for those of you who don't know me I'm Simon Lewis and uh I'm delighted to welcome you to this public forum and before going much further um it's uh customed to recognize the traditional owners of the land in which we meet today uh and pay tribute to their um their leaders past present and emerging um so uh we're delighted to do that I will also make a disclosure um which is that obviously we've got a fantastic speaker today but um he um I'm sure would want us to recognize the fact that he is speaking for his personal view the other thing that I'm feeling completely inadequate about is my own record of of research and and contribution to the society that we exist in the community of Parkinson's and related diseases um and the reason for that is because by the end of this morning you're going to just ask yourself the question how does Bas Bloom do everything that he does um and the answer I have is that he doesn't sleep and he has a very forgiving wife um because he just is uh a force of nature uh in our field um and we're delighted uh to have him in the country we're going to get him to do two um presentations uh today um he swapped the order on us uh because uh he wants us to appreciate what he sees as the problem um and then appreciate what he sees as some potential Solutions so we're going to start off many of you be familiar uh with uh the book that Bas has co-authored um um which I think you know he's going to touch on heavily in this it's available at all good bookstores and Amazon and so it's you know there'll be a QR code and all of those things if you've got your copy with you I'm sure he'll autograph it with you and that'll be fine without further Ado um bass can I invite you to come along and and give your first presentation please welcome bass [Applause] [Music] blo good good well Simon stay here for one minute because you should be grateful for having such a wonderful neurologist in your area Simon is amazing his hospitality is legendary I've been treated like a god a Dutch God and uh but he's also he's got a great heart and he's got a great passion to improve your lives and I really think he deserves Round of Applause for his [Applause] work so yes I decided to switch the order of the presentation we'll start with the problem first Parkinson's is the world's fastest growing neurological condition that's a concern uh that we need to think about and act uh and then in my second talk we'll be talking about Solutions I think that's better to end with Solutions and a better future but to start with the problem first so my main disclosure is I'm Dutch um and this is how a neurologist in in my country practices medicine uh there's invariably a cow and a little church and uh and I always say we we have survived history by negotiating and collaborating um we were squeezed in between France and Germany and England and they're all interested in occupying the Netherlands and the only way to survive was by negotiating and uh this is why I'm still here um my other disclosure is that there's a psychiatrist in my Hospital who's convinced that I carry a mutation in the gene for optimism um so you will hear throughout my talk that although there are alarming signals about the growth of Parkinson's there's also reason for optimism and perspectives uh and I definitely have that mutation uh in that Gene she thinks she can find it by studying me as a n of one uh study but you'll see that I'm very optimistic about the future that's not to say that Parkinson's isn't a horrible disease to live with today but I think there are perspectives and I'm here to also offer hope U I'll be speaking about what we have described the book ending Parkinson's disease uh I'll end with the book um and I'll start with the book we're not making any money out of the book all proceeds go to the greater good um Research into Parkinson's disease the book has been translated in multiple languages it's called the Parkinson pmy in Dutch it's even been translated into um Chinese and German um so it's it's it's it's gaining momentum and that's good because there is really something happening and what is happening is is that Parkinson's is doing world's fastest growing neurological disease the disease has doubled in the last 20 years uh and it will double again in the next 20 years if we don't act we think there are currently about 7 million people with Parkinsons in the world but I think it's actually a a lot more because we're not seeing all the individuals for example in Africa and in Africa Parkinson's is growing fast because all the toxic pesticides that have been forbidden and banned in Western countries are now dumped onto the African market and combined with an aging population it's causing a fast rise of Parkinson in Africa uh these are all individuals who more or less recently announced they have Parkinson so it's a disease that affects artists um and you'll recognize your favorite singer here perhaps uh uh these are Sportsmen we'll talk about sports in a minute and the importance of exercise for all of you uh but uh this is just to show that exercise doesn't give you full protection against Parkinson's even Elite athletes May develop the disease um actors you'll recognize Michael J fox for example but also others um this is Paul Bokus a famous French chef who developed Parkinson and this is the famous actor it's in Dutch lar foner you may have heard of him and then of course perhaps one of the most well-known figures in the world is Pope John Paul now what is striking about all these images they were all men there are only men so that's odd and there's there's at least two reasons I think one reason is Parkinson's is more common in men than in women and we'll talk about that in a minute because it tells us a little bit about the ethology of the disease um but another reason is is that men are more I think more outgoing they're they more easily promote themselves on social media and uh so I think there's a bias this is not reflective of the real gender distribution I will come to that in a minute uh but men are definitely more often affected this is one example of a female patient I'm not sure if there's any famous female individuals here in your country but this is Linda ronad for the fans she's got Parkinsons so one commonly one commonly given explanation for the fast rise of Parkinson's is aging and yes aging is a factor um the disease is more common as we grow older and since we grow older on average and the absolute maximum age is also increasing it is a factor