Parkinson's researchers get grant

By Melissa Garcia - November 11, 2005

Judy Whitmore was diagnosed with young-onset Parkinson's disease at the age of 54.

Six years later, she can still make par on the golf course.

Whitmore is one of the hundreds of people with Parkinson's disease who have benefited from participating in therapy and clinical research at the University of Florida Movement Disorders Center and Evelyn F. and William L. McKnight Brain Institute.

Dawn Bowers, director of the McKnight Brain Institute's Cognitive Neuroscience Laboratory, will begin a new study on Parkinson's disease in July after receiving a $1.7 million grant from the National Institutes of Health's National Institute of Neurological Disorders and Stroke.

Parkinson's disease is a disorder caused by the degeneration of neurons in part of the brain that are important for making dopamine, a neurotransmitter.

Over 1.5 million Americans have Parkinson's disease and experience a variety of symptoms including tremors, slowed movement, poor balance and slow speech, according to the National Parkinson Foundation Inc. Web site.

Bowers' research grant will fund a four-year study on a common side effect of Parkinson's disease that hinders the ability to produce facial expressions.

While most researchers have to apply for grants two or three times before being funded, her application for the grant was accepted in July 2004 on its first submission, she said.

"It was the right study at the right review session with the right reviewers who liked it," she said. "It could have just as easily gone the other way. A lot of it is serendipity."

The grant is a small amount of money when compared to other research grants such as the $12 million grant received by a fellow researcher, she said.

Bowers' research team includes Dr. Michael Okun and Dr. Hubert Fernandez, who are both associate professors of neurology, and Christine Sapienza, professor and associate chair of the department of communication sciences and disorders, she said.

Testing a group of 100 people with Parkinson's disease, the team will use video clips to elicit facial expressions and record them on videotape, she said.

Some of the video clips include bug-eating scenes from "Fear Factor," the "brain-eating" scene from "Hannibal" and scenes from "America's Funniest Home Videos," Bowers said.

By subtracting each 30-millisecond video frame, the researchers can measure exactly how much movement occurred on the face, she said.

In a previous study used to develop this measurement method, a woman with Parkinson's disease asked to see what she looked like on her videotape, she said.

"We showed her the video tape, and she burst into tears," Bowers said. "She said she had no idea that she looked so flat. She remembered herself as someone who was much more emotive."

Lack of facial expression is a symptom that affects the way spouses, family members and even health care providers interact with people with Parkinson's disease, she said.

Patients are sometimes misdiagnosed with depression or apathy due to the problem, she said.

With her research, she hopes to develop a convenient and affordable treatment for those who are frustrated by the symptoms of Parkinson's disease, she said.

Participants will receive a breathing device that requires them to blow out with more force, working both facial and respiratory muscles, Bowers said.

They will exercise with the device at home five times per day for four weeks and then return to the lab to have their facial expressions measured again, she said.

Bowers expects the breathing therapy to make facial muscles more active and able to be more expressive, she said.

"I suspect this is going to work," she said. "It's just like going to the gym helps people tone up."

However, Bowers also sees the potential problem of people not using the device regularly, just like people stop going to the gym, she said.

To see if the benefits of breathing therapy are temporary, research patients will be asked to stop using the breathing device for three months and then be tested for any loss of facial expression ability, she said.

Test subjects will be studied both on and off dopamine medication and also participate in conversations and structured interviews to check for improvements in speech and vocalization, she said.

For the rest of June, Bowers and her team will be preparing video clips and recruiting potential test subjects, she said.

Judy Whitmore, leader of a Parkinson's disease support group in The Villages retirement community, said she and her group have a strong interest in the research.

She is also involved with the Ocala Shakers, an exercise group for people with Parkinson's disease, she said.

Whitmore has worked directly with research team member Dr. Fernandez, who she said changed her life.

"My husband sometimes cries when people ask us about Dr. Fernandez," she said. "It used to be that people thought heroes rode on white horses, but for those of us with Parkinson's disease, they may be people with a white coat."

With the help of doctors, medical research and exercise therapy, Whitmore said several members of her group who used to be confined to wheelchairs are now walking with canes.

She said the breathing and speech therapy research will help people with Parkinson's disease overcome the socially isolating symptoms of the illness.

"It's the face of Parkinson's disease that scares people sometimes," she said. "Kids see grandma and grandpa have a stony look on their faces, and it scares them."

People with Parkinson's disease have a responsibility in helping researchers and doctors care for them, she said.

"I think I'm in better mental condition today knowing that I found people who can help me make my life better," she said.

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Melissa Garcia / words + designs