{"page":"\u003clink rel=\"stylesheet\" href=\"https://lessonplanet.com/assets/packs/css/resources-c03aa079.css\" /\u003e\n\u003clink rel=\"stylesheet\" href=\"https://lessonplanet.com/assets/packs/css/lp_boclips_stylesheets-517835be.css\" media=\"all\" /\u003e\n\u003cdiv data-title='Parkinson\u0026#39;s disease - a journey through a brain' data-url='/boclips/videos/5c54d404d8eafeecae1ef27e' data-video-url='/boclips/videos/5c54d404d8eafeecae1ef27e' id='bo_player_modal'\u003e\n\u003cdiv class='boclips-resource-page modal-dialog panel-container'\u003e\n\u003cdiv class='react-notifications-root'\u003e\u003c/div\u003e\n\u003cdiv class='rp-header'\u003e\n\u003cdiv class='rp-type'\u003e\n\u003ci aria-hidden='true' class='fai fa-regular fa-circle-play'\u003e\u003c/i\u003e\nVideo\n\u003c/div\u003e\n\u003ch1 class='rp-title' id='video-title'\u003e\nParkinson\u0026#39;s disease - a journey through a brain\n\u003c/h1\u003e\n\u003cdiv class='rp-actions'\u003e\n\u003cdiv class='mr-1'\u003e\n\u003ca class=\"btn btn-success\" data-posthog-event=\"Signup: LP Signup Activity\" data-posthog-location=\"body_link_boclips\" data-remote=\"true\" href=\"/subscription/new\"\u003e\u003cspan\u003e\u003cspan\u003eGet Free Access\u003c/span\u003e\u003cspan class=\"\"\u003e for 10 Days\u003c/span\u003e\u003cspan\u003e!\u003c/span\u003e\u003c/span\u003e\u003c/a\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class='rp-body'\u003e\n\u003cdiv class='rp-info'\u003e\n\u003cdiv aria-label='Hide resource details' class='rp-hide-info' role='button' tabindex='0'\u003e\u0026times;\u003c/div\u003e\n\u003ci aria-label='Expand resource details' class='rp-expand-info fai fa-solid fa-up-right-and-down-left-from-center' role='button' tabindex='0'\u003e\u003c/i\u003e\n\u003ci aria-label='Compress resource details' class='rp-compress-info fai fa-solid fa-down-left-and-up-right-to-center' role='button' tabindex='0'\u003e\u003c/i\u003e\n\u003cdiv class='rp-rating'\u003e\n\u003cspan class='resource-pool'\u003e\n\u003cspan class='pool-label'\u003ePublisher:\u003c/span\u003e\n\u003cspan class='pool-name'\u003e\n\u003cspan class='text'\u003e\u003ca data-publisher-id=\"30356011\" href=\"/search?publisher_ids%5B%5D=30356011\"\u003eCurated Video\u003c/a\u003e\u003c/span\u003e\n\u003c/span\u003e\n\u003c/span\u003e\n\u003c/div\u003e\n\u003cdiv class='rp-description'\u003e\n\u003cspan class='short-description'\u003eLEADIN:A drug treatment for Parkinson's is still wishful thinking, but doctors are becoming more adept at understanding and treating symptoms of the disease.Now as researchers mark the 200th anniversary of the discovery of Parkinson's,...\u003c/span\u003e\n\u003cspan class='full-description hide'\u003eLEADIN:A drug treatment for Parkinson's is still wishful thinking, but doctors are becoming more adept at understanding and treating symptoms of the disease.Now as researchers mark the 200th anniversary of the discovery of Parkinson's, they're focusing efforts on discovering how to stop the disease progressing before before patients experience its distressing symptoms.STORYLINE:To find out how a disease progresses and inflicts increasing damage on our bodies the pathologists need to examine what has happened after a patient has died.This brain is of an elderly man who suffered strokes as well as being diagnosed with Parkinson's disease.Despite huge strides in being able to diagnose and understand what kind of a disease Parkinson's is, doctors still struggle to treat all its symptoms, let alone find a cure The disease damages the brain creating tremors in some people, muscle stiffness, an inability to move, memory damage, anxiety and depression.Research charity Parkinson's UK has helped to fund research here at the Parkinson's Brain Bank at Imperial College London.Gentleman begins his investigation with what he calls a macroscopic inspection of the brain, to see by eye whether the disease has created any obvious changes.A softening of the surface could be due to stroke prior to death, sometimes even the cause of death, the transparency of the membrane covering the brain confirms no sign of infection like meningitis.Pathologists like Gentleman also look at the patterns of the folds of the brain for evidence of shrinkage. Gentleman looks at the blood vessels supplying the brain because that will give him an idea of the man's vascular health during his lifetime.There is a sign of atherosclerosis, where the vessels are yellowed and hardened by a build up plaque, but in this case it is not serious.Gentleman explains that he is sectioning the brain to find the different stages of the disease: \"Parkinson's disease pathology, which often starts off as a motor problem, the longer you live the more likely you are to get more  cognitive problems, more decision making etcetera, so we have six areas of the brain that we know there'll be a fairly stereotypical spread of pathology over time.\" The first major cut is to separate the brain stem from the cerebellum this should reveal whether the patient was correctly diagnosed with Parkinson's.Parkinson's is a degenerative progressive disorder which means it gets worse over time. It affects affects nerve cells deep in areas of the brain called the basal ganglia and the substantia nigra. Nerve cells in the substantia nigra in the mid brain produce the neurotransmitter called dopamine, this is responsible for relaying messages that plan and control body movement.As Parkinson's UK's deputy director of research Professor David Dextor explains: \"These neurons neurons start to die in Parkinson's and it's unfortunate you only see the symptoms when you've lost about eighty per cent of them. So quite a lot of damage within the brain has happened by the time you're seeing symptoms, but the symptoms of Parkinson's are not all just about motor control. There are the non-motor features, there's a high instance of depression, a decline in cognitive function as well, so it is a very complex disease which affects quite a lot of different neuronal pathways.