Michael Okun - Ending Parkinson’s Disease: A Prescription for Action
TheIHMC2024-02-14
18K views|7 months ago
💫 Short Summary
The video emphasizes the need to reimagine healthcare, focusing on the individual with Parkinson's as the center of care. It discusses the complexity of Parkinson's disease, the urgent need for more research and action, advocacy efforts, and advancements in treatments. It also highlights the importance of proactive healthcare, personalized strategies, quality sleep, and innovative treatments like vibrating glove therapy. Research on potential treatments, including ambroxol and focused ultrasound, the gut-brain connection, viruses' impact, and combining therapies, is explored. Disparities in care based on gender, race, and access to treatments are addressed, emphasizing the need for public awareness and improved support for individuals with Parkinson's.
✨ Highlights
📊 Transcript
✦
Importance of reimagining healthcare with the person with the disease at the center of care.
03:29Need for a different perspective in addressing diseases like Parkinson's and the journey to find solutions.
Challenge to rethink healthcare strategies and work towards a common goal.
Acknowledgment of potential flaws in the American Healthcare System but emphasis on prioritizing individual's needs in healthcare practices.
✦
Understanding the importance of the 'why' behind diseases like Parkinson's and the impact of treatments and therapies.
07:18A man in the Netherlands unable to walk but could ride a bike highlights the transformative effect of certain activities on patients.
Emphasizing the need for a philosophical approach to addressing neurological disorders and the role of empathy and research.
Mention of a study by Boston Bloom on Parkinson's disease and the significance of unconventional treatments like biking for patients.
✦
Parkinson's disease is a collection of different diseases that researchers are trying to understand better in terms of treatment and outcomes.
08:23Parkinson's disease is the fastest-growing neurological disease globally, surpassing Alzheimer's.
One in 15 people, predominantly men, are expected to develop Parkinson's in their lifetime.
The number of people with Parkinson's is projected to more than double by 2040.
There is an urgent need for further research and action to address the growing challenge of Parkinson's disease.
✦
The speaker emphasizes the increase in Parkinson cases despite longer lifespans, stressing the need for alarm.
12:11Studying various diseases like HIV, cancer, and polio is crucial to understanding how to end them.
The PCT formula for ending a disease is introduced, focusing on prevention, advocacy, care, and developing new treatments.
Advocacy efforts like the 'give a dime campaign' are discussed as ways to raise awareness and funds for Parkinson's research.
Allocating resources based on experiences with other diseases is highlighted as important.
✦
National Plan and Parkinson's Act passed by the House aims to improve Parkinson's disease treatment and care.
16:00Parkinson Disease Avengers group formed to advocate for change in Parkinson's disease treatment.
Understanding advocacy efforts crucial to prevent passing diseases from generation to generation.
Environmental factors play a significant role in degenerative diseases like Parkinson's.
✦
The dangers of tricoro ethylate in dry cleaning and its contamination risks.
20:25TCE contamination at Camp Leun leading to a 70% higher risk for residents.
Advocacy efforts to raise awareness about harmful chemicals like paraquat and push for their removal from the market.
The impact of advocacy in driving change, as demonstrated by FDR and Eddie Caner's efforts in polio research.
The importance of well-known advocates in catalyzing action for positive change.
✦
Transforming HIV and AIDS into a Manageable Condition.
23:45Advancements in treatment have changed the perception of HIV and AIDS from a near-death sentence to a chronic, manageable condition.
Parkinson's Disease Demographics and Progressions.
Parkinson's disease affects a wide demographic range with varying progressions and increasing cases.
Emphasis on Diagnosis and Support for Parkinson's Patients.
Accurate diagnosis and understanding of Parkinson's disease are crucial, along with the timing of care delivery.
Call for Improved Support and Awareness.
There is a need for increased support and awareness for individuals living with Parkinson's disease.
✦
Importance of Proactive Healthcare for Parkinson's Patients.
29:20Monitoring balance is crucial in preventing falls and taking necessary vitamins is essential for overall health.
Patients should be aware of the risk of skin cancer and visit a dermatologist regularly.
Hospitalization kits tailored for Parkinson's patients are necessary due to the dangers of hospital stays.
Patient advocacy and preparedness are key in effectively navigating hospitalizations.
✦
Importance of having a plan and strategy for managing Parkinson's disease, with exercise compared to a drug for its benefits.
30:54Emphasis on the significance of nutrition, particularly a Mediterranean diet, but caution against overreliance on supplements.
Highlighting depression as a significant obstacle, affecting one in six individuals with Parkinson's.
Key role of addressing demoralization in caregiving and patient support.
Vital importance of monitoring sleep quality due to Parkinson's impact on sleep patterns, leading to potential issues despite perceived rest.
✦
Importance of quality sleep and deep brain stimulation in improving brain function and overall health for individuals with neurodegenerative diseases like Parkinson's.
34:35Continuous research and development of new treatments for Parkinson's is crucial due to being underfunded compared to other diseases like HIV.
Emphasis on not giving up on patients and the potential for innovative care approaches to make Parkinson's a livable condition.
✦
Approaches to treating Parkinson's disease include symptomatic therapies, disease-modifying strategies, and finding a cure.
38:33Current treatments such as dopamine therapy and deep brain stimulation offer relief but do not halt disease progression.
Research is ongoing, focusing on precision medicine to target genetic abnormalities associated with Parkinson's.
Despite frequent claims of breakthroughs, a definitive cure for Parkinson's has not been found yet.
Education and awareness through detailed blogs help keep the community informed about the latest research developments.
✦
Breakthrough in Parkinson's Disease Diagnosis
41:36Specific tests can now identify Parkinson's disease proteins in the blood.
Detection process involves shaking and separating fluids.
Primarily aids in diagnosis and monitoring disease progression.
Vibrating glove therapy shows promise in improving Parkinson's symptoms.
✦
Research on ambroxol for Parkinson's Disease
44:52Ambroxol, found in cough syrup, is being studied for its potential to treat or slow Parkinson's disease by targeting the GBA gene.
Innovative approaches in Parkinson's treatment include targeting specific genes, new brain modulation techniques, and repurposing drugs.
Scientists are exploring methods to enhance brain communication using implants and devices.
Balancing curiosity and expertise is crucial in developing new therapies for Parkinson's, emphasizing the importance of a careful approach to innovation in treatment.
✦
Advancements in Research on Brain Health and Disease.
50:02Focused ultrasound has the ability to open blood vessels in the brain through microbubble injection and low frequency usage.
New techniques such as optogenetics and nanoparticles are being explored to stimulate the brain externally.
The connection between the immune system and the brain is under study for potential treatments to slow disease advancement.
Biomarker research is underway to improve the detection and diagnosis of Parkinson's disease, showcasing a significant breakthrough after years of multi-laboratory research.
✦
Research on the gut microbiome in Parkinson's disease is expanding.
54:19The microbiome data is complex and requires interpretation by AI and computers.
Dynamic changes occur over time and experiments have shown altering the microbiome can impact Parkinson's symptoms in animals.
This research holds promise for potential treatments and advancements in understanding the gut-brain connection.
✦
Two Harvard neurologists initially hypothesized that the Spanish Flu would eradicate Parkinson's disease, but this theory was disproven.
57:39Recent studies are exploring the potential link between the Spanish Flu and Parkinson's disease.
Concerns have been raised about a possible relationship between degenerative diseases and the current Coronavirus.
Ongoing debates and research are expected to provide more clarity on the connection between viruses and degenerative diseases in the future.
✦
Research on stool samples and probiotics for Parkinson's disease.
59:52The heterogeneity of Parkinson's disease makes it difficult to find a universal treatment solution.
Immunotherapy targeting Alpha-synuclein protein deposits in the brain has been attempted with varying outcomes.
It is uncertain whether clearing the brain of protein deposits will effectively treat Parkinson's or if the disease will persist.
Antibody therapies have shown promise in Alzheimer's disease, offering hope for future treatments in neurodegenerative diseases.
✦
Potential benefits of combining therapies for Parkinson's disease.
01:02:31Scientists are researching drug combinations targeting different aspects of the disease.
Concerns exist about the timing of interventions.
Monitoring devices such as eyewatches, iPhones, and AA rings can track sleep patterns and vital signs.
Technology can offer valuable insights for individuals managing chronic conditions like Parkinson's.
✦
Importance of Raising Awareness about Parkinson's Disease Disparities.
01:07:03Men are more likely to develop Parkinson's than women, with symptoms varying between genders.
African-Americans with Parkinson's face challenges in receiving care and accessing new treatments, highlighting healthcare disparities.
Emphasis on reaching an inflection point in disease research to drive change and improve outcomes for patients.
✦
Disparities in Parkinson's Disease Care and Support Worldwide
01:09:51Research shows significant inequities in access to treatment and resources for individuals with Parkinson's disease across different communities worldwide.
Efforts by organizations like the World Health Organization have been limited in addressing these disparities, indicating the need for more effective strategies.
Caregiver involvement is crucial for the well-being of individuals with Parkinson's, highlighting the importance of support systems.
Gender disparities in support for women with Parkinson's further emphasize the need for targeted interventions to address unmet needs and improve outcomes.
✦
Research on processed sugar and disease is showing consistent findings across regions.
01:12:30The potential link between processed sugar and disease may converge in data in the next few years.
The speaker advises caution against relying on isolated studies and compares it to past instances of underestimating connections like pesticides and Parkinson's disease.
While definitive conclusions cannot be drawn yet, there are worrisome implications for individuals consuming artificial sweeteners and sugary drinks like Coke Zero.
