What Is Parkinson Disease
Parkinson disease is a movement disorder. It can cause the muscles to tighten and become rigid This makes it hard to walk and do other daily activities. People with Parkinsons disease also have tremors and may develop cognitive problems, including memory loss and dementia.
Parkinson disease is most common in people who are older than 50. The average age at which it occurs is 60. But some younger people may also get Parkinson disease. When it affects someone younger than age 50, its called early-onset Parkinson disease. You may be more likely to get early-onset Parkinson disease if someone in your family has it. The older you are, the greater your risk of developing Parkinson disease. Its also much more common in men than in women.
Parkinson disease is a chronic and progressive disease. It doesnt go away and continues to get worse over time.
Attention Difficulties In Parkinsons
Attention involves filtering information, and people with PD who experience attention difficulties have trouble maintaining focus, especially as the complexity of a situation increases. Attention difficulties can affect both intellectual pursuits and everyday activities, such as walking and holding a conversation at the same time.1,3
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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.
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Environmental Toxins And Parkinsons Disease
Neuronal cell death in PD may also be triggered by exposure to toxic substances or environmental factors which precipitate the symptoms of the disease as they render the brain vulnerable to subsequent physiological chronic stress . The environmental cause of PD mainly refers to exposure to dopaminergic toxins 6-hydroxydopamine , 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine , paraquat and rotenone as these toxins are known to induce formation of reactive oxygen species and oxidative stress which may result in neuronal cell death .
DA is one of the common neurotransmitters present in most parts of the central nervous system . The mesocortical, mesolimbic, nigrostriatal and tubero-infundibular pathways are the four main pathways that play a key role in dopaminergic signaling . DA cannot cross the blood brain barrier, therefore, it is synthesized from tyrosine which is carried into the brain via amino acid transporters . At the dopaminergic neuron level, tyrosine is then converted into dihydroxyphenylalanine by tyrosine hydroxylase then finally into DA by aromatic L-amino acid decarboxylase . DA is then stored in the vesicle until an action potential allows the vesicle to be discharged into the synapse . Monoamine oxidase is the enzyme that is responsible for breaking down excess DA and is known to similarly act on 6-OHDA inducing oxidative stress resulting in apoptosis .
Other Complementary Therapies For Anxiety In Pd
Complementary therapies are a growing group of treatments which may improve the symptoms of PD without medication. I have written past blogs on two complementary therapy approaches for several symptoms of PD art therapy and music therapy.
Various complementary therapy modalities have been developed that may lower stress and anxiety in PD. These include yoga, massage, the Alexander technique, neurofeedback and others. Some of these therapies have been studied in small trials with data suggesting that they may be helpful for the anxiety of PD. Others have not yet been studied, although anecdotally, people with PD may feel that they are very useful in combatting anxiety. In general, this group of therapies may be effective for the anxiety of PD but needs to be studied more rigorously.
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Parkinsons Disease And Depression
Parkinsons disease is a progressive neurodegenerative disorder that affects about 1% of individuals over the age of 65 and is characterized by severe loss of dopaminergic neurons in the nigrostriatal pathway, resulting in motor dysfunction . The exact etiology of PD is currently unknown, but the greatest risk factor for the disease is aging. While the cardinal motor symptoms of resting tremor, bradykinesia, postural instability and rigidity are the most identifiable manifestations of the disease, a plethora of non-motor symptoms may be present as well. One of the most common comorbidities is depression . The most commonly cited prevalence of depression in PD is between 4050% of all PD cases . While the elderly overall have an elevated risk of depression compared to the general population , there is a considerably enhanced risk of depression in PD. Depression in PD has adverse effects on the quality of life of Parkinsons patients and is one of the most disabling aspects of the disease . Depression is also associated with worsened motor function and increased disease severity that directly impacts daily living . However, though the rates of suicidal ideation are elevated in depressed PD patients, actual suicide attempts are uncommon .
What Treatments Are Available
Many Parkinsons patients enjoy an active lifestyle and a normal life expectancy. Maintaining a healthy lifestyle by eating a balanced diet and staying physically active contributes to overall health and well-being. Parkinsons disease can be managed with self-care, medication, and surgery.