you can also see the gender difference uh the light uh curve is men and the dark curve is women um so yes aging is a factor but what is really interesting and this is a complex graph and the only thing you need to look at is this little box here is that after corre ction for the Aging effect uh stroke is actually becoming less prevalent in the world because we're better at preventing Strokes so that's good news and Alzheimer's disease is growing fast but it's explained completely by aging so if you correct for the Aging effect Alzheimer's remains more or less stable does that make sense and the only disease that is growing over and above the Aging effect and literally this was the only only disease in this International survey was Parkinson's disease so it's not just aging and in fact I think aging is not a cause of Parkinson's what international famous neurologists have done is they toured museums in Europe they've looked at textbooks novels poetry paintings um to search for Parkinson prior to 1817 and it was it existed there were rare descriptions but it was a rare rare disease prior to 1817 until of course environmental pollution happened in London where James Parkinson described the disease for the first time and of course in history people did grow old occasionally and and they were astute clinicians in those days so if Parkinson's disease had happened prior to 1817 we should have seen it if it had occurred in the magnitude that that we're seeing today it should have caught people's eyes and don't forget Parkinson's is not a disease of exclusively old people in the Netherlands one in three is below the age of 65 when the disease starts which is when you're in the middle of life when you're still at work and and you know when you do want to and this is Michael J fox of course um so and if if you if we would have seen if if young onset Parkinson's disease had existed prior to 1817 we should have seen it there should have been reports in the medical literature but there are virtually none and I think this slide still has the the Dutch Legends it's that says cumulative exposure on the y- axis and age on the xaxis and I think that aging merely means that we've had more time to be exposed to toxic chemicals um that's basically it so that's why aging is a factor so is it better Diagnostics and I don't think so what you see in red is Parkinson's Disease and its growth and in blue you see multiple sclerosis the diagnosis of multiple sclerosis has been revolutionized by the Advent of MRI and cerebral spinal fluid uh techniques and it's remained more or less stable whereas Parkinson's disease is diagnosed today in the exact same way that James Parkinson diagnosed Parkinson's in 1817 I do it with my bare hands I do it by listening to you by looking at you and you don't need any brain scans so I don't think it's better Diagnostics is it genetics perhaps yes there is a genetic component to Parkinson's there are eight genes that can cause Parkinson's disease two dominant genes goes from generation to generation and six recessive genes what is really interesting and this is a new paper that's under review I hope it will be accepted soon is that these mutations typically cause young onset Parkinson's disease and I wondered how old these mutations are and you can calculate that so this is a Brand New Perspective which I think is interesting a genetic mutation arises somewhere in the world it's like a stone that's been dropped in a pond and then it starts to spread you know like waves based on the spread of GBA one of the most common mutations causing Parkinson's disease which is present in 10 to 15% of Dutch Parkinson patients that mutation is estimated to be 8,000 years old 8,000 years so if GBA itself was the cause of Parkinson's we should have seen the disease before 1817 GBA in animal models interacts with pesticides so that mutation that's been around for 8,000 years only became relevant once we started polluting our our environment so it it makes you susceptible to exposure to toxic chemicals but I don't think GBA for the majority of people is by itself a sufficient reason for causing Parkinson the same is true for lar too it's thousands of years old and lar to interact with pesticides in animal models another line of evidence comes from monotic twins as you may know monotic twins are genetically identical so what people have reasoned and they've done this not just for Parkinson they've done this for all sorts of diseases people have reasoned if you are genetically identical and if the genetic contribution to a particular disease is substantial monocytic twins should have the same disease more often than you would expect based on chance alone and that would be diotic twins right does that make sense and people have looked at this and look at this graph this is also in the same paper that we just submitted at the top you can see type 1 diabetes which has a strong genetic component and look at Parkinson's it's right there at the bottom so yes there is a genetic component to Parkinson's but it's small it's small there is something else going on and indeed and I realize this is a complex slide but these are all the known genes for Parkinson's Disease and these are environmental interactions that we know that exist and it includes many pesticides it includes heavy metals so the gene predispose individuals to a certain susceptibility towards toxic influences from our environment so I'm increasingly convinced that Parkinson's disease is to a large extent a man-made disease just like the pyramids in Egypt have been created by man in a miraculous way this is a disease that is caused by by ourselves and what I'm saying here explicitly is you know I I feel like I'm an activist to try and and and solve this this painful issue this does not mean that you should blame yourself for having Parkinson but I'm making that very explicit here this is caused by industry this is caused by big companies polluting our environment you're not to blame yourself it's impossible to say that your Parkinson is caused by that particular exposure you can't and I'll come to other factors later in my second presentation which I think is huge important um so don't blame yourself don't think oh if only I hadn't worked in that factory I would not have Parkinson today it's impossible to tell it's a complex interplay between your genetic predisposition what you ate what you breathed where you worked and all of that ultimately decides whether or not you develop Parkinson's disease