00:03[Music]
00:13this lecture is being brought to you in
00:15part by the generous Gifts of these
00:20sponsors well thank you so much such a
00:23kind uh introduction and it is uh
00:26wonderful to be back so I have been on
00:29this stage before for and ihmc is such a
00:32a great organization and I've also
00:34spoken here and spoken in Pensacola over
00:37the years and so I just want to shout
00:39out because not too far down the road
00:42here you know we're um at the University
00:44of Florida and so it's great to actually
00:47be in front of a home audience and and
00:50you know hopefully we can have a little
00:52bit of fun tonight uh talking about a
00:56topic that I think is something that
00:58becomes more important
01:00you know as you get more seasoned and so
01:03as a as a treating physician I always
01:06tell people you know never say you're
01:09getting older getting more seasoned okay
01:13so as we get more seasoned okay as we
01:18get more
01:19seasoned we are going to be facing this
01:23challenge a real Public Health Challenge
01:26so not just a a research challenge not
01:28just a care challenge a real Public
01:31Health Challenge about diseases like
01:35Parkinson's and so a number of years ago
01:39um I got together with a few buddies Ray
01:42dorsy and bosan Bloom who are way taller
01:45than me okay and way smarter than me and
01:49we began to think about the construct of
01:54what would it take to end a disease what
01:58would be the prescription for
02:02action and what I want to share with you
02:04tonight is much of what we learned on
02:08that Journey okay and the journey is
02:12really a we journey it's a together
02:15Journey it's not a me Journey okay
02:18shortest poem in history written by
02:21Muhammad Ali had Parkinson disease you
02:24remember me we shortest poem in history
02:27look it up in bartletts okay but the
02:30journey here needs to
02:33be about we this road that we need to
02:37take together and so we're going to talk
02:39about that tonight and I I think it's
02:41going to be a lot of fun and uh and so
02:44hopefully we'll uh we'll hit a whole
02:46bunch of points and what I really want
02:49to do is challenge you I want you to
02:53reimagine I want you to
02:55rethink I want you to put yourself in a
02:58in a different frame of of mind okay so
03:01you remember many of you may have seen a
03:03movie called Dead Poet Society you
03:05remember in Dead Poet Society you know
03:08do you remember when the kid gets up on
03:10the table okay because the teacher says
03:12you got to see things from a different
03:14perspective you got to see things in a
03:15different way this project on ending
03:19Parkinson and a prescription for Action
03:21is all about that it's all about let's
03:24step back and see this in a different
03:27way in a different strategy in a
03:29different way to
03:31journey and for me part of the journey
03:35is how we characterize healthc care and
03:37I don't want to uh Cherry coat things
03:40and I don't want to shock anybody but um
03:43but the American Healthcare System may
03:44be a little bit broken okay I know I
03:47know it's hard to you know it's hard for
03:49you to accept that but it may be a
03:51little bit
03:52broken but we have always said that the
03:56best way to give healthc care is to put
03:59the person with the disease in the
04:01center and to orbit around them whether
04:03you're doing clinical whether you're
04:05doing research whether you're doing
04:06advocacy it's the person that you have
04:08to listen to that has that and that
04:11drives everything that we do and and
04:14that has been the one founding
04:17philosophy so Ken Ford told me he was a
04:20philosophy major which I love okay and
04:22and it's a it's a founding Philosophy
04:25for us when we put together our Center
04:27which became the fixel at the University
04:30of Florida and so this idea that you
04:33have the sun and the Sun is the person
04:35with the disease is so important
04:38especially in the Health Care system
04:39that we live in now where you're just
04:41trying to get an appointment maybe even
04:43get some parking you know see one person
04:45could you imagine actually seeing a team
04:47of people so this sun can light the way
04:52but it's the vision that is going to
04:54help us to pave that road forward in
04:57Parkinson and in other diseases and so
05:00that was sort of the the journey that
05:02Kelly foot who co-founded The fixl
05:04Institute with me 22 years ago and I met
05:08somebody that I had seen their husband
05:10many years ago and uh and and she was
05:12kind enough to to to say to me boy you
05:15were you were much younger then I wasn't
05:18sure if I should if I should trust what
05:20you have to say but um but it turns out
05:24that um that when you think about this
05:27journey you've got to be grounded in
05:29some
05:30philosophy and I think part of that
05:31philosophy helps us on the road and we
05:34have to ask ourselves what's your why
05:37like why do you do things and so for me
05:41the why is you know how is it possible
05:44for a guy like this me look at these
05:46feet okay look at these feet in Muhammad
05:48Ali how is it possible this is
05:501966 okay how is it possible that you
05:54can have that kind of coordination
05:56between the two sides of your body and
05:58and be
06:00this you know amazing and then you get a
06:03disease that robs you of that what's
06:06what is what is that why does that
06:08happen and so for me in my life part of
06:10my why was listening to people part of
06:12my why was looking at people with these
06:15different disorders and saying what's
06:17going on in the brain what's causing
06:19these disorders so I think it's
06:21important for us to have a why okay a
06:24why moment and many of you may have seen
06:27this movie okay called Awakenings right
06:30and you see Robin
06:31Williams right he he drops the the
06:36glasses and the woman who's completely
06:39Frozen this is before dopamine okay and
06:41he's playing the part of the Doctor
06:43Oliver Sachs and teaching the the the
06:46students here what he sees comes
06:48unfrozen and can catch the
06:50ball why that's incredible I mean you
06:54think about this disease what's going on
06:57in the brain to activate this and we
06:59think think about before leave aopa
07:01after dopamine replacement for Parkinson
07:04before surgeries that we've been
07:06involved with with understanding these
07:07circuits and after the care of these
07:10people this this disease that we're
07:12going to talk about tonight is a is is a
07:14mysterious disease and we're still
07:16struggling to try to understand it but
07:18it's also pretty amazing too okay and so
07:23when we think about the why of a disease
07:26like Parkinson this is a video shared
07:29with me from Boston Bloom who's in the
07:31Netherlands and he was a co-author on
07:32the book ending Parkinson's disease and
07:35I remember early on in my career when I
07:37was at Emory there was a woman who
07:40couldn't walk but she could dance with
07:41me okay here's a man in the Netherlands
07:45you know they tend to ride bikes there
07:46he can't walk you saw him Frozen in the
07:49clinic and you put him on a bike and he
07:53just takes off now of course when Boston
07:56Bloom published this in the New England
07:58Journal of Medicine you know you know
07:59the biggest critique that he got why
08:01didn't you put a helmet on the
08:03guy okay the poor guy turns out helmets
08:07are
08:08not mandated in the Netherlands so he
08:11had a pretty good excuse for it but you
08:13see you know this incredible like why
08:16this is a really interesting and many
08:18people live with this disease for
08:21decades and it's not one disease it's a
08:23it's a bunch of different diseases that
08:25we're trying to understand why some
08:26people do better why some people do a
08:28little bit worse why these treatments
08:30work what can we do to develop a
08:32treatment that's more specific for an
08:34individual person and you see him hop
08:36off the bike and he goes back to being
08:38frozen again okay and so when we think
08:41about Parkinson's okay back in
08:452013 we wrote a book for the foundation
08:48called 10 secrets to a happier life and
08:50the book took on a a a bit of a of a
08:54life of its own and it was humbling to
08:56me because I had written so many
08:58research papers that no nobody had ever
09:00read okay and then I wrote this book and
09:03everybody read this this book and it had
09:05you know just 10 things that to me
09:07seemed obvious from all the folks that
09:10we had seen from all over the world we
09:11see patients from every continent people
09:13with disease from every continent except
09:15for Antarctica and we learn those things
09:17and we reflect them back and sometimes
09:19the simple things we don't appreciate
09:22but in that book I I quipped in the book
09:26that we are approaching a Parkinson
09:28pandemic this was in
09:292013 okay a number of years ago and when
09:33you think about pandemic pan means all
09:35deos means people okay if you think of
09:37the Latin translation pandemics the word
09:40is
09:42generally reserved for infectious
09:45diseases okay and I think that's a good
09:47idea to do that but it really wasn't
09:50historically just for infectious
09:52diseases right and it turns out that on
09:54every continent this disease is growing
09:57and it's growing at an alarming rate
10:00okay and so we took a time out we took a
10:03pause and we said you know what's going
10:05on with this disease why is it growing
10:08and what can we do about it you know
10:10because we don't want to pass this on to
10:11the next Generations forward right and
10:15so how big is that challenge well we sat
10:18on a number of committees one of which
10:19was with the World Health Organization
10:21and Ray dorsy sat on another committee
10:23looking at the global burden of disease
10:25and it turns out that it's not stroke
10:28it's not brain tumors it's Parkinson's
10:31Parkinson's is the fastest growing
10:33neurological disease even faster than
10:35Alzheimer's disease there might be more
10:37Alzheimer's but Parkinson is growing
10:40faster okay and why you have to ask why
10:44why do we care well one in 15 people
10:48predominantly men okay predominantly men
10:51but not just men but one in 15 people
10:54are going to get Parkinson in a lifetime
10:56so if you sat in a classroom when you
10:58were were a child and you had about 30
11:00kids in the classroom before things were
11:02overcrowded right it was about 20 30
11:04kids two of those people are going to
11:06get Parkinson so most of you that are
11:08sitting here you know probably know a
11:11couple of people you went to school with
11:13who had Parkinson and that's that is
11:15growing that number is growing and it
11:18hasn't set off the alarm bells that it
11:21should set off and so Ray dorsy is
11:24really good at at making charts and
11:27studying these things and he made this
11:29this chart that I think really brings
11:32home the point okay you don't even need
11:35to see the numbers on this okay there
