AUGUSTA, Ga. (WJBF) – The Centers for Disease Control found that as many as 5.8 million American’s were living with Alzheimer’s Disease in 2020 – a number that is expected to triple to 14 million by 2060. The second most common neurodegenerative disease – after Alzheimer’s Disease – is Parkinson’s Disease, with nearly 1 million people living with it in the United States. The Movement and Memory Disorder Center at the Medical College of Georgia is working hard to research and educate the community about these diseases, and, in doing so, will host it’s 4th Annual Brain Health Symposium.
Brad Means: We wanna focus on the human brain in the upcoming Brain Health symposium. The fourth annual event that is taking place in just a few short days, really. And we can’t think of a better person to do that with than Dr. John Morgan. Dr. Morgan is the professor and director of the Movement and Memory Disorder Center in the neurology department at the Medical College of Georgia Augusta University. And he’s so kind to come back to The Means Report and to talk about these issues, which are so important to so many of us. Thanks for coming back and thanks for what you do.
Dr. John Morgan: Thank you Brad.
Brad Means: Let’s focus on the symposium, certainly a few minutes, but let’s start with some brain disorders and diseases, Alzheimer’s, Parkinson’s. Are we making progress in the fight against those?
Dr. John Morgan: Yes we are.
Brad Means: Yeah.
Dr. John Morgan: It’s been gradual, but there has been significant progress made lately, especially in the realm of diagnosis is one area that’s really taken off nicely. And there’s also been some developments in using antibodies that attack the plaque part of Alzheimer’s, the amyloid plaque that came out with some positive results the other day.
Brad Means: Tell me more about that. Is it something that might lead to a cure or stave it off longer?
Dr. John Morgan: Yeah, so there’s two major things that go awry in the brains of patients with Alzheimer’s. One is a protein called beta amyloid that clumps up into plaques. And another one is called tau, which forms tangles. Plaques are located outside the nerve cells and we think damages the nerve cells and cause them to get sick and and die as part of the process. Tau is inside the nerve cells of the memories and makes them sick that way and clumping up and causing problems. And so we’ve for years tried different antibodies that attack different forms of the plaque protein that’s clumping up, some early fibers before they form into big plaques or that kind of thing. And they found some antibodies that actually once called ustekinumab, which was released in a press release that reduced in early patients with cognitive impairment, the disease process by about 27%.
Brad Means: Wow.
Dr. John Morgan: Over 18 months. And what does that mean? Well, it may mean that someone functions significantly better and may not die of Alzheimer’s. They may have die of something else in the long run. And mainly to better things in the long run.
Brad Means: Similar progress in this horrific disease we know as Parkinson’s.
Dr. John Morgan: Yeah, we’re gaining on Parkinson’s as well. There’s lots of different new drugs that are being studied for Parkinson’s disease to try to slow it down. One is a diabetes type drug called exenatide that’s used for diabetic control. And it’s being studied in a large trial nationwide. There are also other small molecule inhibitors that prevent that clumping up of the protein that goes awry in Parkinson’s called alphas nucleon. And that’s promising as well to stop the formation of Lewy bodies, which happens in that disease.
Brad Means: So are you going for, and you probably already answered this question with your previous answers, better quality of life or cure? What’s priority one for y’all?
Dr. John Morgan: If we just slow either one of these diseases down.
Brad Means: Yeah.
Dr. John Morgan: That’s a huge benefit. And to patients and families, it’s a huge benefit to the economics of healthcare and the cost of Alzheimer’s. There’s about over 5.4 million people with dementia in the United States today, and there’s about a million Parkinson’s patients. So those are the two most common neurogen diseases that we have.
Brad Means: How come we were able to come up with a coronavirus vaccine in a few months, but we can’t cure these ailments quickly?
Dr. John Morgan: Great thought. Virology is maybe a little more straightforward of how to attack it, because it’s a small molecule, a small process with these diseases that cause degeneration of the brain. There are a lot of overlapping processes that if you attack one of them, you may not get it all done. You may need to do multiple different prongs of attack.
