Neurological Disorders

SEPTEMBER 2019 | FUTUREOFPERSONALHEALTH.COM

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NEUROLOGICAL DISORDERS

Kim Campbell

Honoring her husband’s memory through musicdriven Alzheimer’s therapy

Find out what it takes to be a neuroscience nurse

Discover how exercise can bene�ıt Parkinson’s patients

Neurological Nursing Provides Specialized Care to Those in Need American Board of Neuroscience Nursing (ABNN) trustee, Tracey Anderson, discusses the field and gives advice for those interested in pursuing a career in neuroscience nursing.

What are the core steps to becoming a neuroscience nurse?

You must first complete a nursing program and obtain a nursing license. You can earn an ADN or BSN degree. After completion of an accredited nursing program, you must successfully complete the NCLEX-RN, which is required for licensure.

What certifications are required?

The CNRN is a more encompassing credential and may be more appropriate for those working in a general neuro unit or neurosurgical ICU, while those solely focused on stroke care will likely be required to obtain the SCRN credential.

What is the most rewarding part of being a neuroscience nurse?

Neuroscience nurses make an impact and influence patient lives in ways that are not possible in other nursing specialties. They are involved in all phases of care and are often the difference between life or death. Whether guiding a patient and their family through a daunting new diagnosis, witnessing a patient regain functionality throughout their recovery, or supporting a family through difficult decisions about the care and next steps, bonds are often formed that last long after the need for care has passed.

Hope for a New Era in Neurological Disease Treatment Neurological disorders affect more than 100 million Americans a year, a number that is growing as our population ages. Despite this burden of disease, there is reason for hope.

David M. Holtzman Professor and Chair of Neurology, Washington University in St. Louis President, American Neurological Association he development of novel diagnostic methods and treatments is progressing apace for many of the most common and important neurological disorders, including but not limited to Alzheimer’s disease and other dementias, Parkinson’s disease, multiple sclerosis, and migraine headache.

Alzheimer’s While we still await an approved disease-modifying treatment for Alzheimer’s disease and other dementias, many promising therapies are now in clinical trials

which are being tested as preventions in individuals who have Alzheimer’s pathology but do not yet have cognitive decline.

New evidence suggests that the immune system is involved in the progression of Alzheimer’s disease, and new therapies are being developed to target this component of the disease. New blood tests are also emerging that can identify those who can participate in Alzheimer’s disease prevention trials before they even have memory loss.

Parkinson’s In Parkinson’s disease, researchers are testing new biological therapies, such as antibodies, as well as small molecules targeting some of the proteins that put one at higher genetic risk for the disease.

Over the past several years, we have seen development of multiple therapies targeting the immune system that can effectively

treat the relapsing, remitting form of multiple sclerosis. And new science is emerging to develop ways to treat the chronic progressive stage of the disease with novel approaches.

Migraine In the area of migraine, several new treatments targeting what is known as calcitonin gene-related peptide have been approved by the FDA over the last year.

These novel treatments are effective and offer a completely new way to treat migraine for those who do not respond well to some of the other medications used to treat this very common condition.

We are living in a time of great progress across the fields of neurology and neuroscience, and as we learn more and more about the brain, there is reason to be optimistic that better therapies for neurological diseases will continue to emerge in the near future. n

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Breaking Down the Myths About Deep Brain Stimulation Treatments SPONSORED

Patients with Parkinson’s disease (PD) may find relief from their tremors, rigidity, dyskinesia, and difficulty moving with a procedure known as deep brain stimulation (DBS).

The therapy by Medtronic, a medical technology company, uses a surgically implanted medical device to deliver precision-controlled electrical stimulation to targeted areas in the brain.

“It’s like a pacemaker for the brain,” says Dr. Francisco Ponce of Barrow Brain and Spine in Phoenix. “This brain pacemaker helps corrects abnormal brain rhythms.”

New lease on life While DBS isn’t a cure for PD, research shows DBS therapy improves quality of life by 26 percent vs. a 1 percent decline with medication alone.

Brian Baehr, 59, was diagnosed with PD nearly 13 years ago. His body was getting more rigid and,

despite taking medicine, his symptoms weren’t improving. A lifelong athlete, he was frustrated that he could no longer participate in sports he loved, including baseball, skiing, and biking. A few years ago, his doctor, Dr. Ponce, suggested he try DBS. “I loved it. I had such a great result,” he says. “I’m back to doing a lot of physical things that I was losing my ability to do. It’s put a whole new lease on my life again.”

These days, Baehr is back to skiing and playing baseball and takes less medication than he was taking before his DBS procedure. He credits it with helping him have better movement throughout the day.

“DBS can alleviate some movement symptoms and medication may be reduced,” says Steven Goetz, engineering director at Medtronic Brain Modulation, noting it can help some patients improve their quality of life.

Read on to learn more about DBS and debunk some of the therapy’s myths.

Myth: DBS is a new or experimental technology.

Fact: “It’s underutilized,” says Dr. Ponce. “It’s not a treatment of last resort; it’s not experimental.