11:39are three columns here the one on the
11:42left is 1990 under 3 million people with
11:45Parkinson 2015 6.3 million projections
11:50for 2040 12.9 million that's more than
11:53doubling okay the amount of Parkinson
11:56that's going to be on the planet
11:59in many of these estimations don't even
12:02account for young people with Parkinson
12:04and I have people in my practice that
12:05have Parkinson in their teens or 20s
12:09okay so this is really something that
12:11should be setting off alarm Bells we
12:13should be saying wait a minute what is
12:16going on here okay and if you think
12:19about what's the greatest innovation in
12:23the last 100 years okay Ken Ford might
12:27tell you it's some of the robotics that
12:28he had and he does have cool robotics
12:30okay there's no doubt about that but
12:33it's probably the doubling of the
12:34lifespan and you can look up these
12:36charts or there's so many of them on the
12:38Internet you can look them up they all
12:40say about the same thing that the
12:42lifespan has doubled okay literally
12:44doubled since the mid
12:471800s so if we're living longer then we
12:50should just get more Parkinson right
12:52okay but it turns out we looked at the
12:54data and it cannot be
12:56explained just by the fact that we're
12:59living longer okay so we can't just
13:01explain that away and so we have to
13:03think about what is the path forward and
13:06so what we did is we got together and we
13:10said how about other diseases how about
13:13other areas where people have studied
13:16and said you know what's going on and
13:17what did it take to get to the to end a
13:20disease and so we looked at
13:22HIV okay we looked at various cancers we
13:25looked at polio okay this was before the
13:28pandemic polio has been talked a lot
13:29about now because of covid-19 okay and
13:34we started to research the different
13:36diseases and as we assembled all this
13:40with all the interviews and research for
13:41this book we realized that the formula
13:45is simple and we called it the PCT to
13:48end a disease you have to P for prevent
13:51a for Advocate C for care and T for
13:53develop new treatments that is the
13:56formula that drives forward and there
13:58are certain factors that you can do to
14:00catalyze when we say catalyze we mean
14:02make it go faster but that's the formula
14:05okay and you can see this is one of the
14:07advocacy efforts that we had as part of
14:09that book and it was called a give a
14:12dime campaign and it was modeled after
14:15the March of Dimes where people used to
14:19mail dimes to the White House and we
14:21said oh okay well we'll just have them
14:22mail dimonds to the White House it turns
14:23out we had to scra scrap that idea does
14:27anybody know why it's now illegal to
14:30mail uh you know tender to the White
14:33House because so many dimes and so much
14:35they overwhelmed the guy named Irving
14:37who ran the mail ring during this time
14:40and they overwhelmed the mail room with
14:42this and so this idea of sending out
14:46tens of thousands of cards to advocate
14:49for things like Banning certain
14:50pesticides like paraquat okay that we
14:53keep doubling and making sure that tele
14:56medicine stays available even when Co
14:59goes away which it didn't okay and
15:04making sure that we figure out how much
15:06money we need to push into Parkinson to
15:09make that change based on the
15:10experiences of what we had seen in other
15:12diseases so here's a couple of my
15:14co-authors you can tell immediately
15:16there's a big difference between
15:19us not just in intelligence okay but um
15:24but any place that we could smile
15:26anybody who would listen to us us we had
15:29a Booker T Washington type of get out
15:31you know and walk the nation walk the
15:34world and here we are in Barcelona just
15:36trying to get the word out to as many
15:38people as we can and you may have
15:42noticed that in addition to the healthc
15:44care system not always working optimally
15:47we've been over that
15:48point that we don't seem to be able to
15:52agree on things in Congress okay I know
15:55shock okay I know you're all shocked
15:57okay but recently on December
16:0014th there's an act that name is almost
16:04the same name as the book okay that was
16:06represented by Gus bakus from Florida
16:09and and uh representative Paul tonko
16:11from New York that passed at 409 almost
16:15unanimous through the house the national
16:17plan and Parkinson's act and that will
16:19be headed to the Senate and it's looking
16:22good you know like in the Senate and so
16:24these are the things that are going to
16:26make a difference okay and how we're
16:29going to to to push in and that's the a
16:32the advocacy to change things but it's
16:35important for people to understand like
16:37the why like why are we doing this
16:39because this is something we don't want
16:41to pass generation to generation and
16:43things where we can reduce the number of
16:45cases that we're seeing and hopefully
16:48push you know to a better Horizon okay
16:52now when we put out thank you when we
16:55put out the ending Parkinson disease
16:57book the other really incredible thing
17:00that happened was there was a group of
17:03people that were folks who had Parkinson
17:08and they formed an organization and it
17:10was called the Parkinson disease
17:11Avengers the PD Avengers have you ever
17:13heard of that's like the capes and
17:14everything and now there are thousands
17:16of them that have kind of rallied around
17:19this Grassroots effort lesson it isn't a
17:23person that's going to change this and
17:25we know this from polio we know this
17:26from HIV it's a movement
17:28it isn't a person it's a movement okay
17:31and so the movement goes on and so we
17:34think about prevent Advocate care and
17:37treat when I was uh testing the talk
17:40earlier today Gordon who is a great um
17:43uh a specialist here caught this slide
17:47like literally as I went past it really
17:49quickly and he said oh are those super
17:51fun sites and I said wow yes they are
17:54super fun sites and he said you know
17:58this organization ihmc they're on a
18:01super fun site in you know close to a
18:03lot of them in Pensacola and there's a
18:05lot of them here and if you look at
18:07these purple spots he's absolutely right
18:10okay and I always say where do you live
18:12okay super fund sites what are they okay
18:15what is Gordon talking about how did why
18:17why is he concerned about that that's
18:19where something has gotten into the
18:20environment that the American system has
18:23said we need to clean this up because
18:25it's going to probably cause disease or
18:27something bad is going to happen now of
18:31course you probably realize that there
18:32are a lot of these sites and I know it's
18:34going to shock everybody third shocking
18:36thing of the night okay that some of
18:38these sites many of these sites most of
18:40these sites haven't been completely
18:41cleaned up okay but where you
18:45live is something that's becoming very
18:47important for degenerative diseases like
18:50Parkinson disease okay where you live is
18:53very important so I often say where
18:55where do I live well my favorite
18:57pizzeria in uh Gainesville I won't say
18:59which one it is because I don't want to
19:00hurt their business sits on a super fund
19:03site okay I'm not going to stop going
19:04there but I'm I'm I'm gonna maybe I'm
19:06going to take it as takeout right so so
19:09exposure and knowing you know like
19:11what's been there and you see you know
19:14lots of things and Ray dorsy this is one
19:16of the things he does for a living goes
19:17around the country and and checks kind
19:19of like Aaron Brockovich what's going on
19:21and and overlays these Maps as to where
19:24things are happening and investigates
19:26these things this is a a story of
19:28tricoro ethylate okay this is a chemical
19:32that's common in dry cleaning okay and
19:35it turns out that this chemical can get
19:37into the ground on spills and it can
19:39vaporize and it can come up like even
19:41from your home so you could be on top of
19:43a of a vapor fume you know from this and
19:45so you're not completely protected and
19:48so you all have been um let's just say
19:52overrun with these commercials about
19:55Camp leun okay on TV and none of the
19:58authors of our book have testify in any
20:01of these cases they all want us to
20:03because a lot of what we wrote you know
20:06may have sparked you know this sort of
20:09movement you know as to as to these
20:11chemicals or contributed to it and this
20:15paper appeared in one of the Journal of
20:17the American Medical Association um
20:19sub-journals called J neurology an
20:21excellent Journal showing the risk was
20:2370% higher in people who lived in Camp
20:25leun okay from this contamination
20:28of tce in the water okay so we have to
20:32prevent Parkinson so we have to ask
20:35questions they're not hard they're not
20:37hard folks do you know the chemicals and
20:39pesticides to avoid do you pay attention
20:41to where you live and where you spend
20:43time do you use air filters apps are you
20:46supporting bands you know to try to get
20:49these things off the market and out you
20:51know of you know where you might get
20:54exposed and we look at certain
20:56pesticides like paraqua which was on our
20:59campaign our red card campaign we sent
21:01to the White House
21:04paraquat literally doubled in the last
21:0710 years okay here in the United States
21:10okay 32 countries abandoned including
21:12China in the
21:15UK they didn't ban it they banned it for
21:18their people and they ship it here for
21:20our people okay and so you know we we're
21:24been part of an amicus brief to have the
21:26EPA kind of go back and look at this
21:30successfully and also in tce and so Ray
21:32dorsy and the group have been really
21:35absolutely terrific at at at this story
21:39this story is such an important story so
21:42p is prevent a is Advocate and one thing
21:46that you learn if you study other
21:48diseases is it does help to have
21:52Advocates that are well known okay and
21:56so here's a picture of FDR with Eddie
21:58caner who ran a radio show you know very
22:01famous radio show and they literally
22:05created the the hereditary Foundation um
22:09for paraplegia spasticity polio and
22:14drove they drove so much awareness and
22:18so much money into this problem that it
22:21led to Suk and
22:26savementa wasn't an easy road but it was
22:30catalyzed catalyzed so I use that word
22:32catalyzed catalyzed means when you have
22:34a reaction and you're a scientist it's
22:36going to happen and you're going to
22:37speed it up do we want the reaction to
22:39happen in 200 years from now or do we
22:42want it to happen now so we have to
22:44think about how you speed it up here's a
22:46great story picture of HIV okay in HIV
22:52the advocacy efforts included quilts on
22:54the National Mall they included putting
22:57a condom
22:58on Jesse Holmes's house okay which was
23:02very effective okay very effective it
23:04says a condom to stop unsafe politics
23:07Helms is deadlier than a virus
23:10okay and he never voted against the HIV
23:14legislation okay FDA stins here okay and
23:19they increase the amount the number of
23:22dollars that went into HIV by more than
23:25tfold and they drove this to when I was
23:28an intern when I started medicine and I
23:30was a general doctor on the wards we had
23:33literally HIV and AIDS ws and it was it
23:37was almost a death sentence when you got
23:39this disease to now a chronic livable
23:42condition okay there's something to be
23:45learned from that and what that lesson
23:49taught us so prevent Advocate see care
23:54this is really important because a lot
23:56of organizations forget
23:58you've got a tremendous number of people
24:01who have this disease now today okay and
24:05guess what this is the old-fashioned
24:07picture you see the old sketch from 1888
24:101886 from William Go's textbook this is
24:14how people think of Parkinson many of
24:15you here tonight have Parkinson you
24:17don't look like this this is the old
24:20image and so meliss Armstrong at the
24:22University of Florida has redrawn
24:24reimagined Parkinson young people can
24:26have it women can have it men can have
24:28it and not everybody has that same
24:31progression there are 90,000 cases of
24:34Parkinson disease now per year and
24:38growing and increasing and we used to
24:42say up until last year and I've worked
24:46and done a lot of advocacy with the
24:47Parkinson Foundation they're a great
24:49organization and we used to say a
24:51diagnosis of Parkinson occurs every 9
24:53minutes we underestimated and now
24:56there's a new paper out in nature from
24:58Allison Willis and colleagues at the
25:00University of Pennsylvania which is a
25:01Parkinson Center of Excellence it's one
25:03in six minutes one in every six minutes
25:07somebody's
25:08diagnosed it's a problem folks it's
25:11let's say it's not a problem let's say
25:12it's a challenge and we should take this
25:14on as a challenge so we think about care
25:16we've got to think about not only what
25:18we're going to do down the road but also
25:21how we're going to help these people and
25:22so when we think about secrets and
25:25things looking for a sign is important
25:28knowing when you're going to get
25:30something and even the most faithless
25:32among us are waiting to be proven wrong
25:34great quote from the novel pretty by
25:36Julian um Julian Petty now what you will
25:42see is when Julian Lauren put this into
25:45her novel she was saying look we need to
25:49know what this is you know you need to
25:52know what it is that you are trying to
25:57repr represent what you're trying to go
25:59for you know if you don't know what you
26:02have then how do you know you know what
26:04to do okay and so helping people to
26:07understand what they have and what they
26:09don't have is actually an important part
26:11of this journey part of that se that
26:14care and so my apologies to people with
26:16Alzheimer's but but Parkinson is not
26:17Alzheimer's disease totally different
26:20and totally different treatments totally
26:23different Horizons when you take
26:25Parkinson medications one thing that you
26:27learn this is a great quote from Joshua
26:29Harris the right thing at the wrong time
26:30is the wrong thing and anybody who has
26:32kids I have two knows this quote okay
26:35it's it's been around for thousands of
26:37years but in Parkinson unlike any other
26:40disorder on the planet the timing really
26:44matters to how we care for people we
26:46don't get that message out enough when
26:49we deliver a diagnosis of Parkinson when
26:51we say you know those four words you
26:54have Parkinson disease we have to
26:56remember that those words words and how
26:59we deliver a diagnosis are going to
27:01they're going to last forever for that
27:03person that moment is going to last
27:04forever and we do a terrible terrible
27:07job at this an indu sub manian who's a
27:10doctor at UCLA who's an integrated
27:12medicine specialist and a movement
27:13specialist myself and Johnny atcherson
27:17who is a general doctor in the UK who's
27:19an artist but also has Parkinson we run
27:22this blog called Parkinson Secrets where
27:24we give you know kind of advice on hot
27:26topics this month's Hot Topic that is
27:29just going up is is about how we do such
27:31a poor job for Parkinson and Johnny
27:34who's a great artist sent this to me
27:35this morning and uh and he says it's
27:38hard enough to get in and then you have
27:40to get out you know and I think it's
27:42it's the wonderful the idea of the Maze
27:45and how important that is and when we
27:48see folks in the clinic we have to be
27:52thinking like proactively for them
27:54what's what are some of the things that
27:55could happen to you you could fall and
27:57so does your doctor actually sneak up
28:00behind you and pull your shoulders or if
28:01you're in your Europe they pull your
28:03hips okay to see what your balance is
28:06like if they don't they should because
28:08we should be doing everything we can to
28:10prevent Falls seems pretty simple to me
28:12we don't do it should we be taking
28:15multivitamins every day and Ken and I
28:17were talking about this before how there
28:19are all these neutral companies so if
28:20you want to make money invest in a
28:22neutraceutical company but if you have a
28:23disease like Parkinson disease you don't
28:25need all of that stuff okay you need is
28:27one multivitamin because if you're on
28:29dopamine replacement it actually
28:31depletes certain things like B12 and B6
28:34and increases other things like
28:35homocysteine so making sure you're on
28:38just a a simple Centrum or a simple
28:40multivitamin that's what you need okay
28:42not overdosing vitamins but it's very
28:44important we don't tell people that
28:47super important part of the sea like why
28:48are we not telling people these things
28:51did you know that the risk of Parkinson
28:53disease getting melanoma getting a skin
28:55cancer with Parkinson is twice the risk
28:56of the general population if you live in
28:59Florida it's probably even more okay we
29:01don't tell people that we should be
29:03telling people you should go to see the
29:04dermatologist as often as you see the
29:06dentist hoping everybody here sees the
29:08dentist at least once a year okay super
29:11important that's part of that se we're
29:13not doing a good job on that aspect and
29:17it's it's that whole puzzle that has to
29:20come together in order to get to that
29:22ending Parkinson disease being proactive
29:26okay if you have Parkinson disease one
29:30in three people who have Parkinson are
29:33going to go to the hospital at least
29:35once a year one and three and once
29:37you've gone the ratio goes to one and
29:39two we know this from doing multiple
29:41studies through the Parkinson Foundation
29:43all the studies that I did with all of
29:45these great investigators all around the
29:46world didn't change a damn thing okay
29:49you know what did making this kit that
29:53we gave out hundreds of thousands of
29:55these kits it's like you know when you
29:57when you have a bag and you pack a bag
29:59because you know you're you're you know
30:01you're going to go to the hospital
30:02because there's a baby coming okay if
30:04you have Parkinson you should have bagp
30:05packed and this has everything you need
30:07to survive a a Parkinson hospitalization
30:09all the things that you give to the
30:11doctors and the nurses because they may
30:12not listen to you they may not know you
30:14may have to be the advocate that helps
30:17to get you through that hospitalization
30:19because shocker Cher number four okay
30:24the hospital is a very dangerous place
30:26for people who have Parkinson disease
30:28okay great quote by Jared kinz I have
30:31have a favorite Cemetery I go to because
30:33it's really clean and the doctors and
30:35the nurses are all very nice okay think
30:39about it do you have a plan for therapy
30:42and
30:43exercise it turns out that exercise is
30:46like a drug for Parkinson did you know
30:48that did you know that most experts
30:51now prescribe exercise for Parkinson
30:54disease but they say do exercise for
30:57Parkinson disease they don't
30:59say what you should do they don't say
31:01how much you should do it they don't
31:03look at at what your other you know
31:06conditions are that may impact what you
31:08can and can't do having a plan okay
31:11having a plan and a strategy is so
31:14important with Parkinson and we can't
31:15just keep saying okay do this do that it
31:18needs to be a plan you need to check
31:19back in and make sure you're adjusting
31:21that plan over time best way I can
31:24describe it is is when my son who's 16
31:26now when he was in first
31:27grade I'm playing chess with him before
31:30he goes to bed and I'm not a bad chess
31:35player but he was in the process of
31:38beating me for the third straight time
31:40he's in first
31:42grade and he says to me dad do you know
31:46what your problem is this my first
31:49grader okay and I said no Jack what's my
31:52problem and he said your problem is you
31:54don't have a strategy you sit down and
31:57you just show up you don't have a
31:59strategy I have a strategy Dad okay when
32:01you have a chronic disease you need to
32:03be checking in you need to have a
32:05strategy and especially if exercise has
32:07such a high impact on this exercise and
32:10other things need to be coupled with
32:12strategy okay and some of the things
32:15that you'll hear from people is about
32:17nutrition and certainly nutrition is
32:19important and we know in Parkinson a
32:21Mediterranean diet seems to be better
32:23but we don't understand a lot about the
32:25microbiome we're talking about you know
32:28absolutely billions of different
32:29organisms that change by the minute and
32:32change on all the things you do so you
32:33have all these people telling you and
32:35writing all these books about what to do
32:36with nutrition so I often say to folks
32:39be careful of what I call Nutritional
32:41overreach somebody telling you you know
32:44do this do that do this buy this because
32:47it's going to help sometimes it can
32:48actually hurt sometimes probiotics can
32:50actually hurt and so so I think it's
32:54important to take care of your body and
32:56I love the quote if you don't take care
32:57of your body where are you going to live
32:59that's important but be careful of going
33:01overboard okay very
33:03important and what's more important than
33:05depression depression was listed as the
33:07single greatest hurdle in the last
33:10decade we were talking to USA today and
33:12they said what's the biggest hurdle in
33:13Parkinson disease so a decade ago we
33:15were talking about it being
33:16depression it's diagnosable it's
33:18treatable it's part of Parkinson okay
33:21now we're doing a better job in
33:23depression and we realize that one in
33:25six people are actually going to get
33:26demoralized that makes perfect sense we