Brad Means: Would you advise people, Dr. Morgan, to look for warning signs of Alzheimer’s or Parkinson’s and then of course, go speak to their physician? Or do you prefer a test that might be a predictor?
Dr. John Morgan: Yeah, there are some tests that are helpful. There’s a skin biopsy that’s been approved to look in the nerves of the legs and feet to see if you have alphus nucleon deposition. That is fairly accurate for predicting Parkinson’s disease. It looks for that alphus nucleon protein again, there’s a thing called a DAT scan, which can show if you have loss of dopamine in your brain, which goes along with Parkinson’s and its cousins. And then there’s actually a publication that happened the other day that came from interesting work out of a Scottish lady that could smell Parkinson’s disease. She could smell people and tell that they had Parkinson’s or not.
Brad Means: Oh really?
Dr. John Morgan: It was amazing.
Brad Means: Wow.
Dr. John Morgan: They have a musky odor according to her, she’s a super sensitive sniffer and they’ve identified in the sebum, the secretions of the skin fluid that we have, what the changes are that are typical of Parkinson’s disease and now they’re trying to develop a test out of that.
Brad Means: If your parents have a movement or memory disorder, are you probably gonna have one too?
Dr. John Morgan: You’re at higher risk, it’s not one to one or you’re gonna definitely get it. That kind of thing. The way I tell patients that have a mother or father with Parkinson’s, you may have a threefold risk of developing Parkinson’s in your life if your mother or father have it. And that may be like, let’s say you have a lifetime risk of one and a half percent just for the general population, you may have a four and a half percent risk.
Brad Means: Okay.
Dr. John Morgan: So it’s not so bad.
Brad Means: No, that’s helpful. I know you talked about this last time we were together, but it’s worth repeating, especially for those who didn’t tune in then. And it’s lifestyle choices. Anything we can do to enhance our chances of being, hopefully Parkinson’s and Alzheimer’s free as we grow up and grow older.
Dr. John Morgan: Well, one thing’s for sure that if you live a lifestyle that’s adventuresome and dangerous and exciting. So drug, sex and rock and roll, let’s say that kind of situation.
Brad Means: Sure.
Dr. John Morgan: Usually protects you from developing Parkinson’s disease.
Brad Means: Protects you from it.
Dr. John Morgan: Yes.
Brad Means: The folks who are, please tell me more.
Dr. John Morgan: The people who are the Dudley-Do-Rights of the world are the ones who get Parkinson’s.
Brad Means: What in the worlds are you talking about? No.
Dr. John Morgan: Teachers, healthcare workers, farmers. They get Parkinson’s disease.
Brad Means: Why, is too much clean living?
Dr. John Morgan: Maybe, so risk takers tend to have less Parkinson’s disease.
Brad Means: Okay.
Dr. John Morgan: And not just ’cause they’re dying of risk, they fall off a mountain or whatever, that kind of thing. But they have less risk, we don’t know why.
Brad Means: Okay, I had no idea that you were gonna say that, but that’s very enlightening. What can people expect when they attend the brain symposium? Will they talk? Will y’all talk about things that we’ve been discussing today?
Dr. John Morgan: Yeah, we’ll talk a little about everything. And we have a fun program this year. COVID interfered with our programs for a while, of course. But we have an improv group that’s coming that is neuro literate and knows about Parkinson’s and Alzheimer’s disease. And it’s like, who’s lining is it anyway?
Brad Means: Yeah.
Dr. John Morgan: That old program. And they will make you laugh, I promise. So everyone will laugh at this symposium. That’s the what’s one thing that’s wonderful this year. Great group coming in and we’ll talk about diagnosis, what the difference is between dementia and Alzheimer’s disease. What is Parkinsonism, where you don’t have Parkinson’s disease, but you’ve got a cousin of it. We talk about all those things. We have two out out of town folks coming. Chad Hales, who’s at Emory, will be our keynote speaker for the memory side. And Vanessa Henson is coming for the Parkinson’s side from MUSC. She’s the head of movement there.