but at the group level I think the environmental contribution to Parkinson's is clear and I think it's painful so look looking back at history James Parkinson was the first to describe the disease in London which incidentally he actually did based on individuals which to a large extent he merely observed walking on the Streets of London that's how visible and recognizable the Parkinson syndrome is and of course I don't think it's a coincidence that James Parkinson described what he called I'm seeing something new because this is London in those days huge environmental pollution and they've estimated that the amount of air pollution at the time in London with the notorious smog you may remember that um is only surpassed by uh certain cities in India today um but it's re it was gross and this is China today this is China today and what is really fascinating is we published a paper in Journal of Parkinson's disease and what you see here is the on the xaxis is the growth in the in income and on the Y AIS is is the growth in Parkinson's disease and here you can see China Parkinson's is exploding in China where they are now having their Industrial Revolution with lots of environmental pollution it's not just air pollution we now know that repeated hat trauma is a possible contributor to Parkinson's so we know from Scottish soccer or do you say football here soccer Scottish soccer players have a higher risk of Parkinson and it's related to the number of headers people estimate that the headers are important so midfielders have a low are if you're interested in soccer the the headers mainly happen in Defenders and the attackers and they've got more often Parkinson than the midfielders who play the Barcelona TIY tacky football and then there is this interesting gender difference you've seen this slide before Parkinson's is more common in men compared to women and one explanation is is that men more often have jobs that predispose them to exposure to toxic chemicals such as being a farmer or a welder or a metal laborer or a chemical worker or Pest Control worker one chemical which I'm not sure how that is dealt with in your country happy to hear that is tror ethylene tror ethylene is a chemical that's used in in many many places it's used in U in to laundry in in laundries in um it's it's used to degrease Metals it used to be a part of tipex remember when we were using type machines and it's in in shoe polish it's used to decaffeinate Coffee uh and we published this paper recently about trior aylene as an invisible cause of Parkinson's this is a busy slide and I realize but this is all the different um um chemicals in our environment that contain tror ethylene tror Ethylene uh in people who work in triethylene factories have a very high risk of Parkinsons triethylene kills dopamine neurons in animals if you expose them to tror aylene and these are countries in the world where it's abundant and I now realize there you go that's Australia so these are countries with so-called super fun sites where there's a lot of trior ethylene in the environment and we call it the invisible cause of Parkinson because if you live here and there's a factory at at some distance the factories dump it into the environment it goes into the groundw it can travel for Miles evaporate into your house you can't see it you can't smell it but it may contribute to your Parkinsons and a recent study I didn't enter the slide in Jam neurology you probably have seen it in Camp Leon where the American Marines are being trained there was a chemical Factory prior to the military base it's heavily polluted by trior aylene and there's a wave of Parkinsons among American Marines in Camp Leon very convincing relationship between trior aylene and Parkinson's uh and then another chemical of course another job and chemical is uh the job of farming and the use of pesticides uh this is a cartoon drawn by one of my patients who's a lovely and wonderful artist she's amazing um really graphically depicting in one image the tight interrelationship between pesticides and Parkinson men are more often Farmers except for one country in the world which is Japan and lo and behold Japan is one of very few countries where Parkinson's is more common in women than in men now that doesn't prove anything but taken together the whole story is unfolding and beginning to come together and then there is the so-called mptp story have you heard of mptp it's It's a I I'll quickly tell you the story in in the in the 80s of the previous Century heroin was only illegal in the United States if it was exactly heroin it had to be exactly the chemical compound so what so-called kitchen chemists were doing is modify heroin just a little bit they added a flu atom or a carbon atom and then it was legal a seaold and if as a drug addict you were lucky it still caused the same Sensations uh that you were hoping um but it was legal and one of those and they called it designer drugs just like some of you may have your own designer dress you know when you go to a fancy party it's your unique dress so these were designer drugs and one of those designer drugs was mptp mptp was a chemically modified heroin analog that caused end stage Parkinson's disease overnight in young individuals who had injected themselves intravenously with this heroin compound seven individuals in their 20s developed irreversible endstage Parkinson and I was and I did my own PhD work as a 21-year-old I was at the time I was about as tall as Simon maybe even smaller I was really really really this big and uh my mentor Bill Langston actually gave me the videos and this is the original mptp patient that triggered the whole story so this is unique footage this man was healthy the day before and this is when he was found by Bill Langston this is severe Parkinson's obviously untreated and that compound killed every single dogic neuron because of course he was exposed to an extremely high intervenous dose and there were and it was almost a detective story because they found six other individuals they all tracked it back to the same the same chemist who had manufactured the the the pesticide what I find so incredible about that story is those seven individuals had an intact smell even though Simon was referring to this A reduced smell is common in Parkinson they had injected it intravenously we think that many of the toxic chemicals are inhaled and thereby impair smell the chemist who manufactured the mptp developed Parkinson's seven years later and he had an abnormal