Neurology News from NewYork-Presbyterian/Weill Cornell Physician-Scientists

Non-Motor Predictors of Parkinson's Disease

Dr. Melissa Nirenberg

Anxiety, depression and sleep disorders, invisible symptoms of Parkinson's disease, are common, often under-diagnosed, and may be more distressing to patients than physical disabilities, like shaking, slowness and stiffness – symptoms most often associated with the disease.

Dr. Melissa Nirenberg, a physician-scientist and expert on Parkinson's disease at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, believes that it is important to diagnose these "non-motor" symptoms of Parkinson's disease, early.

Her research shows that Parkinson's disease patients who make frequent telephone calls to their physician tend to have raised levels of anxiety and depression, a higher prevalence of sleep disorders, and a lower quality of life than other Parkinson's disease patients, but with similar or mild physical disability. Thus, patients who appear physically healthy may have severe psychiatric manifestations of the disease.

Based on these preliminary findings, Dr. Nirenberg recommends that physicians routinely ask Parkinson's patients about whether they have emotional symptoms, even when they look healthy and have minimal physical disability.

She believes that earlier treatment of these non-motor symptoms of Parkinson's disease may decrease health-care utilization and improve patient quality of life. Her ongoing research will examine how these non-motor symptoms change over time, and whether reducing anxiety and depression might potentially slow the rate of disease progression.

Mutations in MitochondriaDNA May Play Important Role in Parkinson's Disease

Dr. Flint Beal

Errors in DNA found in the mitochondria (mtDNA) – the energy source in cells – may play a role in the brains of those with Parkinson's disease, according to novel research from Weill Cornell Medical College scientists. Drs. Michael Lin and Flint Beal, first and senior author, respectively, believe that their findings on human brain tissue may elucidate mtDNA's special role.

Prior research has shown no difference between the mtDNA of elderly Parkinson's patients and those without the disease.

However, this new research shows that the brains of early-stage Parkinson's patients have more than twice the amount of mtDNA mutations when compared to aged controls and late-stage patients.

One possible explanation is that brain tissue has been destroyed in late-stage patients, but is still observable and abundant in early-stage, because the neurons have yet to die as a result of the mutations. This evidence points to the likely importance of mtDNA mutations in the severity and progression of Parkinson's disease, making mitochondrial DNA a potential target for therapeutic interventions.

Sparse Psychiatric Coverage for Epilepsy Sufferers

	Dr. Cynthia Harden

As many as 50 percent of epilepsy patients have mood and anxiety disorders, according to Dr. Cynthia Harden, epilepsy expert from NewYork-Presbyterian/Weill Cornell. Yet, neurologists often assume the responsibility of treating mood disorders in persons with epilepsy, at least in part due to inadequate health insurance coverage for psychiatric treatment.

Of the epilepsy specialists surveyed, only 21 percent said that referring their patients to psychiatric care was not an obstacle. Such barriers in providing patients health care are forcing doctors to take psychiatric matters into their own hands.

Dr. Harden says that having proper psychiatric health care for these patients is particularly important because of the complexity and fluctuating course of their mood symptoms, making psychiatric monitoring imperative in these individuals.

She believes that insurance companies should recognize the vital link between epilepsy and mood disorders and provide coverage for such cases.

For media inquiries please contact Andrew Klein at 212-821-0560 or ank2017@med.cornell.edu