Thursday, June 16, 2022
Thursday, June 16, 2022
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Does Parkinson’s Disease Affect The Mind

Parkinsons Disease And Alcohol: Your Guide

Dr. James Beck – How does Parkinson’s disease affect the brain?

If you have Parkinsons disease , you may be wondering whether alcohol consumption affects the development or progression of your condition. Some people may wonder if they should avoid drinking completely. As one MyParkinsonsTeam member asked, How does alcohol affect Parkinsons how much can I drink? Or should I avoid drinking altogether?

Some studies havent found that small amounts of alcohol are associated with a higher PD risk, while others highlight the dangers alcohol can pose for anyone with a chronic condition. In addition, there may be adverse interactions between alcohol and common Parkinsons medications. Because of conflicting information, people with PD may feel confused about whether or not to drink.

Ive been told by more than one doctor that I should not have any alcohol, one MyParkinsonsTeam member wrote. And at this point, I dont remember which doctor or specifically why.

So, how do you decide what approach to take?

If you have Parkinsons disease and are trying to decide whether or not to reduce your drinking or quit alcohol completely here are some things to consider.

What Are The Symptoms Of Parkinsons Disease

Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:

Other symptoms include:

  • Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
  • Handwriting changes: You handwriting may become smaller and more difficult to read.
  • Depression and anxiety.
  • including disrupted sleep, acting out your dreams, and restless leg syndrome.
  • Pain, lack of interest , fatigue, change in weight, vision changes.
  • Low blood pressure.

Be Honest With Yourself And Your Doctor

It is important to discuss alcohol consumption with your doctor to make sure you are approaching it safely. Elements of PD, including motor symptoms such as bradykinesia and dyskinesia , will vary from person to person, so its important to make decisions based on your medical history.

Taking into account environmental factors such as how central alcohol is to your social life can affect the decisions you make. Be honest with your doctor about your habits and preferences remember, your doctor wants to work with you to make your symptoms as manageable as possible, not to judge or shame you.

As you decide how alcohol may fit into your life post-diagnosis lifestyle, there are many factors to consider, such as the type of alcoholic beverage, your other risk factors, and your neurologists recommendations specific to your medical history. Most importantly, monitor how you feel when you drink alcohol and be willing to have open and honest conversations about drinking with your doctor and other important people in your life.

I am not even a big drinker, but miss the odd one, wrote a MyParkinsonsTeam member. So, I had an alcohol-free beer, which tasted OK, to be honest.

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The Cerebellum And Parkinsonian Akinesia/rigidity

Parkinsons disease is not a homogenous disease and has two predominant forms: akinesia and rigidity and prominent resting tremor . Akinesia can be defined as a delay or a failure in movement initiation , particularly for self-initiated movements. Functional neuroimaging studies using PET or blood oxygen leveldependent functional MRI frequently demonstrated increased activation in the cerebellum in patients with Parkinsons disease during performance of various upper limb movements . For example, during externally or internally timed simple finger movements , motor timing , complex sequential movements , bimanual two-hand coordinated tasks or two different motor tasks simultaneously , patients with Parkinsons disease OFF medication showed hyperactivation in the cerebellum.

Brain areas more activated in patients with Parkinsons disease than in normal subjects during automatic execution of sequential movements. Modified from, with permission from Oxford University Press.

The neurodegenerative process in Parkinsons disease begins several years before the onset of any clinical symptoms . The motor symptoms of Parkinsons disease usually present after 70% of dopaminergic neurons have degenerated . Presumably, the compensatory effect in the cerebellum and other brain regions accounts for delaying the onset of motor symptoms and preserving relatively normal function.

How Is Parkinsons Disease Treated

Parkinson

There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.

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How Does Parkinsons Affect The Face

Everyday tasks such as getting dressed, writing, picking something up off the floor take twice as long as they used to. Some people describe the feeling of slowness and stiffness as walking through molasses or moving in slow-motion. Because subconscious muscle movements of the face are responsible for ones facial expressions and others interpretation of our mood, patients can be thought to be upset or depressed when they are not. This is known as having a masked face.

A Bottle Neck To Neurological Health

I have noticed that a lot of people with Parkinsons Disease, and other neurological disorders too, such as Alzheimers, suffer with severe neck pain and/or stiff, rigid necks. In terms of neurological problems, our necks can be a pinch point – a constricted passageway or tunnel, through which all the superhighways between our brain and the rest of our nervous system and organs, and from there, out into the far reaches of our fingers and toes, must pass. All of our utilities, the two-way electrical wirings, the broadband and telegraph wires of the nervous system, the water and air supplies, the chemical pipelines providing nutrients and the sewer pipes taking away the excreta of the brain, must pass through this narrow gap. This is no ordinary tunnel: to keep these utility supplies open and running, it was designed to keep on moving itself and in truly extraordinary ways of flexible motions.