33:28just never thought about it okay and so
33:31it's important for us as we're visiting
33:33with people to take care of caregivers
33:35take care of persons with disease and
33:37address demoralization as important as
33:40it is with Parkinson what else is part
33:42of the sea your magic Sleep Number some
33:45of you have a ring like I do on your on
33:47your finger some of you have a watch now
33:50we can watch sleep and some of you think
33:52you're sleeping but you're not actually
33:54sleeping well in Parkinson you have less
33:57Reserve in your brain that means your
33:58brain is maybe you know let's let's say
34:03not functioning like when you were 15 or
34:0620 okay maybe not quite as quick because
34:09of that you have less of what's called
34:11Reserve you want to improve your
34:13function best way to improve your
34:16function sleep if you think you're
34:18sleeping a lot a lot of people are
34:21stunned when they actually look at one
34:23of these sensors I've got two of them on
34:25right now okay and the third one in my
34:27pocket okay you look at the sensor and
34:30you can see you figure out what is that
34:32magic number is it 7 hours 8 hours of
34:35good quality sleep that's going to help
34:37you if you have a neurod degenerative
34:38disease like Parkinson it's going to
34:40help with the fatigue and so
34:42understanding I call it your magic Sleep
34:43Number what's your number that you're
34:45going to be able to help you to get
34:47through that day more than two-thirds of
34:50people have pain with
34:51Parkinson nobody ever asks don't ask
34:56what' your mother say don't don't ask
34:58you're not going to get right and so so
35:00we need to begin to ask people you know
35:02like part of that sea what are the
35:04things that are going to impact your
35:06life two-thirds of people have this
35:08we're not even
35:09asking and then we have people who have
35:11gotten treatments okay so part of the C
35:14is taking care of people who have gotten
35:16some of these Advanced treatments one of
35:18the ones that um that we've worked on in
35:20our lab for over two decades is is
35:22called deep brain stimulation and it
35:25reminds me The Humbling part of this
35:26reminds me that experts are usually you
35:29don't get paid for the easy bread and
35:31butter cases if you're in medicine you
35:33get paid for the hard cases and some
35:34people get these devices and don't do as
35:37well as they should
35:39do and when we saw these people coming
35:41in from all over the world you know we
35:44try to rethink we try to change our
35:45perspective we try to troubleshoot
35:47because a lot of people just figure well
35:48I tried it and it didn't work right well
35:51it turns out that when we looked at this
35:54and this is a picture of a brain and a
35:56picture of of a paper that appeared in a
35:58journal card Archives of Neurology that
36:00later became
36:02jamama it turns out that half of these
36:04people we could help we just needed to
36:08look we needed to take a picture here's
36:10a picture of somebody and the picture
36:12shows an arrow okay you're saying why
36:15why is he showing me this because that
36:18lead that was stuck into the brain is
36:21sitting on a structure called the pineal
36:24gland which is right in the center of
36:26the brain
36:27the seed of the Soul people say you know
36:29philosophers Ken Ford's a philosopher
36:31they say seed of the soul is in the
36:33pineal gland they didn't intend for it
36:35to be in the pineal gland but nobody
36:36took a picture of it to see where it was
36:39so we plucked it out Dr foot and I put
36:41it back in the right place it's doing
36:43great okay so it's important to always
36:46rethink and not give up even if things
36:48don't go when we care for people the way
36:51that we want to this is a chronic
36:53condition with Parkinson a livable
36:55condition and finally we talk about
36:57research talk about developing new
37:00treatments to prevent Advocate care was
37:04the C right T development of new
37:08treatments okay and will it surprise you
37:11if I tell you that Parkinson is
37:13underfunded HIV gets about three billion
37:15a year and that's prevented thousands if
37:19not millions of people from Ever
37:21developing AIDS and very severe HIV it's
37:23really changed the course of that
37:25Parkinson
37:27about 200 to $250 million many more
37:30people with Parkinson it's growing
37:33faster than Alzheimer's and any other
37:35neurological disorder that funnel folks
37:38is not big enough okay and somebody
37:41asked me the other day about you know
37:44tell me about all the failures like we
37:47put all this money in and there are all
37:49these failures I said I'd love to I love
37:51to talk about failure Okay the reason
37:54that I love to talk about failure is if
37:56you're signning scientist and you've
37:57been in the field you realize you need
38:00to fail a lot to succeed if our funnel
38:04is not big enough and we're fighting
38:06over scraps we're not going to even fail
38:08enough to get to where we need to go
38:12this is just known you know this is this
38:16is centuries old wisdom and so we think
38:19about developing therapies for Parkinson
38:22I like to think about it in buckets
38:24because I I consider myself sort of a
38:25simple guy and my and my my son said I
38:28needed to get my act together okay so
38:30the three buckets that I think of this
38:33in are the first bucket is symptomatic
38:35these are therapies that now that could
38:37help people now okay the second bucket
38:40is what if we could slow down the
38:42disease long enough so that something
38:45else overtakes you okay and then and
38:48then of course when they get that then
38:50then we've got to push it out a little
38:51further right but so that's a strategy
38:53we call that disease modifying some
38:55people call that neuroprotection
38:57okay people stopped using the word neuro
38:59protection and degenerative diseases
39:00because it couldn't get there so they
39:01changed the name okay it's a good
39:04strategy and then the last bucket is
39:07cure and we're far away from a cure
39:10although people will say we're going to
39:12cure this in five years give me all your
39:13money and I've heard this over and over
39:15and I work for the Parkinson Foundation
39:17as a as an advocate and as their medical
39:20director and advisor since 2006 and and
39:24my joke is not a joke it's the every
39:27month somebody claims they cure
39:28Parkinson disease and I guarantee you if
39:31we cure Parkinson disease I'm going to
39:32give it to you I'm going to give you the
39:34formula it's not going to be like Coke
39:35I'm going to open the I'm going to give
39:36it to you okay so we're not there on
39:39cure and I like to say the SE bucket you
39:43know we should change the name to the
39:44Pea bucket not what you're thinking okay
39:47Precision medicine like so certain genes
39:50you know that certain uh genetic
39:53abnormalities lead to Parkinson maybe
39:54those will be the first ones that we
39:56devel velop certain specific therapies
39:58to try to treat and the therapy dopamine
40:02okay which is what we gave to the woman
40:05in the video I showed you from
40:07Awakenings from Robin Williams dopamine
40:10as a treatment is still the best single
40:12treatment for Parkinson yet it's over 50
40:14years old and it doesn't stop disease
40:17progression or slow disease progression
40:19so we still I mean we're grateful to
40:21have it grateful to have deep brain
40:23stimulation as well but it's not enough
40:26okay and so we have to begin to ask
40:30questions particularly about hot topics
40:32of what's going on in research and so
40:35induc sub Manan at UCLA and Johnny
40:37atcherson and I we put something up
40:38every month like a detailed blog that
40:41keeps track of some of the newer things
40:43that are happening you know so people
40:45can you know become educated and
40:47actually understand what's going on and
40:49so there's been a lot of controversies
40:52do I need a skin biopsy do I need a
40:53certain type of scan like a DAT scan for
40:55Parkinson disease okay turns out that
40:59the best diagnosis is still with Dr
41:02Garder okay here in his office as a
41:05neurologist even better than what we're
41:07seeing in some of these tests tests can
41:10be useful along the way but it's still
41:12so important to to actually touch and to
41:16treat the person with Parkinson you
41:18probably also heard in the news there's
41:20been a big breakthrough in Parkinson
41:22right a big breakthrough you all have
41:23heard that and um and the break bre
41:26through was in an evolution it's a story
41:31of how since the early
41:332000s we have begun to to be able to
41:36identify Parkinson in the blood okay and
41:40we did that similar to another disease
41:42called mad cow disease nobody Run for
41:44the doors okay we use that technology on
41:46degenerative diseases and it's actually
41:49been going on for a while but finally
41:51you reach an inflection point where you
41:52say okay now if we put Parkinson blood
41:57or Parkinson cerebros spinal fluid the
41:59fluid that bathes the brain and the
42:01spinal cord into a tube and we shake it
42:04really hard for like 20 hours we can
42:07mark it and separate it and then see
42:10some of these Parkinson proteins and so
42:11that's what people are talking about the
42:13ability to Market in blood will it
42:15change the treatment maybe one day but
42:17it's still more of a diagnosis and more
42:19of looking at progression what's coming
42:22what are we seeing what's coming in 2024
42:25okay for Park and disease well one thing
42:27you're going to see coming this week and
42:29I was joking when I came in I always
42:31Chang my slides right up until the
42:32minute and I know a series of papers are
42:35coming out this week on this in a major
42:37journal but they didn't hit right before
42:39so I can't tell you the answers that
42:40they were going to tell you so sorry to
42:42leave you in that but we know that as we
42:47are Marching toward more trials that
42:50we're going to have to do a better job
42:51of classifying Parkinson which isn't one
42:54disease developing staging systems and
42:56classification systems to help us to
42:58drive the clinical trials okay and we
43:02have to ask the certain questions like
43:03why are we classifying patients with
43:06Park is that going to help us maybe
43:09maybe not is it going to help us for the
43:11for your clinicians to talk to each
43:13other is it going to help you to
43:15understand where you are so there's a
43:16whole bunch of things that as we become
43:19a little bit more seasoned we're going
43:22to be able to to help people and
43:24hopefully help to draw those clinical
43:26trials and you'll see and you'll read
43:29about all these in Innovations one that
43:31we wrote about is the the vibrating
43:32glove you may have seen it on NBC right
43:34put the glove on and your Parkinson gets
43:37better okay and there is something to
43:41vibration therapy and in fact there was
43:43a a neurologist called shako who would
43:46see people in the Sal petrier it was a
43:48hospital for women he was some say he
43:51was the very first
43:53neurologist and people would come from
43:55all over the world to see him and they
43:56would get out of the hor drawn carriage
43:57or they would get off after a train ride
44:00and their Parkinson would be better and
44:03he thought well it was probably better
44:04because of the shaking the vibration and
44:06that's where vibration therapy started
44:08and vibration therapy can be helpful to
44:10mildly improve Parkinson it might even
44:12be able to change some of the
44:14oscillations in the brain that we study
44:17for different diseases even in my lab so
44:20this got on NBC and everybody said I
44:22want these gloves give me the gloves I
44:23see the guy on TV with the gloves but so
44:26far folks we haven't seen a placebo
44:28controlled study of this we've seen this
44:30over and over so so I'll be the first to
44:33jump on board and put the gloves on the
44:35Michael Jackson glove one or two and and
44:37give them out but we're not quite there
44:39so it's important that we think through
44:41these things but the idea is is a good
44:43idea how about cough syrups for
44:46Parkinson disease well it turns out that
44:48one of the ingredients in cough syrup
44:51called
44:52ambroxol can be
44:54used on one of the end enzymes that's
44:56important particularly in one of the
44:58genes that causes Parkinson called the
45:00GBA Gene to potentially treat or slow
45:03progression and so there's a new study
45:06that's going on in the UK and then
45:07there's a it started with a guy named
45:09Tony shapira who published the first
45:11study inj neurology a couple of months
45:14ago on this and so there might actually
45:16be something to it the problem is is we
45:18don't want you going and grabbing cough
45:19syrup and taking it because that can
45:20actually worsen your Parkinson
45:22especially all the other ingredients
45:23plus we need to test it to make it's
45:26safe to make sure it's something that
45:28might be helpful but the answer could be
45:31under our noses and so we have to look
45:33and remember there are many types of
45:35research for Parkinson so here's Isa go
45:38gundz here being interviewed by CNN one
45:40of our uh scientists here on brain
45:43oscillations uh Karen heglund doing
45:45research looking at cough and swallow
45:47the leading cause of death in Parkinson
45:49is aspirating into your lungs Don Bowers
45:52in neuros cych uh a paros Shukla and
45:56stimulating from outside the brain
45:57remember it's not just drugs folks okay
46:00there are lots of things that are going
46:02to drive innovation in the field so on
46:05the horizon you're going to see us
46:07targeting specific genes you're going to
46:10see new techniques to modulate the brain
46:12and the Brain circuits new drugs and
46:14then repurpose drugs maybe right under
46:17our noses and even in our lab and others
46:20around the world have been looking at
46:23the idea of understanding the brain's
46:25language so that's what I've done for
46:27most of my career listening to the cells
46:28in the brain trying to understand that
46:30language and then developing implants
46:32and things that might be able to
46:34communicate and improve the symptoms and
46:38this is a very early example from our
46:41laboratory where it's kind of like an
46:43EKG for the brain okay this particular
46:45person has a tick could be a Tremor or
46:47whatever and learning how to pick up
46:50those signals and then to teach a device
46:52how to respond in real time we're now
46:55seeing this after several de we're now
46:57seeing a lot of these Innovations make
46:58their way into the clinic to try to
47:01treat specific symptoms for specific
47:05folks so HRI roer was a Nobel Laureate
47:09and he said that science means that we
47:12constantly have to walk a tight rope
47:14between Blind Faith and curiosity
47:17between expertise and creativity between
47:20bias and openness and experience and
47:24Epiphany between ambition and passion
47:27between arrogance and conviction in
47:31short between an old today and a new
47:35tomorrow and so we think about this
47:38there are all sorts of new therapies you
47:41may have seen this one that was uh
47:43recently on 60 Minutes focused
47:46ultrasound okay in the brain and you can
47:49see you know ways that we can stimulate
47:51from outside the brain to either make
47:53lesions in circuits that's what a focus
47:55ultrasound does or we can shoot the
47:58focused ultrasound in at very low
48:01frequencies to not injure anything and
48:03to open up you see this blood vessel
48:05here to open up the bloodb brain barrier
48:08and the way they do that is is you
48:09inject some micro bubbles into the brain
48:12you see those little bubbles that are in
48:13there and then the focused Ultron makes
48:16the bubbles big and then it pushes The
48:18Vessel open and opens up these areas
48:20called Gap Junctions and things can
48:23suddenly flow in to the brain and so
48:26thinking about also maybe this isn't the
48:28end you know like therapy there are some
48:31problems with this too there are some
48:32positive things about it both as a
48:34therapy but but thinking out of the box
48:37like how we can get things to the brain
48:40this is Ed boen at Boyen works up in MIT
48:44and he and near Grossman developed a
48:46technique where they can stimulate from
48:47outside the brain so maybe we could get
48:49rid of the deep brain stimulators I
48:50think if people said hey we don't have
48:52to go into your brain at some point
48:54you'd say sign me up right right and so
48:56we're not quite there but thinking out
48:58of the box and seeing some of these new
49:01things is important the combination of
49:03light and genetics called optogenetics
49:06called diesel Roth and others from
49:08Stanford and other Laboratories around
49:10the world have really pioneered this in
49:12the laboratory trying to use little tiny
49:15particles called nanop particles and get
49:17them to where they need to go and then
49:19upregulating them with light this is one
49:21of our fellows who's now up at Southern
49:24Illinois Dr kuzi read a great article on
49:27this but thinking about all of the ways
49:29that we can change and think out of the
49:32box you know about uh about how we're
49:34doing things and how we can do things
49:37differently and so sending these small
49:39particles called nanop particles we're
49:41using magnets and magnets and
49:42electricity and magnets and heat
49:45together and so these are some of the
49:47just the cool science things that I saw
49:49on the road recently when I was in a um
49:53gryl
49:54France and thinking about prevention and
49:59thinking about what is it that we can do
50:02as a field to try to reduce the number
50:05of cases we have and the burden that we
50:07have of Parkinson and so there's this
50:09great quote by William F about vaccines
50:11being the tugboats of preventative
50:13health and it isn't necessarily true
50:16that all diseases are going to get
50:18vaccines but there is a link between the
50:20immune system and the brain and the
50:23immune system and other organs and
50:26understanding that and understanding how
50:28we might be able to
50:30utilize this relationship to try to
50:34develop therapies that might slow
50:36progression or might allow us to kind of
50:40reach that end point of the P bucket as
50:42we said or the C bucket at some point is
50:45important we're still far away but it's
50:48something to be thinking about P is for
50:50prevent a is for Advocate C is for care
50:55and T is for the development of new
50:57treatments and as we March in that
51:00direction you're going to hear a lot not
51:03only in Parkinson but in other diseases
51:05about something called a
51:06biomarker something that can tell you
51:09what's going on and this was sort of the
51:11big rage you know like oh there's a big
51:13breakthrough it wasn't a treatment
51:15breakthrough it was an inflection point
51:17after many years of research from many
51:19Laboratories as to how to Mark Parkinson
51:22how to tell somebody has Parkinson and
51:24when you have a really great marker of a
51:27disease then instead of needing
51:30thousands of people to enroll in a
51:31clinical trial you only need hundreds
51:34and that can be a GameChanger when we're
51:37thinking about pushing more dollars more
51:40science more technology but also more
51:44hope for people as we move forward so
51:46this is a biomarker of Imaging Dave
51:48Valen cour and I work on just down the
51:50road here called freeat Imaging for
51:54Parkinson I am supported by National
51:56Institutes of Health by multiple grants
51:58so I always say thank you to the
52:00government for for uh for supporting
52:02much of the work and the taxpayers and
52:05thank you all for the invitation to
52:07speak tonight and I would just say that
52:09when we think of this think
52:13about what we can humbly do to leave the
52:17Next Generation in a better place than
52:20this generation and to try to take those
52:23numbers with Parkinson and turn it
52:25around and so that's what I want you to
52:27think about tonight that's what I I hope
52:30uh has inspired you in some way to think
52:33about what we can do to change things
52:35for the Next Generation so thank you all
52:37for the invitation to to speak it's an
52:40honor to be
52:48here thank you Michael so much so I'm
52:51sure there's a plethora of questions
52:54here um so I'm gonna take a few we're
52:57gonna start back here
53:01sir
53:05okay hi Dr Oaken thanks for being here
53:08I'll stand up so you can see I can see
53:10you I see who you are it's nice to see
53:12you yes he's seen me in the operating
53:15room uh you gave kind of short shrift to
53:19the gut
53:20biome uh I hear a lot about that as a as
53:25a something positive with with Parkinson
53:28if if that is true does it happen
53:32through the blood or through the Vagas
53:34nerve or is it all just quackery in the
53:37first place yeah okay so great I'm it's
53:39a great question and I did give short
53:41shriff and the reason I gave short
53:42shrift was I you know I like to temper
53:46things a bit so people who are actually
53:47seeking care kind of go to things where
53:50we have you know some answers that might
53:53affect their lives and I I find that the
53:55nutritional overreach sometimes people
53:58get over excited I'm super excited about
54:01the research in nutrition it's one of
54:02the areas that is expanding the most we
54:05have a whole bunch of investigators over
54:07the last five years that we've been
54:09investing in you know here you know to
54:11do research in this area and I think
54:14that it's important for people to
54:16realize that when you look at the gut in
54:19Parkinson or you look at the gut in a
54:21normal person there are absolutely just
54:24millions and billions of fudges and
54:27viruses and and things that are living
54:29in there and if you sample it called the
54:32microbiome you take a sample and you
54:34look at this there's Absolut this is
54:36mindblowing there's no human here
54:40present nobody that I've met that can
54:42look at that data and interpret it this
54:45is going to have to be interpreted by Ai
54:47and by computers and of course it
54:49changes dynamically over time I mean
54:51this is just mindblowing to think about
54:53what's going on now there was a great
54:56experiment that was done on the
54:58microbiome in California and then one of
55:01the investigators was young mooved to
55:03Emory named Samson and they published a
55:06number of great papers and several other
55:08folks have done this as well where they
55:10can actually show where they change the
55:12microbiome and induce Parkinson and make
55:14symptoms worse and better in the animals
55:16it's pretty interesting okay it's pretty
55:19interesting and so we know that there
55:20are certain things that you can do
55:22symptomatically with your diet in terms
55:24of timing with certain types of diet we
55:26know certain proteins affect drug
55:27absorption so it gets very complicated
55:30both in the care area but the question
55:33is is what's going on and is Parkinson
55:37two different versions of Parkinson so
55:39there's a great pathologist in Denmark
55:42named perr Borger great name right perr
55:45Borger so per Borg Heimer has been
55:48writing a lot about brain first
55:50Parkinson and body first Parkinson and
55:52one of the the big theories is is that
55:55the body first Parkinson runs through a
55:57nerve called the Vegas nerve that
55:58connects the brain to all the different
55:59organs in the areas and that that's part
56:02of the connectivity but we don't know
56:04what we don't know and anytime a speaker
56:07comes up in front of you and gives an
56:08answer that that that is that long it
56:11tells you they don't know the answer to
56:12the question okay but yeah I didn't mean
56:15to give short shrip I am excited about
56:17that area I know there were some hand
56:20okay
56:22ready thank you very much it was very
56:25enlightening uh many years ago there was
56:28thought that there was an increase in
56:31Parkinson from the people that survived
56:33the Spanish Flu is there any indications
56:36that maybe the people that survived the
56:37Corona virus will have an increased
56:40incident yeah so this is a great
56:42question and I'm just going to
56:43paraphrase back for folks there was this
56:46notion that um that all of Parkinson
56:49disease I'm going to tell you something
56:50really interesting there was a notion by
56:53two Harvard
56:55neurologists okay so they must have been
56:57someone named Schwab and post ganzar
56:59okay and they had this
57:02hypothesis that that because of the
57:04Spanish Flu that all of Parkinson would
57:06die out because only people were going
57:08to get Parkinson were the ones that got
57:09it from the flu they were so sure of
57:12this hypothesis they were I think it was
57:15either time or Life Magazine they they
57:18they were just absolutely you know to
57:21the to the level of arrogance I think
57:23that they they bet anybody
57:25case of scotch that could show them a
57:27case that didn't have anything to do
57:29with the Spanish Flu okay and after
57:32several cases of scotch they abandoned
57:35that hypothesis okay so so so that was
57:39kind of interesting and so the question
57:41of viruses and risk it didn't it didn't
57:44mean that they weren't right at some
57:46level but not all of Parkinson was
57:48caused by that now when we look at flu
57:51there's some papers on flu and Parkinson
57:53disease when that was published recently
57:55in G neurology that was very important
57:57and now Corona virus even this morning
58:00there were for I know all of you use X
58:02or Twitter or whatever it's called now
58:04but there's a lot of scientists are on
58:06that and even this morning there was um
58:08a tweet from Eric toppel who wrote the
58:11democratization of data and and is into
58:13AI talking about a new paper and the
58:16relationship to degenerative diseases
58:18and whether we're going to need to
58:19monitor we don't know the answer yet and
58:23there's a lot of debate
58:25but the debate will um will fade as we
58:28get more years of followup and so we
58:31won't know for sure but there are some
58:34worrisome signs that that there may be a
58:37relationship you know between these two
58:39things and and this could push if it if
58:42it is true and I hope it's not but if
58:45it's true on a large scale this could
58:47push that number even higher and at a
58:50faster rate of Parkinson so it's
58:52something that is very worrisome
58:56Dr cier my good to have you back here
58:58Ina great to be here two questions first
59:02is a followup on the microbiome question
59:04and the question is do you ambition in a
59:08few years of taking stool samples on
59:11patient with Parkinson disease and
59:13prescribe uh mainly probiotics specific
59:17to develop some bacteria that could help
59:19and is that I know that's people there
59:21are people working on that what are your
59:23thoughts about that so I think it's it's
59:25totally possible across there will be
59:28some diseases that I think go in that
59:30direction and it may not be Parkinson or
59:32it may be Parkinson but I do think that
59:35um as gross as it sounds I think that
59:39that what you see in stool samples it
59:42can be used you know to better
59:45understand the microbiome and to design
59:47therapies and so I think it's totally
59:50possible will it happen across all of
59:52Parkinson I'm not sure because Parkinson
59:55is such a heterogenous disease 20% of it
59:58is less than 20% are genes you know
01:00:01there are multiple different causes and
01:00:02so you know it might not end up being a
01:00:05one- siiz fits-all but I do think that
01:00:07there's a good chance you're going to
01:00:09see that what you are seeing now are a
01:00:12number of groups and um and there's some
01:00:14papers that are coming out uh on people
01:00:17doing feal microbiota transplantation
01:00:21transplantation of the cells back in so
01:00:23far hasn't been like super successful
01:00:25but again sometimes when people try
01:00:27things you know it's like it's like
01:00:29being I I I was telling the students
01:00:31this morning it's like being first in
01:00:33line at the keg for a drink of beer
01:00:35isn't always the best place to be okay
01:00:38and so a lot of these these people that
01:00:40they want to be first on feal
01:00:42transplantation first may not be
01:00:43necessarily that it's wrong but the
01:00:46appreciation the understanding may not
01:00:47be there you had a second question um
01:00:49can you comment on immunotherapy on
01:00:51Parkinson's specifically as it relates
01:00:53to Alpha nucle immunotherapy yeah so
01:00:56immunotherapy for Parkinson disease and
01:00:59and this was you know kind of on the
01:01:01tugboat slide of talking about William
01:01:03fos and the and this idea of can you use
01:01:06the immune system against Parkinson the
01:01:09answer is yes so Parkinson deposits a
01:01:12protein in the brain called Alpha
01:01:14nucleon people call it Louis bodies it's
01:01:16actually named after a neurologist I
01:01:17don't think a neurologist would have
01:01:19wanted to be named after a you know a a
01:01:21a bad protein that deposits in the brain
01:01:24and Par but so be it so Frederick Louie
01:01:26gets his name there we talk about Louis
01:01:28bodies they have this thing called Alpha
01:01:30and nucleon and so you say well let's
01:01:32just send antibodies so there's been a
01:01:34couple of antibody trials published in
01:01:36the New England Journal of Medicine
01:01:37didn't work okay some even had side
01:01:39effects of other therapies and so the
01:01:42question comes up is it is it enough to
01:01:44scrub the brain clean by using either
01:01:47viruses or immunotherapies or antibodies
01:01:51you know is that enough or will they
01:01:52still have Parkinson because
01:01:55these proteins these deposits these
01:01:58plaques like you get plaque on your
01:01:59teeth you get plaque on the brain you
01:02:01know like if you get rid of it they
01:02:02still may have Parkinson they may just
01:02:04have a clean brain what is most
01:02:06interesting is is in Alzheimer's disease
01:02:08a lot of people had begun to give up on
01:02:10that but some of these new antibody
01:02:12therapies by clearing away some of the
01:02:14amalloy and the plaque there seems to be
01:02:16some mild benefit to that and so it
01:02:19could be that we're on the road to um
01:02:22what we see in cancer therapies where
01:02:24you a combination of therapies where we
01:02:26you you get a cleat in the ground and
01:02:27you get you get a foothold and maybe
01:02:29piece of the foothold is there's a
01:02:31little bit of benefit from clearing
01:02:32something that's a late process that
01:02:34happens late in Parkinson and then we're
01:02:36going to need drugs and other other
01:02:37things that are going to come in
01:02:39combination like combination
01:02:40chemotherapy hopefully it's not like
01:02:41chemotherapy but combinations of drugs
01:02:43that that strike at different aspects of
01:02:46it but I think a lot of the scientists
01:02:48are concerned that when we go after the
01:02:50sin nucle and deposits it may be too far
01:02:53along in the process process but what is
01:02:55cool is we're able to do it in the
01:02:56animal and in the human and uh and then
01:02:59we'll see and um there there may be some
01:03:01benefit but it hasn't been awesome yet
01:03:05so we're hoping for an awesome moment an
01:03:07aha
01:03:09moment okay we have time for about two
01:03:12and I have that you and you and I'll
01:03:14take you sir okay three
01:03:19then Dr thank you very much for coming
01:03:22this has been very interesting I have
01:03:23two question questions for you you
01:03:25indicated you have a sleep monitor on
01:03:27your wrist and in your pocket and I
01:03:28think in two pockets can you can you
01:03:30tell us and on your hand can you tell us
01:03:32what what is the name of the sleep
01:03:34monitor that you recommend yeah and then
01:03:36the second question is Muhammad Ali had
01:03:39Parkinson for 33 years Michael J fox is
01:03:42still alive he's had it for over 34
01:03:44years how do you explain that these
01:03:46individuals have coped with this long a
01:03:48period of time and maybe because it's
01:03:50lasted so long for some people it
01:03:52doesn't have the urgency that probably
01:03:54HIV or other uh diseases had and that's
01:03:58why there seems to be slow funding for
01:04:00it in Congress yeah great questions okay
01:04:03so let's start first of all I um I will
01:04:06not endorse anybody's product but I will
01:04:09tell you I have an eyewatch I have an
01:04:11iPhone and I have an AA ring and uh and
01:04:14and I don't think there's anything
01:04:15magical about you know like which device
01:04:18you know you know is the one that's
01:04:20right for you it's just that these
01:04:22devices are now able to do things that
01:04:25seem just absolutely mind-blowing crazy
01:04:28to me so like when I'm in bed at night
01:04:31and you know my wife is meditating or
01:04:33doing whatever she's doing and and I'm
01:04:35sitting there listening to a book or a
01:04:37podcast or whatever and I fall asleep
01:04:39you know in the middle of the pock this
01:04:40thing picks up right when I fall asleep
01:04:43looks at my heart rate variabil is able
01:04:45to tell that and then is able to tell me
01:04:46when I wake up how many hours I actually
01:04:48got of sleep and whether I was it's not
01:04:50perfect it's not like a sleep study that
01:04:52we do you know at the the university
01:04:54it's not to that level but it's it's
01:04:56pretty awesome to get you close enough
01:04:58to that and then you know once you get
01:04:59to a certain number of hours you're
01:05:01going to do better the next day with
01:05:03those hours and it also can tell you if
01:05:06something's wrong so what the
01:05:08problem say the problem the challenge
01:05:10when you go to a doctor is it's hard
01:05:12enough to get in to see the doctor so
01:05:13they check your temperature and your
01:05:14temperature is 98.6 or whatever they say
01:05:16that's within normal well if the device
01:05:18is checking it all the time your heart
01:05:20rate variability your temperature and
01:05:22everything it can detect small small
01:05:24variations in that so then the device
01:05:26you might wake up one morning and the
01:05:28device may say you should take it easy
01:05:30today you know and then you don't even
01:05:31fret about it you're like yeah I should
01:05:33take it easy today you know because and
01:05:35and the device is right you know there's
01:05:37something ain't right you know something
01:05:38just isn't right so I think there's
01:05:40value to that second question on
01:05:42Muhammad Ali so um so I I subscribe to
01:05:46What's called the gold water rule which
01:05:48you know if those of you that remember
01:05:49when Barry Goldwater ran for the
01:05:52presidency they um they be merched him
01:05:56um and it led to the Goldwater rule
01:05:57because they said he was unfit and the
01:05:59psychiatrists voted him as being unfit
01:06:01for office and so those of us that take
01:06:03care of people we're supposed to take an
01:06:06oath that unless we see the person in
01:06:08person we examine them and we have
01:06:10permission of the family we can't talk
01:06:11about them I was under that oath with
01:06:14the Ali family for many years and then
01:06:16recently they gave us permission and we
01:06:18published his data last year in
01:06:20Parkinson disease in jamama and it turns
01:06:24out that he had a form of Parkinson
01:06:26disease called tremor dominant Parkinson
01:06:27disease it wasn't just from being hit in
01:06:30the head okay repeatedly now that can
01:06:32contribute to neurological damage but he
01:06:34had a a form where he was responding to
01:06:36dopamine he had young onset Parkinson
01:06:39and um and so it raises an important
01:06:43question of what you raise is the
01:06:45awareness of the public it's confusing
01:06:47for the public right to see these things
01:06:50in people and it's also confusing to see
01:06:52where some people at Parkinson can go 20
01:06:5430 years and some people can go 10 or
01:06:57eight right and some people have a
01:06:59Tremor and one in five people don't have
01:07:02a Tremor you you see all of these things
01:07:03and so so I think getting the awareness
01:07:06out is important but there are lots of
01:07:08examples of diseases that have sprinted
01:07:11forward toward getting that funnel
01:07:13increased for funding and getting what
01:07:15they need to change the um the overall
01:07:18trajectory there are lots of examples
01:07:21that have happened and um and these
01:07:23diseases are long-term chronic so I I
01:07:26would love to blame it on that that's a
01:07:28good a good idea but I don't think it's
01:07:31just that I think we just haven't hit
01:07:33the inflection point where you know like
01:07:35in HIV and in polio and everything once
01:07:38we wake up and we get enough people on
01:07:39board and we hit that inflection point I
01:07:42think it's going to change that that's
01:07:44what I think and I give myself and
01:07:46everybody else that's been at it for 20
01:07:48years with Parkinson Foundation Michael
01:07:50J fox Foundation everything I give us
01:07:51all an F an F for not reaching that in
01:07:53Reflection Point but with your help we
01:07:55can hopefully get there
01:07:58yeah good evening thanks for being here
01:08:00yeah just a quick question in your
01:08:02observations with patients is there a
01:08:05higher propensity based on gender age
01:08:09race and you said places to live yeah so
01:08:13um so there are differences the more men
01:08:16get Parkinson disease than women and
01:08:18then the types of symptoms that men and
01:08:20women get are different and that's been
01:08:22studied there are different is in um in
01:08:25race we know for example that people um
01:08:30of African-American or black descent
01:08:32that have Parkinson disease are not
01:08:33getting care so it it isn't so much that
01:08:36there's less Parkinson there but they're
01:08:38just not you know getting the care
01:08:40they're not getting access to new
01:08:43surgical treatments and and this is a
01:08:46huge huge issue and so we have an
01:08:49initiative here at Florida called black
01:08:51PD that we work with Michael J Fox
01:08:54foundation on to try to reach people
01:08:56that have um you know various you know
01:08:59what we call uh folks that have been in
01:09:01communities that are just either not
01:09:04getting the information but also what
01:09:06we've learned is Ashley RWS who was one
01:09:09of our medical students went off to
01:09:10Stanford and came back and she goes into
01:09:12the communities and finds out that we
01:09:14are not doing a great job you know not
01:09:16just in African-American communities but
01:09:18in communities all over the US okay and
01:09:20getting the word out and teaching people
01:09:22about the therapy and also creating
01:09:24trust back and forth we know this is
01:09:27true not just in African-Americans in
01:09:29the US we know it's true in african-
01:09:31American and black populations
01:09:33throughout the world we also know that
01:09:35we see these disparities across the
01:09:37world in other areas we see Parkinson
01:09:39disease in every single continent so
01:09:41it's like pan and deos like and and and
01:09:44so there are some huge inequities and
01:09:49huge problems and um I sat on a
01:09:51committee for the World Health
01:09:52Organization about this and we actually
01:09:55put out a paper two years ago six action
01:09:58steps that the world needs to take you
01:10:01know for improving the disparities in
01:10:03Parkinson particularly in low-income
01:10:05countries but it hasn't improved and the
01:10:09one thing I can tell you that is
01:10:11troubling to me is um is when we keep
01:10:14talking about it but there's absolutely
01:10:16not been any progress in it and that is
01:10:18really frustrating and so it means
01:10:20either we're not doing something right
01:10:22we're not doing it enough and we're not
01:10:25paying attention to it enough and so
01:10:27these things are super important the
01:10:28final point I'll make is is that when
01:10:30you have Parkinson disease having a
01:10:32great caregiver care partner is super
01:10:34important and that actually correlates
01:10:37with how well you're going to do and so
01:10:38when we see somebody in the clinic you
01:10:41know the students always say to you why
01:10:43do you spend so much time with a care
01:10:44partner when they first start and then
01:10:46after they spend a long time they
01:10:47realize ah you should be spending all
01:10:49your time with the care partner and the
01:10:50caregiver because that's the key to the
01:10:52person doing well and it's so important
01:10:56and it turns out that when the the man
01:11:00or the woman has Parkinson disease it's
01:11:03different the support that they get and
01:11:06for women who have Parkinson disease
01:11:07they don't get the same support that men
01:11:10do that's a problem that's a huge
01:11:13problem an unmet need and it's it's
01:11:16something that's been been shown over
01:11:17and over in research yet we still
01:11:20haven't done enough about it to address
01:11:24it so so there are serious inequities
01:11:27and and that should be part of our
01:11:29equation yeah was there one more
01:11:32question in the very back that I
01:11:34see uh thank you for coming doctor um
01:11:37I'm curious is there clinical research
01:11:41that actually shows processed sugar
01:11:44having uh an effect on the development
01:11:47of
01:11:47Parkinsons yeah so uh great question
01:11:50there's actually a whole bunch of
01:11:52research on processed sugar and diseases
01:11:55in general processed sugar on dementia
01:11:58in general but not processed sugar yet
01:12:02on Parkinson now the way that these
01:12:04research studies are done so you know
01:12:06here's like in they call it inside
01:12:08baseball for any Baseball fans this is
01:12:09the inside baseball Story the way that
01:12:11these studies are done on pesticides on
01:12:14associations when you want to know if
01:12:16processed sugar is responsible for
01:12:18something you want to know if pesticide
01:12:19is responsible for something one study
01:12:21is one study what you're looking for is
01:12:23a whole bunch of people in a whole bunch
01:12:26of different regions showing the same
01:12:28finding over and over so what we're
01:12:30seeing now with processed sugar and
01:12:33disease are are lots of one-offs okay
01:12:37and what we're going to see over the
01:12:38next you know 5 to 10 years is either a
01:12:41convergence or Divergence of data that
01:12:45suggests that there's something to this
01:12:47story and so I always get a bit nervous
01:12:51about like one study here one study
01:12:53there but in Parkinson on the pesticide
01:12:5620 years ago Ray dorsky and I we talk
01:12:58about this a lot and we're writing
01:13:00another book right now and so we talk
01:13:02all the time and we talk about how 20
01:13:05years ago you know like if you said
01:13:07pesticides and Parkinson disease people
01:13:10you know like we were all like how could
01:13:11that be and there was only one or two
01:13:12studies you said head trauma in
01:13:14Parkinson how could that be and now we
01:13:16say of course of course you know like
01:13:19yeah of course that is so will it be the
01:13:21same story you know for processed sugar
01:13:24I don't know it's too it's way too early
01:13:26to tell although there are some um both
01:13:29intriguing and uh and very worrisome for
01:13:32those of us that like like Coke Zeros
01:13:34and things like that there's some
01:13:35worrisome um information there for those
01:13:38of us that like diets off drinks and
01:13:40other things like that
01:13:42so so y'all thank you so much and
01:13:44Michael thank you so much for being
01:13:52here
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