Brad Means: Will y’all have any tests or exams for folks? Or is that for a doctor’s visit down the road?
Dr. John Morgan: Yeah, for a doctor’s visit down the road. But we can certainly, we have the classy to get folks in pretty quick.
Brad Means: Who’s the audience? People with these ailments? Their loved ones or both?
Dr. John Morgan: Both, we wanna see patients and caregivers both there. And there’s something for everybody to learn and help you live better with this diseases.
Brad Means: I know you said there are no tests or exams at the actual forum, but do you Dr. Morgan or your colleagues ever pick up one the symptom perhaps that leads to somebody being a patient after the symposium is over?
Dr. John Morgan: Oh, many times.
Brad Means: Really, what do you, tell me about that?
Dr. John Morgan: So patients will say, I came for information. I was wondering if my husband or my wife had memory troubles. How, was it just senior moments or was it more than that? And then they learned from our symposium. And then you can kind of identify whether your loved ones are having senior moments and aging related cognitive changes, which are normal.
Brad Means: Yeah.
Dr. John Morgan: Forgetting where you put something, forgetting someone’s name.
Brad Means: Do the example of the refrigerator. I vaguely remembered, I think.
Dr. John Morgan: Yeah, a good example is this. So if you’re putting up the groceries one day and you have your keys in your hand and you put the milk in the refrigerator and you leave your keys beside the milk accidentally, if you have, let’s say you do that and you have Alzheimer’s disease, you’ll find your keys later and you’ll have no idea how it got there. It doesn’t make sense to you. You don’t know who put it there. You may even think someone else hid ’em there, that kind of thing.
Brad Means: Okay.
Dr. John Morgan: If you’ve got typical age related kind of forgetfulness, you’ll say, oh yeah, I was putting the milk up and I left it there.
Brad Means: Okay, ’cause that happens. I mean that’s a legitimate example. What about Parkinson’s? If you shake one day.
Dr. John Morgan: Yeah.
Brad Means: And you think, “Oh, I definitely have Parkinson’s.”
Dr. John Morgan: So this kind of shaking, where you’re shaking both hands and your feeding yourself and your head shakes. Your voice shakes, is more likely what we call essential tremor, okay? Like Katherine Hepburn had. But Parkinson’s disease usually starts on one side. You have shaking of one hand or one leg, it gets slower, it gets stiffer on that side, it’s harder to use, harder to put on your belt, handwriting may get smaller, all those kind of things. So stiffness, slowness, and tremor are the three major features of one side with Parkinson’s most likely.
Brad Means: I know we’re talking about the human brain, so I’m guessing physical fitness can’t really help us if we stretch each day, might we stave off the stiffness that could appear in a Parkinson’s arm, does that help?
Dr. John Morgan: Yeah, so there’s data that to say that there’s a therapy called big therapy, which is amplitude based therapy to help you move larger in your amplitude of movements. Big therapy can make Parkinson’s symptoms and signs better, even better than a walking regimen and self-directed exercise. And so, it’s been very helpful. And then there’s also cognitive therapy, like for folks, Parkinson’s patient can develop some cognitive changes as well, and Alzheimer’s patients definitely develop that. But cognitive and physical exercise makes your brain juicier and bigger. Okay, we all start out with a grape and as we age, it goes to a raisin. If you go to a raisin too fast, you probably have dementia. Okay, the brain shrinks.
Brad Means: Yeah.
Dr. John Morgan: More with dementia. But there’s been evidence that doing exercise, both cognitive and physical exercise makes your brain bigger and juicier.
Brad Means: Dr. John Morgan, thanks for what you do for the patients, certainly, but for those who are trying to keep ’em going and be around him every day.
Dr. John Morgan: Thank you.
Brad Means: Absolutely. Dr. John Morgan MCG at AU, our special guest. We love having him.