smell isn't that fascinating and why I'm telling you this story those are the some of the folks the the poor young Lads that develop Parkinson the the mptp is converted to MPP plus which is the actual toxic compound which looks almost identical to paraquat paraquat is a pesticide that has been banned in many countries in the world even in China and guess what it's still used here in the United in Australia which I honestly I think is insane I think it's incredible it's it's a p it's used to kill um uh to protect plants so industry calls it uh plant protection compounds they have all sorts of euphemisms in my country uh but but but paraquat is one of the most toxic compounds on the planet one sip will kill you and paraquat this is paraquat in the United States it's still used abundantly the Michael J fox Foundation is now taking action to ban paraquat it's been linked to Parkinson's in a number of studies that's very consistent and if you feed paraquat to a mouse to a rat or other experimental animals it will cause it will kill dope imic neurons and cause Parkinson symptoms but you're using it today I'm not saying it's the cause of your Parkinson's but I think I'm an activist I really feel that I'm an activist and I think you should take action in your country against paraquat and you may want to check out what the Michael J fox Foundation is doing in the United States um but I think it's it's it's crazy so what is further evidence that we that Parkinson's is an environmentally caused disease there are so-called heat map studies and my career has been built around Heroes so I have a number of Heroes in my life that have shaped my career and that have created the B Bloom that's standing here in front of you Simon is one of them um another really great hero is Andre Barb and remember barau so barau I never met him but barau died at a young age um he was a French Canadian neurologist and um everything he wrote actually later turned out to be true but he died in his early 50s and he died just before this paper came out and barau was the very first man in the world to study the environmental distribution of Parkinson's and he reasoned that if the environment had nothing to do with Parkinson's the disease should be spread evenly across the country and this is Quebec Montreal um uh and uh Quebec sorry this is Quebec and what you can see is that Parkinson's is not evenly distributed across Quebec but there are pouches there are clusters where Parkinson's is more common so it's not evenly distributed and in fact this is a bit of a technical graph but this is the dose of the pesticides in water and the risk of Parkinson's and there's a more or linear relationship so the higher the concentration of pesticides in water the higher the risk of Parkinson's and it was not evenly distributed this has now been repeated in a number of countries this is France this is the prevalence of Parkinson's in France and if you can overlay this one one with the use of pesticides in in wineyards you see this is there's the the Bordeaux region this is the Mediterranean region there's the Champagne region it overlaps one to one the French now acknowledge that Parkinson's is an environmental hazard disease among wine farmers and again there is a dose response relationship in France the higher the concentration of pesticides uh on on the land the higher the risk of Parkinson's disease and in Holland we're seeing much more Parkinson in the areas where we've um where we um uh uh develop our our famous tulips um and that is something really bizarre and you know why this is bizarre you know you know what is you know the symbol the international symbol of the fight against Parkinson's you know what it is it's a tulip and the same damn tulip in my country is associated with a higher risk of Parkinson's isn't that if you come to think of it it's ridiculous isn't it and this is the James Parkinson tulip there's even a special James Parkinson did you know it's a real James Parkinson tulip and this is the symbol of the Dutch Parkinson patient Association so pesticides also reach the food chain so we breathe it we eat it um and there is one study and I'll I'll I'll be cautious about this but I'm just going to mention it to you there's one study in Hawaii where pesticides were used for pineapple uh culture and those pesticides entered the leaves of the pineapple trees the leaves were fed to cattle and the pesticides made it to the milk of those cows which subsequently was found in identifiable doses in supermarkets in Hawaii and was subsequently found after death in the basil gang of the brains of Parkinson patients it was even found in the milk of breastfeeding mothers now this was an exceptional story that's not been repeated elsewhere milk products are consistently related to a higher risk of developing Parkinson I don't think that this is because milk is polluted with pesticides I think this was an extreme condition but an overdose of milk products the Dutch eat a lot of cheese a lot of cheese um is an interesting relationship what I'm actually concerned about is is for example wine so um a survey in the Netherlands showed that red wines in Dutch supermarkets 2023 contain seven different pesticides including glyphosate Roundup the weed killer that you use to kill the weed Roundup is found in red wines in Dutch supermarkets in 2023 and then buyer says yeah but it's at a very low concentration uhhuh seven different pesticides and it adds up so what I recommend to all my patients is if you've got Parkinson and we'll come to that in a minute what wash your vegetables wash your fruit eat biological whenever you can if you want to avoid Parkinson's you want to steer away from pesticides if you already have the disease you definitely want to steer away from pesticides because there are now two new studies and I'll show you one to show that if you already have Parkinson's and you're still exposed to pesticides your prognosis is worse which makes perfect sense if you have few dopamin neurons left in your brain you want to do everything to protect those and there are now three studies and again this is just one of them showing that if you already have Parkinson's things get even worse when you're still exposed to pesticides now I told you I had this mutation in the gene for optimism there were also protective factors this is a beautiful paper by um Alberto aerio and Michael Schwarz child there are risk factors and protective factors for Parkinsons we talked about the risk factors