How Parkinson’s Affects The Nervous System
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It has long been understood that Parkinson’s disease does not just cause movement symptoms, but also causes a litany of non-motor symptoms with effects throughout the body. One of the organ systems that is affected is the cardiac system, encompassing the heart, as well as the major and minor blood vessels.
Secondly, what are the changes to the brain caused by Parkinson’s disease? The brain changes caused by Parkinson’s disease begin in a region that plays a key role in movement, leading to early symptoms that include tremors and shakiness, muscle stiffness, a shuffling step, stooped posture, difficulty initiating movement and lack of facial expression.
Similarly one may ask, does Parkinson’s affect your spine?
Low back pain and back of the neck pain are probably the most common pain conditions in PD. The reason Parkinson’s Disease patients have so many problems with their low back and their neck is their posture. Because of the stooped posture, the muscles in the lower back have to pull much harder to keep the spine upright.
Does stress cause Parkinson’s?
Research suggests that stressful life events may increase the risk of Parkinson’s disease. In addition, animal studies indicate that stress damages dopamine cells, resulting in more severe parkinsonian symptoms. In humans, acute stress can worsen motor symptoms, including bradykinesia, freezing, and tremor.
Increased Feelings Of Anxiety Or Depression
Anxiety and depression have been linked to Parkinsons. In addition to movement problems, the disease can also have an impact on your mental health. Its possible that changes in your emotional well-being can be a sign of changing physical health as well.
If you are more anxious than usual, have lost interest in things, or feel a sense of hopelessness, talk to your doctor.
Stooping Or Hunched Posture
People who have Parkinsons disease may notice changes in their posture due to other symptoms of the disease, such as muscle rigidity.
People naturally stand so that their weight is evenly distributed over their feet. However, people who have Parkinsons disease may start bending forward, making them appear hunched or stooped over.
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Lightheadedness And/or Dizziness Upon Standing Up
People with PD can experience these symptoms due sudden drops in blood pressure when standing up, potentially leading to falls. This may occur because the disease affects a part of the nervous system that controls blood pressure.
Some PD medications also may be to blame. Its not uncommon in early PD. According to a 2020 study in the journal Geriatrics and Gerontology International, nearly half of people with early Parkinsons experience it.
Tremor In Other Conditions
While tremor is a common symptom of Parkinsons, it can also be a symptom of other conditions, most notably essential tremor. The main difference between Parkinsons tremor and most other types of tremor is that in Parkinsons resting tremor is most common. Other conditions are usually characterized by action tremor, which tends to lessen at rest and increase when youre doing something, like trying to make a phone call or take a drink.
Tremors of the head and voice are also common in essential tremor but rare in Parkinsons.
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Tips For Better Sleep
- Keep a regular sleep schedule go to bed at the same time and get up at the same time.
- Choose your bedtime based on when you want to get up. Plan to spend seven to eight hours a night in bed.
- Make a bedtime routine for example, snack, bath, tooth-brushing, toileting and follow it every evening.
- Spend time outdoors and exercise every day, in the morning if possible. Avoid exercise after 8:00 p.m.
- If you cant get outdoors, consider light therapy sitting or working near a light therapy box, available at drug stores and department stores.
- If you nap, try to do so at the same time every day, for no more than an hour, and not after 3:00 p.m.
- Sleep in a cool dark place and use the bed only for sleeping and sexual activity.
- Do not read or watch television in bed.
- Use satin sheets and pajamas to make moving in bed easier.
- Minimize drinking liquids for three hours before bedtime to avoid frequent nighttime urination.
- Go to the bathroom immediately before retiring.
- Place a commode next to the bed, to minimize the effort, and light to get up during the night.
- Avoid:
- Alcohol, caffeine and other stimulants such as nicotine
- Heavy late-night meals
- Heavy exercise within six hours of bedtime
- Thoughts or discussions before bedtime about topics that cause anxiety, anger or frustration
- Clock watching
- Screen time television, phones, tablets one or two hours before bed.
What Is The Treatment For Parkinson’s Disease
There is currently no treatment to cure Parkinson’s disease. Several therapies are available to delay the onset of motor symptoms and to ameliorate motor symptoms. All of these therapies are designed to increase the amount of dopamine in the brain either by replacing dopamine, mimicking dopamine, or prolonging the effect of dopamine by inhibiting its breakdown. Studies have shown that early therapy in the non-motor stage can delay the onset of motor symptoms, thereby extending quality of life.
The most effective therapy for Parkinson’s disease is levodopa , which is converted to dopamine in the brain. However, because long-term treatment with levodopa can lead to unpleasant side effects , its use is often delayed until motor impairment is more severe. Levodopa is frequently prescribed together with carbidopa , which prevents levodopa from being broken down before it reaches the brain. Co-treatment with carbidopa allows for a lower levodopa dose, thereby reducing side effects.
