Do infections cause Parkinson's disease? Mercado and colleagues present a compelling new review in the Journal of Parkinson's Disease. My take: There is increasing evidence that pathogens may play a role in triggering or in contributing to some (many) cases diagnosed as 'synucleinopathy.' How? Infection leads to inflammation. Then, we must next consider whether a genetic variant (i.e. a PD gene) is present or absent. Finally, there will emerge both a clinical phenotype and a biological subtype. Remember, post-encephalitic, PINK1, PARKIN and LRRK2 may all be (biologically) synuclein negative. Also, we must consider whether you are a susceptible host? The authors present a clear way to ponder a potential role for infections in Parkinson's disease. content.iospress.com/article… @ParkinsonDotOrg @FixelInstitute @journal_PD #Parkinsons

It may seem counterintuitive, but what if you treated Parkinson's fatigue with some exercise? Ann-Kristin Folkerts and colleagues did just that in a new paper @journal_PD. Key Points: - Fatigue is common and can be debilitating. - The authors zeroed in on randomized controlled trials. - 14 drug and 16 non-drug studies were examined. - Modafinil compared to placebo: non-significant effect on fatigue. - Physical exercise in 8 studies had a small significant effect. - Acupuncture no effect (but not a lot of data). My take: First, I love the idea that if you are fatigued, trying some exercise therapy may be a 'counterintuitive' way to derive some benefit(s). Second, if you are fatigued w/ your Parkinson's, don't forget to address sleep first, and perhaps get a tracking device and look toward 6+ hours of sleep a night (not just being present in bed!). Have someone check out your medication list as sometimes, less is more. Finally, do not shy away from a formal sleep study and a sleep expert, as this can be helpful and sometimes apnea will need to be treated both for fatigue, but also to reduce heart related effects of this sleep/breathing disorder. It is early days for exercise, and these studies were small and thus will need replication and a better understanding of how to tailor exercise to help an individual with Parkinson's related fatigue. content.iospress.com/article… #Parkinsons #fatigue #sleep