Even slight damage or stiffening up of the neck can cause constrictions or interruptions of these important electrical and chemical flows. For oxygen and nutrients that enter through the mouth or nose, it is double jeopardy, as they have to pass through the bottle-neck twice, down into the lungs or to the gut, and back up again to get the brain. The neck is therefore a primary attention site for progressive symptom reduction strategies. In this article, we look at aspects of the neck and consider what we can do to improve our lot.

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What Are The Complications Of Parkinson Disease

Parkinson disease causes physical symptoms at first. Problems with cognitive function, including forgetfulness and trouble with concentration, may arise later. As the disease gets worse with time, many people develop dementia. This can cause profound memory loss and makes it hard to maintain relationships.

Parkinson disease dementia can cause problems with:

  • Speaking and communicating with others
  • Problem solving
  • Forgetfulness
  • Paying attention

If you have Parkinson disease and dementia, in time, you likely won’t be able to live by yourself. Dementia affects your ability to care of yourself, even if you can still physically do daily tasks.

Experts don’t understand how or why dementia often occurs with Parkinson disease. Its clear, though, that dementia and problems with cognitive function are linked to changes in the brain that cause problems with movement. As with Parkinson disease, dementia occurs when nerve cells degenerate, leading to chemical changes in the brain. Parkinson disease dementia may be treated with medicines also used to treat Alzheimer’s disease, another type of dementia.

Parkinsons Doesnt Always Cause Dementia

How does Parkinsons disease affect memory?

While cognitive decline is common in both Alzheimers and Parkinsons, it is less likely to occur in Parkinsons patients. According to studies, only half of those with Parkinsons develop cognitive difficulties. This can range from mild forgetfulness to full-blown dementia.

When dementia does manifest itself with Parkinson, it occurs in the subcortical area of the brain. Alzheimers dementia occurs in the cortical area of the brain. As a result of this, the clinical symptoms of these two dementias can be somewhat different.

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Which Medicines Are Used To Treat Parkinsons Disease

Guidelines released by the Scottish Intercollegiate Guidelines Network recommend starting with a dopamine agonist, levodopa with a dopa-decarboxylase inhibitor or a monoamine-oxidase inhibitor. Other medicines are also sometimes used, usually in addition to one of these three main types of medication.

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Some Other General Points

Stay as active as possible. Exercise regularly as much as you are able. This may not be possible when the condition is more advanced. However, it is something to consider when symptoms are not too bad. You may walk more slowly than before but a daily walk is good exercise and may help to loosen up stiff muscles. Well-meaning relatives or friends may tell you to rest and take things easy. However, as much as possible and for as long as possible, resist the temptation for others to do things for you just because it may be quicker.

Constipation is common in people with PD. Help to reduce the chance of this by having lots to drink and eat plenty of vegetables, fruit, and foods high in fibre. Exercise can also improve constipation. Sometimes laxatives may be needed to treat constipation.

Some medicines taken for other conditions can interfere with dopamine and make PD worse. These may be prescribed for such things as mental illness, sickness, vertigo and dizziness. Check with your doctor if you are unsure about any medicines that you take.

Driving. If you are a driver you should tell the DVLA and your insurance company if you develop PD. Your insurance may be invalid if you do not. Depending on the severity of symptoms and the medicines that you are taking, you may still be allowed to drive following a medical assessment.

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Caring For Someone With Parkinsons

Practice patience and understanding when dealing with Parkinsons. You may be very frustrated and challenged as a caregiver, but those with Parkinsons are just as frustrated. Their physical and mental conditions can be debilitating, depressing, and humiliating.

Diet and nutrition can have a huge impact on the health and comfort of a Parkinson patient. Eating well, getting more rest, sleeping well, fresh air, and exercise can make a difference. Getting the right medication and complementary therapies is also important.

As Parkinsons impacts a patients motor skills, modifications to the living environment may have to be made to accommodate wheelchairs and limited mobility issues. Professional in-home assistance for Parkinsons can allow Parkinson patients to remain independent and can enhance quality of life.

Most importantly, seek help and support from family, friends, and caregiving support groups. Take advantage of the resources in your community. Shouldering all the burden can take a toll on a caregiver.

Take care of yourself or you wont be able to take care of your loved one. Follow the preventive advice provided above for yourself as well, and take deep breaths!

Resources

Is Parkinsons Disease Inherited

How To Cure and What To Avoid in Parkinsons Disease ...

Scientists have discovered gene mutations that are associated with Parkinsons disease.

There is some belief that some cases of early-onset Parkinsons disease disease starting before age 50 may be inherited. Scientists identified a gene mutation in people with Parkinsons disease whose brains contain Lewy bodies, which are clumps of the protein alpha-synuclein. Scientists are trying to understand the function of this protein and its relationship to genetic mutations that are sometimes seen in Parkinsons disease and in people with a type of dementia called Lewy body dementia.