pesticides dairy products melanoma is an interesting one just quickly melanoma because we're in Australia I think this is the number one melanoma country in the world if you have Parkinson the risk of developing a melanoma is a bit increased inadvertently people think it's because of leopa treatment but that's not true the risk is associated with the disease not with the treatment so don't avoid treatment because you want to avoid melanomas but have your skin checked if you have got Parkinson I think particularly in this country not sure if that's common practice Simon but okay good what I want to focus on in the next part is the protective factors and there's a number of them and I will walk you through the most important ones one of the factors that is most consistently associated with a lower risk of developing Parkinson's is smoking now please please please don't start smoking or tell your children to go smoking and we don't know why this is uh it could be that smoking has some intrinsic protective effects it could be uh one one thing is that Smoking may make your nose less permeable to the pesticides that we inhale there is good animal work to suggest that pesticides make the gut less permeable to pesticides SES that we eat but another explanation could be that if you are born with a lot of dopamine you are more likely to enjoy a cigarette because you have a tuned up reward system dopamine is the reward neurotransmitter so maybe smoking is just a signal a biomarker that you have a lot of dopamine and the same high level of dopamine protects you from dropping below a critical threshold enough to cause your Parkinson symptoms so maybe it's artificial maybe it's real uh we've talked about this with Alberto airio and it it deserves further study it's the most consistent protective factor in all epidemiological studies and we don't fully understand it another more interesting one is the Mediterranean diet the Mediterranean diet is associated with a lower risk of developing the disease but there are now three studies to show that if you adhere to the diet after you've been diagnosed your prognosis is also better so each like a Greek is is and then somebody said ah that means lots of suaki no no no not not the the stakes it's the fish it's the oil olives uh uh uh fruit veggies nuts that kind of stuff so if you're in doubt ask your dietician if you've got Parkinson I would recommend adhering to a Mediterranean diet the other Factor widely studied still poorly understood is a few cups of coffee those protect against the risk of developing Parkinson whether coffee helps you after your diagnosis is unknown I tell my patients in my clinic that I don't know but if you enjoy a few cups of coffee take it it probably also helps to promote bowel movements and constipation is notorious for all of you it's a risk factor so in case I forget in case I forget the most commonly made error in my country but there's two common errors but the one of the two is not to treat constipation it's not part of this presentation but it's so important that I want to share it with you constipation is an early symptom of Parkinson's it's very common I think ultimately almost all patients with Parkinson's have constipation it leads to bacterial overgrowth changes in the gut microbiome and those bacteria start to convert Le aopa into dopamine in your gut the dopamine cannot enter your brain which means that the constipation will lead to a lower efficacy of your Parkinson drugs so treat constipation aggressively exercise 2 liters of water per day fibers and laxitives if needed but treat it and if you don't know how to do it ask your GP ask your Parkinson nurse ask your neurologist but don't accept chronic constipation please the other error is not to treat the night sleep you need dopamine to treat to sleep well and many neurologists inadvertently think that Parkinson's goes on holiday at night it doesn't so you need long acting dopaminergic drugs to cover the night if you sleep better you'll be better during the day the other protective factor is exercise exercise is um uh in a number of studies asso associated with a lower risk of developing Parkinson's disease how Exercise Works is still largely a black box we don't know although there are some really cool new studies and I don't have time to go into those but I will tell you just one of them it's a study that we published in Lan neurology and we we put people on a stationary bicycle and we asked them to exercise for 30 minutes at home three times a week and what we showed is that exercising three times a week where you crank up your heart rate a little bit was associated with a stabilization of motor symptoms whereas the control group declined over time which is what you would expect in Parkinson's disease Daniel corkos in the United States did a similar study on a treadmill and found the exact same thing so that is not the same as disease modifying we're all looking for treatments to slow down the progression of Parkinson I I think exercise is closest to delivering that promise out of all the interventions in the world it's those two studies the one by Daniel corkos the one by my group but we think we are actually even closer because these are brand new data this was published in anal of Neurology late last year and in our study we also did brain scans and lo and behold there a beautiful paper in anal of Neurology we show that in the control group that was only doing stretching exercises the brain shrank a little bit the brain shrinks over time happens all the time and we stopped the brain from shrinking through exercise and moreover the exercise group but not the stretch group made new functional connectivity between the damaged basil ganglia and the healthy brain cortex so if you're on the treadmill if you're on your stationary bicycle if you're in the pool and you think I'm not motivated to exercise what you should think is that brain is sprouting it's making new connections I mean isn't that motivating and again before I forget there are three components to exercise and please listen carefully one is the aerobic component and you can titrated to your heart rate but the nerve that innovates the heart is also affected by Parkinson that's not to worry about at all so don't even think about it other than the fact that people with Parkinson some of you folks have difficulty cranking up your heart rate above 100 so if you go to the gym and your exercise drill coach is trying to crank up your heart rate and it doesn't work