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One of the highlights of the PAN forum this week was a talk by Dr. Ken Olden
of the National Institute of Environmental Health Science.  New evidence from
the "Twins Study" points primarily to environmental causes, or as Dr. Olden
indicated a genetic susceptibility that is triggered by an environmental
insult. (Environment includes such factors as diet and lifestlye, as well as
exposure to toxins.)  

If Congress appropriates budget increases (grass roots lobbiests at the Forum
are asking for $25 million for NIEHS), The NIEHS is planning a significant
effort to unravel the mysteries of the causes of PD. This research will not
only help prevent PD in the future, but it will also add 
knowledge about the processes of development of the diseases which will likely
suggest new approaches to treatment.  NIEHS is also part of a coordinated
effort underway (in an embryonic state so far) at NIH (led by NINDS and
including NIA and NIMH)to initiate a large scale prospective longitudinal
study of neurodegenerative diseases, similar to the Framingham Heart study.  

To launch their initiative, on July 22, NIEHS is conducting a brainstorming
"concept forum" to develop a PD research agenda. I have been invited to
participate with NIEHS on a panel that includes distinguished scientists such
as Dr. C. Tanner (Parkinson's Institute), Dr. T Dawson (Hopkins), Dr. L Nelson
(Stanford), and Dr. W. Olanow (Mt. Sinai).  Although I have enough knowledge
of epidemiology to converse on the subject, I am primarily a patient
representative in the discussion. To carry out this role as effectively as
possible, I am seeking input on potential environmental triggers for PD.

PLEASE RESPOND WITH THEORIES OR ANECDOTES FROM YOUR KNOWLEDGE AND EXPERIENCE
ABOUT POSSIBLE CAUSES OF PD.  INCLUDE DOCUMENTATION AND BACKGROUND INFORMATION
IF AVAILABLE.  

Many of us speculate about the cause and trigger of our disease.  This time
your speculation can contribute to a PD research agenda.  I will compile all
written responses for the panel and I will use the information as a basis for
my input to the meeting.

To me the motivation exhibited by NIEHS has been an essential missing
ingredient in our previous efforts to realize the goal of the Udall Act to
devote $100m a year to Parkinson's focused research. PD grass roots political
support and cooperation with NIEHS illustrates a model for working with other
Federal Health Agencies as well as other Institutes at NIH, particularly
NINDS, to develop research agendas to deliver better treatments to those of us
now afflicted with PD and to prevent future occurences of the disease.  

Perry Cohen





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