Self careExercise is as important as medication in the treatment of PD. It helps maintain flexibility and improves balance and range of motion. Patients may want to join a support group and continue enjoyable activities to improve their quality of life. Equally important is the health and well being of the family and caregivers who are also coping with PD. For additional pointers, see Coping With Parkinsons Disease.
These are some practical tips patients can use:
Medications There are several types of medications used to manage Parkinsons. These medications may be used alone or in combination with each other, depending if your symptoms are mild or advanced.
After a time on medication, patients may notice that each dose wears off before the next dose can be taken or erratic fluctuations in dose effect . Anti-Parkinsons drugs can cause dyskinesia, which are involuntary jerking or swaying movements that typically occur at peak dosage and are caused by an overload of dopamine medication. Sometimes dyskinesia can be more troublesome than the Parkinsons symptoms.
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Stress Takes Its Toll In Parkinson’s Disease
- Northwestern University
- A stressful lifestyle could lead to the premature death of a group of neurons, whose loss triggers the symptoms of Parkinson’s disease, according to a new study. Isradipine, a drug already approved for human use by the FDA, has been shown in preclinical studies to reduce the stress on these neurons and rejuvenate them. Scientists currently are conducting a clinical trial to find out if isradipine can be used safely and is tolerated by patients with Parkinson’s.
We all know that living a stressful lifestyle can take its toll, making us age faster and making us more susceptible to the cold going around the office.
The same appears to be true of neurons in the brain. According to a new Northwestern Medicine study published Nov. 10 in the journal Nature, dopamine-releasing neurons in a region of the brain called the substantia nigra lead a lifestyle that requires lots of energy, creating stress that could lead to the neurons’ premature death. Their death causes Parkinson’s disease.
The good news is preclinical research shows this stress can be controlled with a drug already approved for human use. By preventing calcium entry, the drug isradipine reduced the mitochondrial stress in dopamine-releasing neurons to the levels seen in neurons not affected by the disease.
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Beyond The Substantia Nigra
In Parkinsons, other areas of the brain beyond the substantia nigra are involved as the condition progresses. Changes in higher brain areas are linked to non-motor symptoms that can affect people with Parkinsons later on in the condition, and often have a significant impact on quality of life.
For instance, symptoms that affect memory and thinking can be linked to the presence of Lewy bodies in the largest area of the brain the cerebral cortexas well as the limbic system. The limbic system is also believed to be involved in symptoms involving mood and pain, and similar changes in the inferior temporal gyrus, an area of the brain involved in processing what we see, are thought to be the reason for hallucinations.
But research into the spread of Parkinsons through these areas, and how we can stop it , is just one side of the story. There is also ongoing research into where Parkinsons starts, and the effects it is having before it reaches these areas.
The presence of non-motor symptoms many months and maybe even years before the physical symptoms, such as tremor and slowness of movement, points towards the presence of other changes in the body long before the loss of dopamine-producing cells in the substantia nigra. These early symptoms could even help researchers predict those who will go on to be diagnosed with Parkinsons, which would help in the development of new and better treatments.
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What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.
People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.
Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.
How Is Parkinsons Disease Diagnosed
Diagnosing Parkinsons disease is sometimes difficult, since early symptoms can mimic other disorders and there are no specific blood or other laboratory tests to diagnose the disease. Imaging tests, such as CT or MRI scans, may be used to rule out other disorders that cause similar symptoms.
To diagnose Parkinsons disease, you will be asked about your medical history and family history of neurologic disorders as well as your current symptoms, medications and possible exposure to toxins. Your doctor will look for signs of tremor and muscle rigidity, watch you walk, check your posture and coordination and look for slowness of movement.
If you think you may have Parkinsons disease, you should probably see a neurologist, preferably a movement disorders-trained neurologist. The treatment decisions made early in the illness can affect the long-term success of the treatment.