and he's taking his whip you know trying to get you to titrate not to your heart rate titrate to your breathing pattern and the best those is when you can still maintain a conversation but you sentences are a bit briefer does it make sense then you've got the right dose and I tell all my patients exercise every day and why every day if you exercise three times a week there's always tomorrow if you have to exercise every day there's no ifs ends or buts you just build it into your regime the second component so that's the aerobic component 30 minutes each day and there's a really cool study by Gizelle petsinger from the United States where she's because sometimes people think ah I've got a busy life when do I have 30 minutes 30 times 1 minute turns out to be as good as one block of 30 minutes so if you don't take the escalator and climb the stairs you've got your one minute snack and we call it now exercise snacks so instead of snacking on your French fries or you know snack on exercise isn't that really cool the second component is to sheare volume of activities and that's an independent Factor so taking 6,000 steps at a Leisure Pace without penting is better than 4,000 steps at a Leisure pace so increase your volume add 30 minutes of aerobic workout and add a bit of strength training particularly of your hip muscles and upper leg muscles they become a little bit weaker over time and that may hamper your ability to rise from a chair or rise from a car or rise from your bed those are the three existing exercise modalities that you should adhere to so back to pesticides you know I'm a man on a mission and particularly this week so yes I have a forgiving wife but there's a big debate in Europe right now around glyphosate which is round up which which is going to be extended for another 10 years but not up to me because what is what is the problem in Europe probably in Australia and the United States pesticides are being screened for neurotoxicity by exposing an experimental animal to the compound and to see if it becomes parkinsonian and that is a major flaw and the reason is that the threshold for you to develop parkinsonian signs and this is true for humans but it's also true for Animals is you only develop parkinsonian signs if you've lost 70 to 80% of your dopaminergic neurons which means that and this is beautiful about the brain it has a reserve capacity but that same Reserve capacity means that you may miss relevant toxicity if you wait for symptoms to arise so this would be a genuinely safe pesticide it doesn't kill any dopaminergic neurons does that make sense this would be a truly unsafe pesticide it kills so many neurons that you see symptoms right does it make sense but this is what is happening all the time if a pesticide kills 60% of dopam minic neurons in a mouse the mouse looks happy and safe but the compound isn't safe this is a major problem and a second major problem is that we are all exposed to cocktails to mixtures of different pesticides remember I mentioned the the wine the Dutch wine that contains seven different pesticides there is a Sprint study in Europe where they have looked at the number of pesticides in farmhouses guess what how many pesticides are present in an average Dutch farmhouse in house dust on the kitchen table what do you think 30 higher 110 110 this is the reality and it includes pesticides that have already been banned for some time because they persist in our climate and it's the sum of 110 times a little bit that is causing Parkinson and this is just this is a technical slide but this is glyphosate glyphosate is Round Up This is the mptp this is the number of dopamine cells this is saline so you see that mptp kills dopamine neurons but if you add glyphosate it gets even worse this is Kimberly Paul who is also one of my heroes Kimberly Paul looked at cocktails in California and as it turns out certain cocktails are more commonly associated with Parkinson's than other cocktails this is a paper in nature just came out if you take a cocktail and you take a single pesticide it's toxic to the mouse in a high dose the moment you add a second pesticide they're both highly toxic at very low doses but it's never been tested and you can already see Monsanto or berer or senta say it's the other compound in the mix it's not mine it's insane so we need better animal experiments and in case I forget I don't want to kill thousands and thousands of animals we need urgently invitro Alternatives so that we don't have to kill animals but the current gold standard is still an animal study just wanted to make that disclosure that and in Holland clever people are working on Virtual human bodies where you can mimic pesticides toxicity in in vitro models what is interesting is that the European food and Safety Authority that's the European institution now admits that their own procedures give us no insight into the risks of Parkinson's disease they admit it but this week Europe is going to decide about glyphosate about Roundup and the dosier doesn't include that limitation that that's what the paper to L and neurology is about the doche they acknowledge it's wrong and they ignor it in the files pushed by industry I think it's insane so to Sunrise so it's is perfect timing Simon um two things that I wanted to say is one is Parkinson's I think I've called Parkinson's the canary in the coal mine is was that used here in in in in in your country as well so when the canary stopped singing it meant that the air was toxic and you had to get away pesticides also cause cancer tror aylene also causes cancer I think Parkinson's is just the visible tip of the iceberg of what we're doing to ourselves so I think we're living in a time of environmental diseases and Parkinson is just the tip of the iceberg the people that are exposed are primarily those who are working with it work exposure we now know that residents nearby residents are also exposed if you live nearby Farmland you're at risk and through the food chain ultimately all of us are affected all of this is described in the book ending Parkinson's disease I was fortunate enough to hand a copy of the Dutch version of the book to the queen of the Netherlands and see how happy she looks it's almost as if her husband just proposed to her isn't that incredible you can buy the book here and in case you're thinking I'm promoting my salary no all proceeds are devoted to efforts to end Parkinson's disease and I want to end with an upbeat note uh Tom Isaac's a wonderful Ambassador for Parkinson's he says this is a time of courses hope instead of conservative paternalism I want to end there and that's that's wonderful um I will uh kick off some questions please of course I'm Christine J CH and in case you don't know me um I'm very motivated about this theme because I've been read I've read your book and I've heard Ray speak the co-author of the book and his talk at the world Parkinson Congress was amazing um and really motivated me that we need to learn about this yes my question is um my uncle has Parkinson's but he's in denial but he says he he's over already in his late 80s but he used Roundup he was a farmer a cane farmer in North Queensland Roundup as well as Zam zamine with the G yeah and so we're wondering if that could be related to Parkinson's yeah so again I it's impossible to tell any given individual that this is the cause of your Parkinson's so and I say that first of all because I really don't know and second also to alleviate concern so that people look back and regret and say if only I hadn't used Roundup you know I would not have parking but at the same time I can't say it's not the cause and at the group level it's clear um the the case for Roundup is is not so clear as for par what I think Roundup could be a cause of Parkinson my concern about Roundup is it's not proven to be safe because the criteria are wrong and there are six studies that have linked Roundup to Parkinson's is that definitive proof no is it a reason for concern absolutely before we go to the next question bass can I just ask you I mean the rates of Parkinson's are about one in 100 if you're over 60 or you know 1 in 1,000 generally with the influence of pesticides we've sort of looked at the literature it's about triple the ratio when you look at those old studies that would be what three in 1,000 so what's the new data showing us about that number cuz you not saying Parkinson is caused by pesticide you're saying it's contributing factor to some cases yes I I think knowing that Parkinson's was bitterly rare prior to 1817 I think any new case of Parkinson's is one too many but having said that I mean the Greeks have it in their literature the Egyptians have it in literature but rare sportic wow it it was not writing as much no but you know for ex have a healthare system I I I think there are wonderful and accurate descriptions of gout of diabetes of all sorts of diseases Parkinson's it's it's there yeah you know and or it could be Parkinson's but the full-blown picture it's rare they've looked at paint rron for example painted breast cancer very accurately in one of the nude portraits of one of his many wives and and he didn't understand breast cancer he just painted what he saw and that typical stew posture it's not there so I I I think it was it was there but it was rare and I think we got on the back thank you hi I'm Paula I've had Parkinson's for 33 years I was first symptomatic 19 I've got parking jeene my mom's got two and dad's got one my mom and dad came from villages in Greece would that genetic version of Parkinson's being affected by by pesticides in Greece how did they get the genetic mutation right I I don't think the I'm not a an expert on genetics myself but I don't think that the Parkin mutations are very different from each other so I think whether Parkin arose in Greece or in elsewhere in the world doesn't really matter I know that Parkin is one of the genes that affects mitochondria and guess what pesticides do they kill mitochondria my mom doesn't have Parkinson's and she's got two bad genes so yeah exactly so that that that's one other reason so the the penetrant the word penetrant is a technical word for you have a gene but not everybody gets the disease so uh the penetrance for example for lar 2 is is 70% roughly the same for GBA and you can have genetic mutations in parking genes and not develop the disease so you need something else and parking in animal models intera with pesticides okay thank you thank you I've lost the other microphone in the room there we are in the front yeah hi b um we missed a little bit here the three exercise things aerobics was to relate to heart rate what was the second one the volume of activities simply simply taking more step and the third one is strength training strength training volume and strength thank you yeah then we'll come over here yes yes I just I'm curious about the link between the pesticides and Parkinson's and is that um also connected with Louis bodies um in terms of Louis body dementia as my partner here was um diagnosed with Louis body dementia two years ago and this year he's now been um accorded to be suffering from Parkinson so is there a linkage there I mean I know there's a sort of shadow zone between the two to some extent yeah no it's a very good question the there's a still a bit of a debate in the literature and among experts about what lowy body disease is I'm in the camp that says it's one disease I think Parkinson's disease oh are you in the other Camp yes oh that's interesting Camp they both cause Louis bodies and we know that Parkinson's is not one disease you should call it Parkinson's diseases and uh some for some it starts in the gut for others it starts in the nose yet for others it starts in the brain uh um and why not start in cortex so what's your point so at the next movement to sorts meeting uh they've asked me to do the controversies uh section you all know this on on the committee and and so we're going to have Dan Vine tra versus Glenda Halliday um and the bottom line is the neuropathology is different and the really important part about this is because um and this is published in brain a couple weeks ago I published it basically what demen Louis body patients do is that they protect their cells and then fall in a heap whereas Parkinson's disease what happens it's a bit like playing cards and you give a card away and give a card away so Parkinson's has this long disease 15 20 years and then you DeMent demential Louis bodies you get it later and when you get it bang everything happens and the really important reason that is there is really important is because if we knew what the lementary Louis body patients were doing to protect themselves against the S nuclear opathy we should treat our Parkinson's patients with whatever that magic magic is is is the point I'd make this is wonderful two friends uh debating so we have a paper that came out this week in brain this week I'm sure you've read it and no but it's a really cool paper and