Searching for Ways to Slow PD

“How can I slow disease progression?” That’s a question that Laurie Mischley, ND, PhD, MPH and her team at Bastyr University Research Institute are working to answer. By following people with Parkinson’s over many years and examining their lifestyles, Dr. Mischley’s research aims to give people with Parkinson’s practical advice on how to improve their health outcomes. We sat down with her to get the latest scoop on her work.

1. Tell us a little about your longitudinal study of people with Parkinson’s.

We are currently following over 1000 individuals with PD from around the world, looking for modifiable lifestyle variables associated with different rates of disease progression. We recently presented a poster at the World Parkinson Congress (WPC) demonstrating the Mediterranean diet, exercise, rasagiline (Azilect), oral glutathione and coenzyme Q10 were associated with improved outcomes in PD. We’re writing up the manuscript now for publication, and hope to have the manuscript available to the public in a few months.

We’re still recruiting and invite anyone with a diagnosed or suspected form of Parkinsonism to join the study: www.CAMCarePD.bastyr.edu.

The more people who participate, the more we learn about lifestyle factors that may affect disease progression. For example, we can see already that wine is associated with improved PD outcomes. Now we need more participants to discriminate between red and white.

2. What do you hope to learn from this study?

For the past 199 years since Parkinson’s was first described, people have been asking their doctors, “Is there anything I can do to slow disease progression?” The goal of this study is to answer this question, in a completely pragmatic and patient-centered way. What do those doing unusually well have in common? What about the people doing unusually poorly – what do they have in common? The next steps will be to analyze these data over time and find out whether changing diet and exercise improves health outcomes.

For instance, Indu Subramanian, MD presented data at WPC showing individuals who do yoga are more than twice as likely as sedentary individuals to say their overall disease had improved over the six months prior. It may be that the feel-good chemicals released in the brain during a yoga practice make them think they’re doing better, or maybe yoga results in clinical improvements.

3. What are a few of your key findings so far?

I’m especially interested in what we’re seeing with the medications and supplements. Both coenzyme Q10 and rasagiline (Azilect) had a series of studies suggesting they may slow PD progression, but both failed to demonstrate this effect in Phase 3 clinical trials. Our data show that in a real-life setting, individuals who take coenzyme Q10 and rasagiline do seem to have a slower progressing disease.

There are a lot of reasons why a therapy may not perform well in a randomized clinical trial, but may work outside of a clinical trial. For instance, in both these clinical trials, individuals did not use dopamine replacement therapies, whereas most patients are on dopaminergic therapies in a real world setting. One hypothesis is that a person must be on dopamine replacement in order to get the benefits from coenzyme Q10 or rasagiline.

4. Can people still participate in the study? If so, how do they get involved?

Yes! The more people who participate, the more we learn. You can get involved by visiting www.CAMCarePD.bastyr.edu.

5. What one piece of lifestyle advice would you give to someone with Parkinson’s?

Social health is as important as exercise and nutritious food!

Laurie Mischley, ND, PhD, MPH is an associate clinical investigator at Bastyr University Research Institute in Seattle, Washington and a medical advisory board member at BGF. Her clinical specialties include Neurology, Nutritional Medicine and Prevention. To learn more about Dr. Mischley’s work, visit www.CAMCarePD.bastyr.edu.