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Anxiety And Laterality Of Parkinson’s Disease
A number of studies have examined the relationship between anxiety and laterality of parkinsonian symptoms. These studies have shown that anxiety in patients with Parkinson’s disease was associated with mainly left sided symptoms. If anxiety in patients with Parkinson’s disease was a psychological response to disability, then patients with right sided parkinsonism would be expected to be more anxious: in fact the opposite is the case.
What Are The Causes
The cause of Parkinsons is largely unknown. Scientists are currently investigating the role that genetics, environmental factors, and the natural process of aging have on cell death and PD.
There are also secondary forms of PD that are caused by medications such as haloperidol , reserpine , and metoclopramide .
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Lack Of Exercise/physical Activities
The idea that exercise might have a role in Parkinsons disease is not new. Researchers have been trying to find a connection between Parkinsons and exercise for many years. They think that those who do regular exercise are less likely affected by the disease than those who dont.
A study published in the Journal of Neurology suggests that higher levels of physical activity may reduce the risk of developing Parkinsons disease. In this study, 125,828 provided information on physical activity in early adulthood. During the follow-up, a total of 387 Parkinsons cases were identified. The study found that the people who didnt develop the disease were mostly involved in some sort of higher levels of physical activity.
Similarly, one meta-analysis that included data from 8 prospective studies has concluded that moderate to vigorous physical activity may have an inverse relationship with a risk of Parkinsons.
Although it is not known how exercise could protect someone from developing Parkinsons, researchers think that it may inhibit abnormal changes in dopamine neurons and contribute to the healthy functioning of brain parts involved in body movement.
Is Parkinsons Disease Inherited
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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Does Anxiety Cause Freezing Of Gait
Although baseline levels of anxiety were not different between groups, anxiety induced during the walking paradigm was significantly amplified in Freezers beyond the level of Non-freezers. This would suggest that in Freezers, goal-oriented movement has the potential to induce greater anxiety, leading to a cautious and potentially maladaptive movement response such as freezing of gait. Thus, in other circumstances such as walking in darkness, or approaching doorways and narrow spaces, the anxiety-driven need for cautious movement might explain the occurrence of freezing in these situations. One might question whether freezing precedes anxiety or if anxiety does in fact lead to a freeze episode. Panic attacks and heart rate increases have been identified prior to and during a freezing episode. However, inferring a causal relationship would be difficult since there was no manipulation of anxiety-inducing conditions. Rather, associations make it ambiguous as to whether panic attacks and autonomic responses provoke freezing of gait or are a reactive response. The current findings support and extend this research, demonstrating that anxiety is in fact a cause of freezing of gait rather than simply a response, since manipulations of anxiety directly influenced the amount of freezing of gait participants experienced. Spatiotemporal gait changes , which have been previously linked with freezing behaviour, were also increased when anxiety was heightened.
What Is Parkinsons Disease In Dogs
Parkinsons disease in dogs is similar to the same condition in people.
You may notice a loss of balance and tremors, for example.
There are also a number of differences between human and canine Parkinsons disease.
This article discusses the signs you should look out for that indicate canine Parkinsons.
We can also provide tips on caring for your dog diagnosed with this neurological disorder.
Its important to stress that your veterinarian can provide health advice on your dog with Parkinsons, and you can always get a second opinion if you believe that your dog doesnt have the disease.
This can help you prepare for whats to come.
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Common Complications And Side
As Parkinsons disease progresses , symptoms have a knock-on effect. Deterioration and impairments in the body can lead to a variety of other health concerns that cause a person great difficulty.
As much as these potential concerns cause discomfort for a person, all are treatable with appropriate medication or therapies.
Associated complications which can arise include:
How to manage some of the more common side-effects of Parkinsons disease
The nature of Parkinsons disease progression means that the condition manifests in a variety of ways, not just in areas of mobility. Non-motor symptoms can sometimes be of more distress to a sufferer, troubling their day-to-day lives even more so than their physical ailments.
Once certain non-motor symptoms are recognised, it is easier to understand why and how they are adversely affecting quality of life, as well as gain control through appropriate treatment.
Other problems which can also be effectively managed include: