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AGH neurosurgeon may have breakthrough on Parkinson's http://www.pittsburghlive.com/x/pittsbu ... 55632.html

Sep 8, 2011 – Dr. Peter Jannetta wasn't necessarily searching for a breakthrough in the treatment of Parkinson's disease as he prepared a patient for surgery ...

even though this is parkinsons it still is a blood flow issue that was corrected. we know they are finding ccsvi in parkinson patients. "wonder if some of us could have a problem similiar to this lady". "remember dr. noda and ctos" and ms, parkinsons etc. patients benefited and it takes pressure off arteries so it more than likely at the same time takes some pressure off the veins at the same time. also ucc chiro.'s help some and i'm sure a properly aligned spine should help blood flow. now this!!

wouldn't we all love to get the miracle this lady did. hopefully soon. NOW THE MIRACLE WE NEED ARE ALL THESE DR.'S GETTING TOGETHER SO WE CAN GET THIS MIRACLE.

forgive my computer skills and my screwed up hands ok? here's more.

WPAHS News: New Hope for Parkinson's Patients?
Allegheny General Hospital neurosurgeon, Dr. Peter Jannetta, talks to Pittsburgh's KDKA-TV about a potentially important new discovery linking a treatable blood vessel abnormality in the brain to Parkinson's Disease.

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MRI Study Suggests Brain Blood Vessel Abnormality May Be Factor in Parkinson’s Disease
Email PageRSS Thursday, September 8th, 2011

A potentially treatable blood vessel abnormality in the brain may be the cause of Parkinson’s Disease in some patients, according to a study published today in the journal Neurology International by a team of leading physicians and neuroscientists at Pittsburgh’s Allegheny General Hospital (AGH).

Recognized worldwide as one of the preeminent authorities on diseases associated with vascular compression of cranial nerves, the study’s lead author, Peter Jannetta, MD, is credited with developing the modern surgical technique to treat such conditions. Called microvascular decompression (MVD), the procedure involves repositioning compressive arteries in the brain and placing a protective pad between the artery and the structure it is compromising.

It was in course of treating a patient for the cranial nerve disease trigeminal neuralgia who also suffered from Parkinson’s Disease that Dr. Jannetta first observed the possible role of vascular compression in Parkinson’s. In addition to vascular compression of the left trigeminal nerve, the patient also had notable compression of an area of the brain called the left cerebral penduncle. The cerebral penduncles are two cylinder-like nerve bundles in the brain stem that act as a conduit for signals that control motor functioning throughout the body.

After performing MVD of the left trigeminal nerve, Dr. Jannetta decompressed the patient’s cerebral penduncle by mobilizing and repositioning the offending artery. The results were stunning. By post-operative day five, the patient’s Parkinson’s symptoms, including severe tremor and rigidity, had disappeared. She remained symptom free for 18 months, after which she suffered a full recurrence. A follow-up MRI scan showed new compression of the non-treated right cerebral penduncle by the opposite posterior cerebral artery.

Based on this case, Dr. Jannetta and his colleagues at AGH conducted a blinded MRI study analyzing the brains of 20 patients with Parkinson’s and 20 healthy control subjects. The study showed that 78 percent of the Parkinson’s Disease patients had visible arterial compression/distortion of one or both cerebral penduncles.

Of the study’s 20 control subjects, just two had low grade compression of the cerebral penduncle and one of those was subsequently diagnosed with Parkinson’s.

“Though we clearly need to continue our research on a larger scale to substantiate this remarkable observation, the very idea that a manageable vascular abnormality in the brain may be a critical factor in disease onset and manifestation for some Parkinson’s patients is an extremely exciting possibility,” Dr. Jannetta said.

Parkinson’s affects more than one million people in the United States and despite significant advancements over the past several decades in uncovering the pathogenesis of the disease, conventional treatments provide symptomatic relief only.

Dr. Jannetta said his team’s data raises compelling questions that will be addressed in follow up studies: Is there a form of parkinsonism related to arterial compression of the cerebral penduncle? Does unilateral cerebral penduncle arterial compression cause unilateral disease only? Can it cause bilateral Parkinson’s Disease in time? Can MVD relieve parkinsonism and if so, will it be as safe and effective as seen in other diseases?

A multi-center clinical trial to further explore the AGH team’s premise and is slated to begin later this year.

In addition to Dr. Jannetta, who serves as Emeritus Professor of Neurosurgery at AGH, other members of the study team included AGH neurosurgeons Donald Whiting, MD, Matthew Quigley, MD, and Joseph Hobbs, MD, neurologist Jon Brillman, MD, and neuro-radiologists Melanie Fukui, MD and Robert Williams, MD.

Dr. Jannetta and his colleagues at the AGH Jannetta Cranial Nerve Disorders Center, including neurosurgeon Khaled Aziz, MD, have performed more than 10,000 microvascular decompression surgeries.

Dr. Aziz’s recent addition to the program has enabled Dr. Jannetta to expand his groundbreaking research into the role of vascular compression in a growing number of cranial nerve and brainstem syndromes, including hyptertension and diabetes.

A landmark paper published by Dr. Jannetta in the August 2010 edition of Surgical Neurology International presented the first evidence that vascular compression of a section of the brain called the medulla oblongata is a factor in Type 2 diabetes.

thanks blossom,

I've got a buddy with MS who has terrible facial pain, so I've forwarded these articles to her. Also, I wonder how many of us MSers have other vessels gone awry?? These are early days indeed!!

PN

_________________
Albany 2010. Brooklyn 2011
Hurry up and wait.

Someone invite these guys to talk at ISNVD....!
This is supported by a blinded MRI research study that showed three-fourths of the Parkinson's patients had this specific compression issue and that only one-tenth of the control subjects did. And then one of the two control subjects with the anomaly got diagnosed with Parkinson's.

Great questions. I will be interested in the results. And let me snarkily add that I hope there are no neurologists who object to this research. Also, not snarkily, I hope that they will have no funding issues.

This makes me wonder: we have seen many examples of ballooned out veins above the neck. For CCSVI the stenosis is relieved. Does that relieve pressure that is causing expansion upstream, and do the veins go back to a more normal size? Is this a problem that worsens with age? Is the atrophy caused by this pressure increase? Is it reversible? I have heard of math geniuses with hydrocephalus whose CSF pressure was so great it left their brains in a thin layer pressed up against the inside of the skull, after which the person developed normally.

Time for some pre- and post-angioplasty MRVs!

_________________
"Try - Just A Little Bit Harder" - Janis Joplin
CCSVI procedure Albany Aug 2010
'_MS' is over - if you want it
Patients sans/without patience

Blossom, thanks!!

You always discover the newest discoveries, and you always close your posts by asking all the different doctor specialties to work together for the benefit of the patient--thank you very much for always keeping emphasis on this ideal.

First hint (besides stroke and heart failure) that arterial problems might run in my family.

_________________
"Try - Just A Little Bit Harder" - Janis Joplin
CCSVI procedure Albany Aug 2010
'_MS' is over - if you want it
Patients sans/without patience

points north, sounds like there are other groups gearing up for some trials. so check anywhere you can..... i will say i called a soon as i was aware of this as i'm not far from pittsburgh and i got a recording--they were bombarded. remember when it came out about dr. dake. and the gold rush so to speak over ccsvi.

looks like there are some neuro.'s in this group.

even if you have no facial pain i don't think it matters as they found all her symptoms went away.

I'm confused...

From the article:


When the article is discussing arterial compression, it is referring to an artery compressing a structure in the brain. In this case, the cerebral peduncle. While this is a great discovery for Parkinson's Disease patients, I'm not sure what it has to do with CCSVI. The brain is not compressing the artery and causing blood flow problems. It's the other way around. The artery is compressing a structure in the brain and compromising its function.

A good description of the cerebral peduncle's function can be found here. It is directly involved in controlling body movements.

A better picture showing the location of the cerebral peduncle.

NHE

NHE, maybe this might open neuros to the possibility that vascular problems can cause neurological problems. Yes, in this case it was an artery pressing on the brain, but that I assume is not normal. It might be good to look at Michael J fox and see what goes on with his vascular system when he skates. As he is able to do that. What changes when he skates? Number 1 his heart rate increases.
I wonder how many more abnormalities with our (MS patients) vascular system has. I am sure more will be discovered.

There's quite a difference between the way this discovery by Dr. Jannetta of MVD for Parkinson's disease was received by the medical community and the way the discovery by Dr. Zamboni of CCSVI for MS was received. I wonder why the difference? Any ideas?

If Dr. Jannetta's findings can be easily reproduced through imaging, that will be a difference.

CCSVI, despite having mixed results in imaging tests, should be easily seen in cadaver research. I've seen one letter to the editor of some journal, where the doctor reported finding bad valves in two deceased MS patients, and I've also seen some slides in a presentation by Dr. Zamboni, of bad valves taken from both deceased patients and patients who were having grafting done. But I would like to see some CCSVI cadaver research show up in google scholar. It is hard to argue with something physical that is either there or not there.

It is also interesting to ask: if Parkinson's patients have this compression of the brain by an artery, if they also have CCSVI, would they deteriorate faster or have worse Parkinson's? The idea being that CCSVI creates a generally unhealthy brain environment and that the compressed area of the brain would fail quicker in such a setting.

happy poet asks

There's quite a difference between the way this discovery by Dr. Jannetta of MVD for Parkinson's disease was received by the medical community and the way the discovery by Dr. Zamboni of CCSVI for MS was received. I wonder why the difference? Any ideas?

maybe because we have the PITTSBURGH STEELERS!! because it certainly was not because of any neuro's or dr.'s i came across when i was trying to get ccsvi accepted.

here i go again but so it should be--these dr.'s should "team up" and play to win as a team for us patients the fans and not have a power struggle within.

my sister is in late stage parkinsons,she cant walk or talk. I would drive down and get her imaged tomorrow if I knew what the tests were. Ideas?

It's an MRI but I don't know if it's a specialized MRI. Has she had MRIs done?