Several other gene mutations have been found to play a role in Parkinsons disease. Mutations in these genes cause abnormal cell functioning, which affects the nerve cells ability to release dopamine and causes nerve cell death. Researchers are still trying to discover what causes these genes to mutate in order to understand how gene mutations influence the development of Parkinsons disease.

Scientists think that about 10% to 15% of persons with Parkinsons disease may have a genetic mutation that predisposes them to development of the disease. There are also environmental factors involved that are not fully understood.

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Sidebar: Morris K Udall Centers Of Excellence For Parkinson’s Disease Research

The Morris K. Udall Parkinsons Disease Research Act of 1997 authorized the NIH to greatly accelerate and expand PD research efforts by launching the NINDS Udall Centers of Excellence, a network of research centers that provide a collaborative, interdisciplinary framework for PD research. Udall Center investigators, along with many other researchers funded by the NIH, have made substantial progress in understanding PD, including identifying disease-associated genes investigating the neurobiological mechanisms that contribute to PD, developing and improving PD research models, and discovering and testing potential therapeutic targets for developing novel treatment strategies.

The Udall Centers continue to conduct critical basic, translational, and clinical research on PD including: 1) identifying and characterizing candidate and disease-associated genes, 2) examining neurobiological mechanisms underlying the disease, and 3) developing and testing potential therapies. As part of the program, Udall Center investigators work with local communities of patients and caregivers to identify the challenges of living with PD and to translate scientific discoveries into patient care. The Centers also train the next generation of physicians and scientists who will advance our knowledge of and treatments for PD. See the full list of Udall Centers.

Living With Parkinson Disease

These measures can help you live well with Parkinson disease:

  • An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
  • High protein meals can benefit your brain chemistry
  • Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
  • If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.

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Cognitive Changes In Pd

Cognitive symptoms in Parkinsons disease are common, though not every person experiences them. In some people with PD, the cognitive changes are mild. In others, however, cognitive deficits may become more severe and impact daily functioning. Similar to slowness of movement , people with Parkinsons disease often report slower thinking and information processing . Attention and working memory, executive function, and visuospatial function are the most frequently affected cognitive domains in PD.

Cognitive deficits that are mild and do not impair ones ability to carry out activities of daily living have been termed mild cognitive impairment. Studies estimate that mild cognitive impairment occurs in about 20-50% of patients with PD. We now recognize that mild cognitive changes may be present at the time of Parkinsons disease diagnosis or even early in the course of PD. They may or may not be noticeable to the person. They may or may not affect work or activities, depending on the demands of specific tasks and work situations.

Location of the substantia nigra. FrozenManCC BY-SA 4.0

The substantia nigra is an area of the mid brain located at the top of the spinal cord, which has been the focus of much work into how Parkinsons affects the brain.

You can read more about the alpha-synuclein protein, and how it plays a role in the spread of Parkinsons, in a previous blog post:

So What Do We Know So Far

Parkinson’s Disease: How is the brain affected?

Location of the substantia nigra. CC BY-SA 4.0

The substantia nigra is an area of the mid brain located at the top of the spinal cord, which has been the focus of much work into how Parkinsons affects the brain.

There are a right and a left substantia nigra, and often one side is affected before the other. Because of this, people with Parkinsons often experience symptoms primarily on one side of their body, particularly in the early stages. Indeed, this common feature of the condition often helps to distinguish Parkinsons from other similar conditions.

When it comes to confirming a diagnosis, it is the substantia nigra where pathologists look for changes at the end of life in brain tissue that has been donated to research. And the loss of the dopamine-producing cells in this area of the brain, accompanied by the presence of clumps of alpha-synuclein protein , has been the hallmark of Parkinsons for decades.

You can read more about the alpha-synuclein protein, and how it plays a role in the spread of Parkinsons, in a previous blog post:

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Surgical Treatment For Parkinsons

This is advised when the disease progresses and the medications are no longer controlling the symptoms of PD adequately.

  • As the disease progresses, Levodopa still works, but the brains response to the medication becomes less predictable. Levodopa may take longer to kick in and may wear off earlier, requiring patients to take medication more frequently during the day. Higher doses of levodopa are associated with abnormal involuntary movements, known as dyskinesias . Unpredictable medication effect results in OFF time when patients feel stiff, rigid, stuck, frozen, slow, or fatigued, compared to ON time when movements are smooth and closer to normal.
  • Treatment options as the disease progresses include taking levodopa more frequently making the medication last longer by adding medications to reduce the metabolism of levodopa, or dopamine adding or changing to long-acting forms of levodopa , or adding or changing to long-acting forms of dopamine agonist . Amantadine can be added to reduce dyskinesia. As these options are being considered and implemented, its time to consider deep brain stimulation surgery .
  • Deep brain stimulation surgery is FDA-approved for the treatment of motor complications in Parkinsons disease and is not experimental. DBS is not a last-resort treatment. It has been shown that DBS is more beneficial when performed earlier in the course of the disease compared to waiting for disability.

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