It’s standard of care.” DBS therapy started in 1987 and Medtronic first received FDA approval for tremor treatment in 1997, followed by approval for PD and other indications. Worldwide, over 150,000 Medtronic DBS devices have been implanted.

There are over 250 neurosurgeons performing DBS procedures in the United States.

Myth: DBS is only used for people with very advanced PD. Fact: Previously, DBS was indicated only for advanced PD, but in 2015, Medtronic received FDA approval for treatment in patients earlier in their PD progression.

DBS combined with medication may reduce some symptoms in individuals with levodopa-responsive PD for at least four years including motor complications from four months to three years.

The therapy continues to be an option for those with advanced, longer-standing motor symptoms. Medtronic also has indications for people with essential tremor, epilepsy, dystonia, and obsessive-compulsive disorder.

Myth: DBS is a very invasive surgery.

Fact: DBS is brain surgery. The Medtronic DBS system uses an

implantable neurostimulator to deliver electrical stimulation to the brain. The system consists of a neurostimulator, a lead, and an extension that connects the lead to the neurostimulator.

Neurosurgeons have used electrical stimulation for decades as a way to locate specific sites within the brain. It was discovered that stimulating different areas of the brain could suppress some symptoms of PD. Typically, patients recover from surgery within a few days and stimulation may start within a few weeks after the surgical procedure. Baehr, who chose a non-rechargeable device, says his recovery was quick.

Looking to the future of neurological care, we continue to invest in the innovation of Medtronic DBS therapy to further increase the benefits to patients.

For patients diagnosed with PD, it’s important to begin a conversation with their clinician around when DBS may be a good option for them.

For more information on Medtronic DBS Therapy, go to www.medtronicdbs.com. n Kristen Castillo MEDIAPLANET • 3

Starting the Migraine Conversation with Your Healthcare Provider

With a little preparation, however, these visits can produce amazingly helpful results. Here are a few suggestions for navigating those discussions.

1. Preparation is key Take the time to gather your thoughts and medical history before sitting with your clinician. The more information you can supply, the better chance your physician has to make the correct diagnosis.

2. Provide your migraine history Be prepared to discuss when your migraines first began, if they have changed over time, where the pain is and what it feels like, and what symptoms precede, accompany, and outlast the head pain.

3. Bring your medication and medical history Bring medical records, a list of past and current treatments, and the responses to those medications (including vitamins and supplements).

4. Be open & honest This is your chance to get the help you need, so be honest and explain how migraine affects your family, social, and professional life. Even infrequent attacks can be disabling, so describing how migraine affects your life helps clinicians choose the best treatment plan for you. The American Migraine Foundation has also designed a tool with additional tips to help patients talk with their physician and address migraine head-on.

Download the complete guide at moveagainstmigraine.org.

Lawrence Newman, M.D., FAHS, Vice Chair, American Migraine Foundation; Director, NYU Langone Medical Center — Division of Headache

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PHOTO: SEAN FLYNN

As a neurologist who sees patients with migraine — and a migraine patient myself — I understand how you might feel intimidated when talking with your doctor about migraine.

Kim Campbell Fighting Alzheimer’s With Music Kim Campbell, wife of legendary musician Glen Campbell, discusses her husband’s battle with Alzheimer’s and her efforts to provide comprehensive treatment to families afflicted by the disease.

Tell us more about your foundation, the Kim & Glen Campbell Foundation.

In honor of Glen’s musical legacy and his courageous journey with Alzheimer’s, I established the Kim & Glen Campbell Foundation to advance the use of music as medicine and to fund the research necessary to develop new forms of music therapy for the care management of those who have dementia and beyond.

You must meet so many families struggling with caring for their loved one suffering from Alzheimer’s.

What is the biggest piece of

advice or words of wisdom you give them?

Keep your sense of humor.

When on stage and experiencing a memory glitch, Glen would turn to his audience and ask, “Have you ever walked into the kitchen and wondered what you went in there for?” Then he’d smile his infectious smile and say, “I figured out how to stop that from happening: I quit going into the kitchen.”

Take care of yourself and stay positive. Losing Glen to this disease made me so deeply depressed and fatigued that I began to fear I might become the second victim of the disease. In order to be a good caregiver for Glen, I had to take care of myself.

What advancements in Alzheimer’s research and neurology in general are you most excited about?

There are hundreds of clinical trials going on around the world with many brilliant minds behind them.

Every time I meet with a scientist involved in one of these trials, I am encouraged by their passion, determination, and optimism.

What we can do right now is more research on which therapies will help individuals with Alzheimer’s and their loved ones. What are the things we can do to reduce stress and anxiety for all concerned? To help these individuals reconnect emotionally with their own memories, themselves, and their families? There is still much work to be done.

Kim Campbell is the keynote speaker at the American Neurological Association’s 2019 Annual Meeting in St. Louis, providing the caregiver perspective to the nation’s leading academic neurologists and neurosurgeons. n

Breaking Down Stigma and Raising Awareness for Migraine Disease PHOTO: ERICA CARRASCO

“You look fine.” “I get headaches too, what’s the big deal?” “Drink more water.”

These are comments people with migraine hear daily, leaving them frustrated and invalidated. There are only so many times a person can explain that water will not cure their 46-day migraine before deciding it’s better to suffer in silence.

