GM1 ganglioside in Parkinson\u27s disease: Pilot study of effects on dopamine transporter binding.

OBJECTIVE: GM1 ganglioside has been suggested as a treatment for Parkinson\u27s disease (PD), potentially having symptomatic and disease modifying effects. The current pilot imaging study was performed to examine effects of GM1 on dopamine transporter binding, as a surrogate measure of disease progression, studied longitudinally. METHODS: Positron emission tomography (PET) imaging data were obtained from a subset of subjects enrolled in a delayed start clinical trial of GM1 in PD [1]: 15 Early-start (ES) subjects, 14 Delayed-start (DS) subjects, and 11 Comparison (standard-of-care) subjects. Treatment subjects were studied over a 2.5 year period while Comparison subjects were studied over 2 years. Dynamic PET scans were performed over 90 min following injection of [(11)C]methylphenidate. Regional values of binding potential (BPND) were analyzed for several striatal volumes of interest. RESULTS: Clinical results for this subset of subjects were similar to those previously reported for the larger study group. ES subjects showed early symptomatic improvement and slow symptom progression over the study period. DS and Comparison subjects were initially on the same symptom progression trajectory but diverged once DS subjects received GM1 treatment. Imaging results showed significant slowing of BPND loss in several striatal regions in GM1-treated subjects and in some cases, an increased BPND in some striatal regions was detected after GM1 use. INTERPRETATION: Results of this pilot imaging study provide additional data to suggest a potential disease modifying effect of GM1 on PD. These results need to be confirmed in a larger number of subjects

Trinity Lutheran Church v. Comer: Playing in the Joints and on the Playground

In Trinity Lutheran Church of Columbia v. Comer, the Supreme Court determined that a state could not deny a church generally available benefits because of its religious character. Before Trinity Lutheran, the Supreme Court consistently recognized the existence of a ¿play in the joints¿ between the Establishment Clause and Free Exercise Clause, meaning some state government actions are neither prohibited by the Establishment Clause nor required by the Free Exercise Clause. Issues concerning tax exemptions and state funding are consistently held to fall within the ¿play in the joints,¿ which permits state and local governments to refuse to fund religious institutions, even if funding would be constitutionally permissible. This Comment argues that the Trinity Lutheran decision is problematic and Locke v. Davey is the proper interpretation of the relationship between the First Amendment religion clauses and state funds, as it recognizes the importance of federalism and leaves state tax issues sub-constitutional

Trinity Lutheran Church v. Comer: Playing in the Joints and on the Playground

In Trinity Lutheran Church of Columbia v. Comer, the Supreme Court determined that a state could not deny a church generally available benefits because of its religious character. Before Trinity Lutheran, the Supreme Court consistently recognized the existence of a ¿play in the joints¿ between the Establishment Clause and Free Exercise Clause, meaning some state government actions are neither prohibited by the Establishment Clause nor required by the Free Exercise Clause. Issues concerning tax exemptions and state funding are consistently held to fall within the ¿play in the joints,¿ which permits state and local governments to refuse to fund religious institutions, even if funding would be constitutionally permissible. This Comment argues that the Trinity Lutheran decision is problematic and Locke v. Davey is the proper interpretation of the relationship between the First Amendment religion clauses and state funds, as it recognizes the importance of federalism and leaves state tax issues sub-constitutional