it's it it helps to motivate you so we we did a big study in 520 patients who all were they received deep phenotyping but they were scanned on the same scanner at the rotb University Center repeated over time and we divided people into rapid progression and slow progression the difference between people with bad Parkinson and benign Parkinson or slow Parkinson is not the Bas of ganglia it's the cortex so what we have shown in a number of studies is that the baso ganglia lose their function but the healthy cortex takes over functions in fact this is what is happening with exercise the sprouting the moment the Louis bodies reach to Cortex that's when you're done because now your compensation collapses so if you've got Louis Body Disease and your compensation is gone right from the outset that's why the cous collapses more that could be a possible explanation right we're in violent agreement we're in violent agreement and Mr Nish uh oh thank you baz and Simon for today it's very much appreciated uh the other environmental explosion that's taking place or catastrophe that's taking place is the use of the present of microplastics in our system is there any link been drawn between microplastics and Parkinson's um so I was on um uh P past is not microplastics is it that's the other concern no no so microp I I honestly don't know um I if I speak to environmental toxicologists and I speak to them a lot these days they think it's ultimately it's the mixture it's the sum of everything we're exposed to and that that some might well include microplastics um I was actually on the Dutch national talk show last week and there's a hefty debate in Holland around a factory in Rotterdam that's producing pasas um and because they had an issue in the same session where I was to speak on Parkinson's on pasas I looked up the literature and there were two or three studies that link pasas which I had never associated with Parkinson's to toxicity to dopamine cells so ultimately I think it's the sum of all the things in our environment you know that determines whether or not you develop Parkinson that's why it's also so horrendously difficult to tell in any individual that you know what caused your Parkinson so I don't know of any studies but I can easily see how it might contribute so we're we're got to be a little bit late going for lunch sorry coffee but I can see uh Marian Hoffman uh it's great to hear your voice on the uh incoming specific question um any specific exercises for strength training you mentioned basically doing the leg thrusts and squats building up those big quad muscles is that the sort of thing that we should be aiming for um yeah so exactly so um the the the the thigh muscles the the upper leg muscles that's important so squats is is is important uh in terms of the aerobic exercise I'm not sure if that's also part of the question nobody studied which form of aerobic exercise is better so whether you play basketball volleyball tennis jogging cycling it doesn't matter do what you like and make sure you do something that you adhere to or you can throw it into the mix there's one exception It's a Wonderful study by Jay Alberts who went on a cycling tour with patients and professionals on a tendon bicycle and the healthc care professional was sitting in the front the individual with Parkinson was sitting in the back and most of those folks after that day of cycling felt dram dramatically better and and then he thought about it and the healthy person was determining the pace in the front so he did he then did a study published where he compared two types of cycling either with a low resistance but like this or with a higher resistance and like this the net workout was identical but the health benefits were greater for low resistance and fast movements spent the first 10 years of my life working with pesticide regulations and things the thing for me is um where where does the impetus come from now to to get your activism going you know yeah some someone online has asked the same thing how do we connect globally right um well the the book gives some recommendations but I think we should bundle forces I and I think I'm inspired by Ray dorsy and Ray dorsy says we should become loud you know HIV was deemed to be untreatable until individuals with HIV chained themselves to the front door of industry and of regulatory bodies demanding better treatments and I love working with you folks because I think for whatever reason people with Parkinson are just the nicest people on the planet but I sometimes think we are too nice we're too kind and we're not loud enough and I think you've seen my presentation I'm not saying Parkinson's is 100% environmental but I think there's a large contribution and we should become loud learn from each other you know read the book read the recommendations the the final pages on on activism and bundle forces um I think uh two points one there's a lady with a clipboard on the front desk who would like to try and connect you so she she's wearing a nice right red top so talk to her in coffee and we're going to have one last quick question so you've been very patient then we'll go for coffee thank you you can you speak into the microphone please you are an an activist R into the microphone you are an activist you also mentioned that the pesticides are a big issue creating creating um this Parkinson disease you also mentioned that large companies that manufactur the pesticides are involved in these what are we doing to make those companies accountable what are you doing okay what are you doing well I I'm very active in my country and in Europe and I speak to buer to senta to Monsanto you know you know what the other striking thing is all the studies that are proposed to the European Body are performed by industry themselves they can repeat experiments as often as they like until it gives them the desired result there's a paper in the guardian showing that industry leaves out 30% of the studies that show toxicity out of the records I mean it's ah so what do we do they have a powerful Lobby there's $8.4 billion doar in Roundup each year earned by The Joint companies so their Lobby is powerful but I'm also a powerful activist my name is being heard and seen I publish a lot about this um I think your voices collectively you're with s million in the world your voice too you know and with your background I think we should bundle forces bring our countries together and be loud and and make ourselves heard wonderful wonderful wonderful okay