In earlier stages of Parkinson’s disease, substances that mimic the action of dopamine , and substances that reduce the breakdown of dopamine inhibitors) can be very efficacious in relieving motor symptoms. Unpleasant side effects of these preparations are quite common, including swelling caused by fluid accumulation in body tissues, drowsiness, constipation, dizziness, hallucinations, and nausea.
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Does Parkinsons Affect Voice
The voice is affected too, because the voice box is ultimately controlled by the basal ganglia as well. Thus the voice becomes soft, slurred and hushed. Others may comment that the patient is mumbling. The mumbling goes away temporarily once the patient becomes aware of it but soon returns to the soft, slurred state.
This temporary improvement when attention is paid is true of many of the motor symptoms of PD because the condition primarily affects subconscious movements, and does not directly affect nerve or muscle control at the most basic level. Thus, conscious awareness can override the slowness to a certain extent. This fact is one reason why physical therapy and physical activity are so useful and necessary in treating PD.
- Slowness of walking and other movements
- Trouble with dexterity
- Reduced arm swing or stride length
- Delayed reactions physically
- Reduced facial reactions
- Softer or slurred speech
- Tremor in one or both limbs with the limb at rest
- Sometimes also tremor with holding a posture or with actions
- Usually asymmetric
Imbalance, loss of balance reflexes
- May fall backwards
What We Know About Dementia
The National Institute on Aging says that dementia affects approximately 3.4 million Americans, or 13.9 percent, of the U.S. population ages 71 and older and is usually caused by brain damage associated with Alzheimers disease, vascular dementia or Parkinsons disease. And in Canada, the number of people living with dementia is expected to rise 66% by the time we reach 2031.
It is important to differentiate the various types of dementia for about 70% of patients, a diagnosis of dementia will be accompanied by a diagnosis of Alzheimers disease. Although these terms are often used interchangeably, Alzheimers and dementia are not one in the same. Dementia is a loss of brain function that refers to a group of illnesses.
Although dementia may be a symptom of Alzheimers, it may have other underlying causes, such as Picks disease, hypothyroidism or head trauma. While Alzheimers is the leading cause of dementia, vascular dementia, which is often caused by stroke, accounts for about 17% of all dementia cases.
While people will experience dementia differently, most people with dementia share some of the same symptoms that may come and go.
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What Is The Outlook For Persons With Parkinsons Disease
Although there is no cure or absolute evidence of ways to prevent Parkinsons disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.
Currently, you and your healthcare teams efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinsons disease can live fulfilling lives.
The future is hopeful. Some of the research underway includes:
- Using stem cells to produce new neurons, which would produce dopamine.
- Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
- Using a naturally occurring human protein glial cell-line derived neurotrophic factor, GDNF to protect dopamine-releasing nerve cells.
Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.
How Is Tremor Classified
Tremor can be classified into two main categories:
Resting tremor occurs when the muscle is relaxed, such as when the hands are resting on the lap. With this disorder, a persons hands, arms, or legs may shake even when they are at rest. Often, the tremor only affects the hand or fingers. This type of tremor is often seen in people with Parkinsons disease and is called a pillrolling tremor because the circular finger and hand movements resemble rolling of small objects or pills in the hand.
Action tremor occurs with the voluntary movement of a muscle. Most types of tremor are considered action tremor. There are several sub-classifications of action tremor, many of which overlap.
- Postural tremor occurs when a person maintains a position against gravity, such as holding the arms outstretched.
- Kinetic tremor is associated with any voluntary movement, such as moving the wrists up and down or closing and opening the eyes.
- Intention tremor is produced with purposeful movement toward a target, such as lifting a finger to touch the nose. Typically the tremor will become worse as an individual gets closer to their target.
- Task-specific tremor only appears when performing highly-skilled, goal-oriented tasks such as handwriting or speaking.
- Isometric tremor occurs during a voluntary muscle contraction that is not accompanied by any movement such as holding a heavy book or a dumbbell in the same position.
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What Are The Different Categories Or Types Of Tremor
Tremor is most commonly classified by its appearance and cause or origin. There are more than 20 types of tremor. Some of the most common forms of tremor include:
Essential tremor
Essential tremor is one of the most common movement disorders. The exact cause of essential tremor is unknown. For some people this tremor is mild and remains stable for many years. The tremor usually appears on both sides of the body, but is often noticed more in the dominant hand because it is an action tremor.
The key feature of essential tremor is a tremor in both hands and arms, which is present during action and when standing still. Additional symptoms may include head tremor without abnormal posturing of the head and a shaking or quivering sound to the voice if the tremor affects the voice box. The action tremor in both hands in essential tremor can lead to problems with writing, drawing, drinking from a cup, or using tools or a computer.
Tremor frequency may decrease as the person ages, but the severity may increase, affecting the persons ability to perform certain tasks or activities of daily living. Heightened emotion, stress, fever, physical exhaustion, or low blood sugar may trigger tremor and/or increase its severity. Though the tremor can start at any age, it most often appears for the first time during adolescence or in middle age . Small amounts of alcohol may help decrease essential tremor, but the mechanism behind this is unknown.
Dystonic tremor
Cerebellar tremor
Trouble Moving Or Walking
Do you feel stiff in your body, arms or legs? Have others noticed that your arms dont swing like they used to when you walk? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson’s disease. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem stuck to the floor.
What is normal?If you have injured your arm or shoulder, you may not be able to use it as well until it is healed, or another illness like arthritis might cause the same symptom.
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What Causes Parkinson Disease
Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.
Tips For Dementia Care
Dementia can be challenging for both patients and caregivers but knowing what to expect can help ease the journey. Caregivers may not be able to anticipate the level of dementia on a daily basis, but they can be prepared to manage the varying symptoms of dementia as they progress.
The different stages of dementia require different degrees of caregiving. 2 With mild dementia, people may still be able to function independently, however, theyll experience memory lapses that affect daily life, such as forgetting words or where things are located.
People experiencing moderate dementia will likely need more assistance in their daily lives as it becomes harder for them to perform daily activities and self-care. They may hallucinate, get lost easily and forget where they are, and not remember what day of the week it is.
Someone with severe dementia will likely lose their ability to communicate and need full-time daily assistance with tasks such as eating and dressing. They may not remember their own name or the names of others. Physical activity and ability may be seriously impaired and they may be more susceptible to infections, such as pneumonia.
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Early Symptoms Of Parkinson’s Can Be Overlooked
Symptoms of Parkinson’s disease are divided into 2 groups: motor symptoms and non-motor symptoms.
Early non-motor symptoms can be subtle and it’s possible to overlook them as signs of Parkinson’s: for example, anxiety and depression, fatigue, loss of smell, speech problems, difficulty sleeping, erectile dysfunction, incontinence and constipation. Another sign of Parkinson’s is handwriting that becomes smaller.
Motor symptoms of Parkinson’s can include tremor , slowness of movement , muscle rigidity and instability .
It’s possible for non-motor symptoms to start occurring up to a decade before any motor symptoms emerge. Years can pass before symptoms are obvious enough to make a person to go to the doctor.
There’s no ‘one size fits all’ when it comes to Parkinson’s disease different people will experience different symptoms, and of varying severity. One in 3 people, for example, won’t experience tremor.
On average, 37 people are diagnosed with Parkinson’s every day in Australia. Parkinson’s Australia
What Are The Primary Motor Symptoms Of Parkinsons Disease
There are four primary motor symptoms of Parkinsons disease: tremor, rigidity, bradykinesia and postural instability . Observing two or more of these symptoms is the main way that physicians diagnose Parkinsons.
It is important to know that not all of these symptoms must be present for a diagnosis of Parkinsons disease to be considered. In fact, younger people may only notice one or two of these motor symptoms, especially in the early stages of the disease. Not everyone with Parkinsons disease has a tremor, nor is a tremor proof of Parkinsons. If you suspect Parkinsons, see a neurologist or movement disorders specialist.
Tremors
Rigidity
Bradykinesia
Postural Instability
Walking or Gait Difficulties
Dystonia
Vocal Symptoms
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Parkinson’s Disease Diet And Nutrition
Maintaining Your Weight With Parkinson’s Disease
Malnutrition and weight maintenance is often an issue for people with Parkinson’s disease. Here are some tips to help you maintain a healthy weight.
- Weigh yourself once or twice a week, unless your doctor recommends weighing yourself often. If you are taking diuretics or steroids, such as prednisone, you should weigh yourself daily.
- If you have an unexplained weight gain or loss , contact your doctor. He or she may want to modify your food or fluid intake to help manage your condition.
- Avoid low-fat or low-calorie products. . Use whole milk, whole milk cheese, and yogurt.
How Does Parkinsons Disease Affect The Brain
The part of the brain that is affected is called the basal ganglia, which functions like the autopilot of your brain, facilitating subconscious movements. Because PD causes the brain cells in this deep circuitry to deteriorate, patients natural movements become slow and stiff. Many patients describe feeling as if they had aged overnight.
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How Is Tremor Diagnosed
Tremor is diagnosed based on a physical and neurological examination and an individuals medical history. During the physical evaluation, a doctor will assess the tremor based on:
- whether the tremor occurs when the muscles are at rest or in action
- the location of the tremor on the body
- the appearance of the tremor .
The doctor will also check other neurological findings such as impaired balance, speech abnormalities, or increased muscle stiffness. Blood or urine tests can rule out metabolic causes such as thyroid malfunction and certain medications that can cause tremor. These tests may also help to identify contributing causes such as drug interactions, chronic alcoholism, or other conditions or diseases. Diagnostic imaging may help determine if the tremor is the result of damage in the brain.
Additional tests may be administered to determine functional limitations such as difficulty with handwriting or the ability to hold a fork or cup. Individuals may be asked to perform a series of tasks or exercises such as placing a finger on the tip of their nose or drawing a spiral.
The doctor may order an electromyogram to diagnose muscle or nerve problems. This test measures involuntary muscle activity and muscle response to nerve stimulation.