While these comments rarely come from a malicious place, they stem from misconceptions and prove just how little the general public knows about migraine. Migraine is an invisible disease linked to language that makes it sound less severe than it really is. All of this makes migraine the perfect target for stigma.

The facts One of the biggest misconceptions about migraine is that it is “just a headache.” With attacks often accompanied by visual dis-

turbances, nausea, vomiting, dizziness, and sensitivity to sound, light, and smell, it’s not surprising migraine is the sixth-most disabling disease in the world. In addition, many people with migraine also live with other conditions, such as depression, hypothyroidism, fibromyalgia, and insomnia. Nearly 1 in 4 U.S. households includes a person with migraine, making the odds of you knowing someone impacted by this disease very high.

Shades for Migraine brings global attention Migraine is often dark and isolating, but for at least one day out of the year, Shades for Migraine changes that with a fun social media challenge. On June 21, people around the world show they care and wear a pair of sunglasses to stand in solidarity for those with migraine. Participants show their support by posting a photo to social media with the hashtag #ShadesForMigraine.

This is a simple way people can raise awareness, no matter their connection to the disease. The campaign makes migraine visible and opens the door to new conversations about this disease, ensuring the message is heard beyond the migraine community.

We’re counting on you The past few years have been monumental for the migraine community. Groundbreaking treatments emerged, celebrities spoke out about their experiences, and dozens of initiatives were formed. Despite that, the burden of migraine impacts us all. If we all do our part, even something as small as wearing a pair of sunglasses, migraine will start to get the attention it deserves. n Alicia Torborg, Executive Director, Association of Migraine Disorders MEDIAPLANET • 5

Living with Parkinson’s: Christine’s Story

Debunking Common Parkinson’s Disease Myths

1. Parkinson’s only affects movement, causing tremor, stiffness, and slowness There are many PD symptoms unrelated to movement. Non-movement symptoms are quite common and include impaired sleep, constipation, bladder symptoms, fatigue, pain, anxiety, and depression.

2. You can judge how severe a person’s Parkinson’s is based on a single observation Many PD symptoms fluctuate, and not all symptoms are visible. Many people with Parkinson’s can experience offtimes when symptoms are problematic and can be more visible. This mostly occurs when medications are wearing off. People with PD also experience on-times when they feel well and medications are working.

3. M edication is the only treatment for Parkinson’s In addition to taking medication as prescribed by their care team, people with Parkinson’s can improve symptoms and live well despite the disease. Research shows that exercise can help with symptom management and can improve mobility, stamina, mood, and quality of life.

4. A doctor can predict a patient’s Parkinson’s prognosis No two people experience the same Parkinson’s progression, symptoms, or reaction to treatments, so even the best doctors cannot predict exactly what lies ahead. People living with PD who seek expert care from a comprehensive care team have better outcomes. In fact, neurologist care saves about 4,600 lives each year in the United States alone.

John Lehr, President and CEO, Parkinson’s Foundation

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PHOTO: COURTESY OF THE KIM & GLEN CAMPBELL FOUNDATION

This year alone, 60,000 people will be newly diagnosed with Parkinson’s disease (PD). There are many myths and misconceptions about PD and its treatment. Knowing what is fact and what is fiction can help you optimize your care and quality of life.

Just because you have it doesn’t mean it has you.

Christine S. was diagnosed with Parkinson’s disease at 49. This mother of five and rodeo star talks about living with her disease and her recent 70-pound weight loss.

What would inspire you to kick up your fitness routine and lose 70 pounds? For Christine, it was hearing a diagnosis of Parkinson’s disease at the age of 49. Fitness has always been a part of her life, but the news of her PD, in her words, “put a fuel under” her and caused her to take control of her lifestyle and eating.

Fearless and determined Christine’s determination and outgoing nature are obvious to everyone, and they make her a pillar of strength for her friends and for her family, including her five children. She also

credits meditating, which she began doing after her diagnosis, with helping to reduce her stress level which in turn helps with her tremors.

“I also began moving quite a bit, because the way I see it, moving water never freezes, so I continue to move as much as possible!” she says.

Christine is sharing her sense of optimism and determination with people across the country in big ways — as a cast member of APDA’s “Look Closer” public service announcement and as a panelist at the recent APDA West Coast Parkinson’s Education Forum. Christine also participated in APDA’s PRESS™ program — a specialized eight-week support group for people diagnosed within the past five years.

“Thanks to the PRESS program and APDA, I found the courage and confidence to stay strong and continue to push forward on bringing awareness to Parkinson’s, not only this month but for the rest of my life,” she says.

A lifelong battle Describing her PD, Christine says, “It is not a friendly disease and it does not discriminate; however, just because you have it doesn’t mean it has you. I didn’t choose it, it chose me.

But I’m still the same Christine, and although it might progress, I’m going to fight, and I’ll never stop fighting.

Thanks to APDA, my determination is unshakeable.” n Eloise Caggiano, Senior Director of Communications, American Parkinson Disease Association (APDA) MEDIAPLANET

Read more about neurological disorders and how to treat them at futureofpersonalhealth.com