantly decreased travel. This is the largest study to evaluate telemedicine in this Parkinsons patient population.

Drs. Wilkinson and Spindler will present [P2.048] Telehealth in the Parkinson's Disease Subspecialty Clinic: The Key to the Patient-Centered Medical Home on Tuesday, April 29, 2014 during P2: Poster Session II: Movement Disorders: Co-morbidities and Novel Care Models from 7:30 a.m. to 11 a.m. in Hall E. The study was supported by the Veterans Affairs Medical Center's VISN 4 Center for Evaluation of Patient-Aligned Care Teams (CEPACT).

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Penn Neurologists Report on Promise of Statins, Estrogen and Telemedicine as Potential Targets and Interventions for ...