\"It's the bicentenary of the discovery of Parkinson's disease. Dextor and fellow researchers are keen to translate what they know about it into a treatment which is able to stop it.In the Brain Bank Gentleman's examination has found the first sign of disease. He's been looking for a lining of black cells on the mid brain. The line is made of dopaminergic cells which are black because they contain a pigment called neuromelanin.Progressive layers are deposited throughout our lives and the older you get the darker it should be. Pointing to the substantia nigra in the mid brain he points out that in this brain there is not a continuous black line you would expect in a normal brain.Gentleman says: \"And that's completely consistent with the short term of Parkinson's disease where people are losing those black cells.\"Gentleman explains: \"At this level at the macroscopic gross level the main indication for Parkinson's disease is to look at the substantia nigra in the mid brain. Do we see a loss of pigmentation in this area and in this case we do, there's still quite a lot of pigment here though so that suggests quite a short disease course so far in this patient.\"From the brain stem Gentleman detects the patients experienced a three year course of Parkinson's.A cavity in the cerebellum points to a stroke, that also could have contributed to to the patient's motor problems in addition to the Parkinson's.A closer examination at the stem reveals more vessels which have hardened fatty deposits stopping 75% of the blood flow to the patient's brain. Throughout Gentleman takes samples which are preserved in wax on slides that can be examined at a microscopic level.Gentleman starts looking for signs of longer term disease.He points to the neo cortex and says \"Stage six the last stage of six is when it gets in this area.\" The brain's frontal lobe is most affected by degenerative disorders like Parkinson's and Gentleman removes a piece of tissue which will allow him to determine how far the Parkinson's has gone and to see whether any changes have been caused by Alzheimer's.Dextor is keen that the knowledge they have gained is translated into drug treatments within years rather than decades.He admits: \"We've made huge strides in unravelling these complex mechanisms, so we know quite a lot about why the cells are malfunctioning and dying within the Parkinson's brain, but we've been a bit slow in translating those findings into developing new drugs really.\"Dopamine relays messages between the substantia nigra and other parts of the brain to control movements of the human body and allows us to have smooth, coordinated muscle movements. When sixty to eighty percent of these cells are damaged they don't produce enough dopamine and the symptoms of Parkinson's disease begin to appear.In some people tremors can be reduced by the use of electrical stimulation.Gentleman says: \"There's an area of the brain which can be stimulated in Parkinson's patients to stop the tremor. It doesn't work in all patients, but in some patients you can put in an electrode and stimulate and stop the tremor.\"Pointing to the area he says: \"So the electrode will come down through the top of the brain into the brain stem, it's a very tricky operation because the brain stem is a very small but densely packed part of the brain where all information flow up and down is going through.\"In the Parkinson's brain the pathologist is also looking for a protein called  Alpha-synuclein which is produced around the tip of the nerves.Abnormally large deposits of this protein create abnormal structures, or inclusions called Lewy bodies.If Lewy bodies are found in the outer layers of the brain, this is usually associated with problems with cognitive abilities. Gentleman says the progressive nature of Parkinson's is a problem, but also a window of opportunity.He explains:\"With Parkinson's disease and Alzheimer's disease you may have ten years of the slow incidious spread of pathology before you see any spread of the symptoms and you can look at that in two ways. That's a potential therapeutic window. So and the moment we don't have any drugs that stop the disease process, we are symptomatically treating, we're treating what we see, but if and when and hopefully with the research that goes on, we'll be able to find a drug that will stop the progression. We then need to be able to  identify those people to give that drug to, before they start showing symptoms.\"Pushed to envisage a time frame for any treatment he says: \"I think we're probably still ten years behind cancer field in terms of our approach.\"But greater understanding of the proteins like Alpha synuclein is also offering opportunities for treatment as other laboratories advance in the field of genetics and profiling.According to Dexter: \"What they've done now is you can actually analyse the whole protein signature for all the proteins in the blood and also in the cerebral spinal fluid and this is probably where an early detection system might come into play that there may be a different signature of proteins within the Parkinson's blood compared to the healthy donor's blood.\"Parkinson's Awareness Week runs until the 16th April 2017.London, UK - 6 March 20171. Close of complete brain of former Parkinson's patient 2. Various of pathologist Professor Steve Gentleman removing the vessels which deliver blood to the brain3. Various close of Gentleman examining vessels to see whether there is any hardening 4. SOUNDBITE: (English) Steve Gentleman, Professor of Neuropathology, Department of Medicine Imperial College London\"Parkinson's disease pathology, which often starts off as a motor problem, the longer you live the more likely you are to get more  cognitive problems, more decision making etcetera, so we have six areas of the brain that we know there'll be a fairly stereotypical spread of pathology over time.\" 5. Various of Gentleman separating the brain stem 6. Various of Gentleman carrying out the first crossection 7. Various of Professor David Dexter walking through laboratory8. SOUNDBITE: (English) Professor David Dexter, deputy director of research, Parkinson's UK \"These neurons neurons start to die in Parkinson's and it's unfortunate you only see the symptoms when you've lost about eighty per cent of them. So quite a lot of damage within the brain has happened by the time you're seeing symptoms, but the symptoms of Parkinson's are not all just about motor control. There are the non-motor features, there's a high instance of depression, a decline in cognitive function as well, so it is a very complex disease that affects quite a lot of different neuronal pathways.\"9. UPSOUND: (English) Steve Gentleman, Professor of Neuropathology, Department of Medicine Imperial College London (shows close of substantia nigra the dopamine producing area of the brain). \"And that's completely consistent with the short term of Parkinson's disease where we are losing those black cells.\"10. SOUNDBITE: (English) Steve Gentleman, Professor of Neuropathology, Department of Medicine Imperial College London\"At this level at the macroscopic gross level the main indication for Parkinson's disease is to look at the substantia nigra in the mid brain. Do we see a loss of pigmentation in this area and in this case we do, there's still quite a lot of pigment here though so that suggests quite a short disease course so far in this patient.\"11. Close of Gentleman dissecting the brain stem 12. SOUNDBITE: (English) Steve Gentleman, Professor of Neuropathology, Department of Medicine Imperial College London\"Stage six the last stage of six is when it gets in this area (refers to the neo cortex) 13. Close of Gentleman removing a section of the neo cortex which deals with sophisticated brain functions14. Various of Gentleman putting sample in container to be conserved for microscopic examination later15. SOUNDBITE: (English) Professor David Dexter, deputy director of research, Parkinson's UK \"We've made huge strides in unravelling these complex mechanisms, so we know quite a lot about why the cells are malfunctioning and dying within the Parkinson's brain, but we've been a bit slow in translating those findings into developing new drugs really.\"16. Various of Gentleman dissecting the brain into layers 17. SOUNDBITE: (English) Steve Gentleman, Professor of Neuropathology, Department of Medicine Imperial College London\"There's an area of the brain which can be stimulated in Parkinson's patients to stop the tremor. It doesn't work in all patients, but in some patients you can put in an electrode and stimulate and stop the tremor.\"18. Close of dissected brain 19. SOUNDBITE: (English) Steve Gentleman, Professor of Neuropathology, Department of Medicine Imperial College London\"So the electrode will come down through the top of the brain into the brain stem, it's a very tricky operation because the brain stem is a very small but densely packed part of the brain where all information flow up and down is going through.\"20. Various of dissection 21. Top shot of container holding samples taken from the brain22. SOUNDBITE: (English) Steve Gentleman, Professor of Neuropathology, Department of Medicine Imperial College London\"With Parkinson's disease and Alzheimer's disease you may have ten years of the slow, incidious spread of pathology before you see any spread of the symptoms and you can look at that in two ways. That's a potential therapeutic window. So and the moment we don't have any drugs that stop the disease process, we are symptomatically treating, we're treating what we see, but if and when and hopefully with the research that goes on, we'll be able to find a drug that will stop the progression. We then need to be able to  identify those people to give that drug to, before they start showing symptoms.\"23. Close of Gentleman working 24. SOUNDBITE: (English) Steve Gentleman, Professor of Neuropathology, Department of Medicine Imperial College London\"I think we're probably still ten years behind cancer field in terms of our approach.\"25. Close of Gentleman taking sample 26. SOUNDBITE: (English) Professor David Dexter, deputy director of research, Parkinson's UK \"What they've done now is you can actually analyse the whole protein signature for all the proteins in the blood and also in the cerebral spinal fluid and this is probably where an early detection system might come into play that there may be a different signature of proteins within the Parkinson's blood compared to the healthy donor's blood.\"27. 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