Creatine <<

ScienceDaily (Mar. 23, 2007) -- Whether a supplement used by athletes
to boost energy levels and build muscle can slow progression of
Parkinson's disease is the focus of a North American study.

Creatine, under study for a number of neurological and neuromuscular
diseases such as Lou Gehrig's and muscular dystrophy, may help
Parkinson's patients by giving an energy boost to dying cells, says
Dr. Kapil D. Sethi, neurologist and director of the Movement Disorders
Program at the Medical College of Georgia.

"We think it may help cells that are damaged or overworked," says Dr.
Sethi, a site principal investigator on the National Institute of
Neurological Disorders and Stroke study. MCG hopes to recruit 45
patients for the study that will enroll 1,720 patients at 51 sites in
the United States and Canada.

Mitochondria, the powerhouse for cells, become dysfunctional in the
brain, muscle and platelet cells of many patients with Parkinson's
disease, Dr. Sethi says. Powerhouse dysfunction is discernible in
postmortem brain studies and in muscle biopsies and measures of
platelet activity in the living.

"By giving more energy to the cell, you are giving them a safety
margin," Dr. Sethi says. "If a cell is dying, it takes another route
and that would be surviving."

The goal is to slow progression of a disease that affects about 1
million people in North America. Hallmarks include tremors, rigidity
and slowed movement. Late in the disease, the majority of patients
also develop dementia and behavior disorders.

Today's therapies -- including the gold standard, a synthetic dopamine
called levodopa and MAO-B inhibitors that forestall breakdown of
dopamine -- are geared toward treating symptoms. Dopamine, a
neurotransmitter critical to movement, is depleted in Parkinson's.
Researchers hope newer therapies, including creatine, can be added to
the mix to help slow the disease.

The creatine study will enroll patients who have been on standard
therapies from 90 days to two years and follow them for five years.
Half the enrollees will get creatine and half placebo. The hope is for
at least a 20 percent reduction in disease progression, so that at the
end of five years, patients on creatine will look like placebo
patients at four years, says Buff Dill, MCG study coordinator.

A number of methods will be used to periodically measure disease
progression, including the Unified Parkinson's Disease Rating Scale.

Following disease progression over many years and measuring endpoints
such as falling, nursing home placement, dementia and death is the
only way to effectively assess treatment for a disease that typically
progresses slowly, Dr. Sethi says. In fact, the study may be extended
five more years, based on preliminary results and funding, he says.

Those who get creatine may have the added benefit of increased muscle,
as is true of athletes, Dr. Sethi says, noting that many patients
experience muscle atrophy and weight loss.

Although creatine is available over the counter, he believes
Parkinson's patients will still be interested in the study. "Patients
realize that we don't know if it works. They are willing to take the
risk of being on placebo for the cause of science and to learn more
about the disease," he says, noting the altruistic nature of many of
his patients. "They want to beat this disease and if they can't, they
want to help somebody else beat it."

Avicena Group, Inc., will provide creatine and placebo for this first
large study in a series of National Institutes of Health-sponsored
exploratory trials in Parkinson's.

MCG will participate in a similar study of coenzyme Q10, another
natural supplement that boosts energy production, later this year. Dr.
Sethi, project director of the Parkinson Research Alliance of India,
which is working to bring more clinical trials to his homeland, plans
to incorporate these supplements into innovative treatment cocktails
that will be studied there.

Adapted from materials provided by Medical College of Georgia.

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Parkinson's Disease Linked To High Iron Intake
ScienceDaily (Jun. 10, 2003) -- ST. PAUL, MN - People with high levels
of iron in their diet are more likely to develop Parkinson's disease,
according to a study in the June 10 issue of Neurology, the scientific
journal of the American Academy of Neurology. People with both high
levels of iron and manganese were nearly two times more likely to
develop the disease than those with the lowest levels of the minerals
in their diets. The study compared 250 people who were newly diagnosed
with Parkinson's to 388 people without the disease. Interviews were
conducted to determine how often participants ate certain foods during
their adult life.

Those who had the highest level of iron in their diets - in the top 25
percent - were 1.7 times more likely to be Parkinson's patients than
those in the lowest 25 percent of iron intake. Those whose level of
both iron and manganese was higher than average were 1.9 times more
likely to be Parkinson's patients than those with lower than average
intake of the minerals.

Iron and manganese contribute to oxidative stress, a situation where
cells release toxic substances called free radicals as part of normal
energy consumption and metabolism.

"Oxidative stress may cause degeneration of brain cells that produce
dopamine - the same cells that are affected by Parkinson's disease,"
said study author Harvey Checkoway, PhD, of the University of
Washington in Seattle.

People who had higher than average dietary iron intake and who also
took, on average, one or more multivitamins or iron supplements per
day were 2.1 times more likely to be Parkinson's patients than those
who had lower than average dietary iron intake and who took fewer than
one multivitamin or iron supplement per day.

Those who had higher than average dietary manganese intake and also
took an average of one or more multivitamins per day were 1.9 times
more likely to be Parkinson's patients than those who had lower than
average dietary manganese intake and who took less than one
multivitamin per day.

Additional studies are necessary to confirm these results, Checkoway
said.

Foods rich in both iron and manganese include spinach, legumes, nuts
and whole grains. Iron is also abundant in red meat and poultry.

Checkoway said that the benefits of eating foods rich in iron and
manganese and in taking multivitamins outweigh the risks of developing
Parkinson's disease.

"Our findings may improve understanding of how Parkinson's disease
develops," he said. "But, there are most likely numerous
environmental, lifestyle and genetic factors that determine who will
develop the disease. It's too early to make any recommendations about
potential dietary changes."

The research was supported by grants from the National Institute of
Environmental Health Sciences.

The American Academy of Neurology, an association of more than 18,000
neurologists and neuroscience professionals, is dedicated to improving
patient care through education and research. A neurologist is a doctor
with specialized training in diagnosing, treating and managing
disorders of the brain and nervous system such as stroke, Alzheimer's
disease, epilepsy, Parkinson's disease, autism and multiple sclerosis.

Adapted from materials provided by American Academy Of Neurology.

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Tom

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