How Does Parkinson Affect The Nervous System
How To Keep Your Nervous System Healthy?Here are some important recommendations:
Research Is Underway To Further Understand The Cardiac Effects Of Parkinsons
It is possible to image the sympathetic nervous system of the human heart by injecting a radioactive tracer, meta-iodo-benzyl-guanidine, . Development of this technique, known as MIBG cardiac imaging, holds much promise as a test to confirm the diagnosis of PD , to identify those who are at risk of developing PD in the future, and to distinguish PD from related disorders. MIBG cardiac imaging is still considered an experimental procedure for detection of PD and is not yet in use as a clinical tool for this purpose.
A recent research study was conducted in monkeys in which the destruction of the sympathetic nerves of the heart was chemically induced to mimic the changes that are seen in PD. The cardiac system was then imaged using a number of new-generation radioactive tracers, which bind to markers of inflammation and oxidative stress. This model system may help to shed light on the molecular changes that accompany the loss of the sympathetic nerves of the heart and can also be used to track the response of the cardiac system to therapeutic agents.
What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
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Drug Therapy And Research
If the disease progresses beyond minor symptoms, drug treatment may be indicated. Drug therapy for Parkinsonâs typically provides relief for 10â15 years or more. The most commonly prescribed medication is L-dopa , and this helps replenish some of the depleted dopamine in the brain. Sinemet, a combination of levodopa and carbidopa, is the drug most doctors use to treat Parkinsonâs disease. Recent clinical studies have suggested, in the younger person, the class of drugs called âdopamine agonistsâ should be used prior to levodopa-carpidopa except in patients with cognitive problems or hallucinations. In those older than 75, dopamine agonists should be used cautiously because of an added risk of hallucinations.
Other drugs are also used, and new drugs are continually being tested. It is common for multiple drugs to be prescribed because many of them work well together to control symptoms and reduce side effects. Contrary to past beliefs, starting Sinemet in newly diagnosed people does not lead to early symptoms of dyskinesia . Current knowledge is that the disease progression causes dyskinesias, not a âresistanceâ to the drug.
Quality of life studies show that early treatment with dopaminergic medications improves daily functioning, prevents falls, and improves a personâs sense of well-being.
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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 dont 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.
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Causes Of Parkinsons Disease
At present, we do not know the cause of Parkinsons disease. In most people there is no family history of Parkinsons Researchers worldwide are investigating possible causes, including:
- environmental triggers, pesticides, toxins, chemicals
- genetic factors
- combinations of environment and genetic factors
- head trauma.
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Characteristics Of The Population
This was an observational, cross-sectional, comparative pilot study carried-out in an ambulatory setting. Non-demented PD patients were consecutively recruited from our department. Patients with suspected atypical or secondary parkinsonism were excluded, as well as those with comorbidities known to influence HRV , or those patients taking drugs that are known to reduce HRV . Similar exclusion criteria were used for healthy controls , who were matched 1:1 for sex and age to PD patients. All the participants gave their informed consent to participate in the study. The study was approved by the local ethics committee and conducted according to the principles of the Declaration of Helsinki.
During the study period, 127 patients were evaluated. Overall, 104 patients were excluded because they did not meet the inclusion criteria . Five of the final 23 patients invited, refused to participate in the study.
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Clinical And Ecg Evaluation
Each patient underwent an extensive evaluation including Hoehn & Yahr stage , Unified Parkinsons Disease Rating Scale , and Scale for Outcomes in PD for autonomic symptoms . Medications and comorbidities were recorded, using the Cumulative Illness Rating Scale . Levodopa Equivalent Daily Dose was also calculated. A long term time domain analysis of heart rate variability using 24-h 12-lead ECG recording , encompassing morning and night hours was performed and evaluated according to the NASPE/ESC Task Force in PD patients and age-matched healthy individuals. Both groups were asked to perform normal daily activity excluding intense physical activity. All time domain parameters analysed have been summarized in Table and calculated using cardioscan II software .
Table 1 HRV Time domain parameters evaluated in PD patients and controls
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.
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How Parkinsons Disease Affects The Brain
The Parkinsons disease brain stops producing dopamine cells, which in turn causes problems with movement and coordination known as motor symptoms. We all have a basic understanding of how Parkinsons disease affects the brain, but what really happens when someone has Parkinsons disease? Lets explore the facts surrounding the Parkinsons disease brain and how it differs from a normal, healthy brain.
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The Facts About Parkinsons Disease
Parkinson’s disease is a progressive neurogenerative disease that causes nerve cells in the area of the brain that controls movement to weaken and/or die. While healthy neurons produce a chemical called dopamine, which the brain needs a certain amount of in order to regulate movement, weakened neurons produce lower levels of dopamine. What causes these neurons to weaken is currently unknown.
Some patients with Parkinson’s disease also suffer from a decline in norepinephrine, a chemical that transmits signals across nerve endings and controls various functions, such as blood pressure and heart rate.
More than 10 million people worldwide are currently living with Parkinson’s disease and nearly one million will be living with the disease in the United States this year, according to the Parkinson’s Foundation.
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Diagnosis Of Parkinsons Disease
A number of disorders can cause symptoms similar to those of Parkinson’s disease. People with Parkinson’s-like symptoms that result from other causes are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinson’s, certain medical tests, as well as response to drug treatment, may help to distinguish them from Parkinson’s. Since many other diseases have similar features but require different treatments, it is important to make an exact diagnosis as soon as possible.
There are currently no blood or laboratory tests to diagnose nongenetic cases of Parkinson’s disease. Diagnosis is based on a person’s medical history and a neurological examination. Improvement after initiating medication is another important hallmark of Parkinson’s disease.
What Are Statins And Should I Be Taking Them
Statins are a group of medicines that help to lower the risk of cardiovascular disease by reducing blood cholesterol levels.
They may be recommended if you already have cardiovascular disease or are at high or medium risk of developing it in the next 10 years.
As with any decision about medical treatment, taking statins is a personal choice and should be made following discussion with your GP or nurse.
The effect of statins for people with Parkinson’s is an area of very active research.
Some studies have suggested that taking statins may reduce the risk of developing Parkinson’s and there is currently a clinical trial underway in the UK which is looking at whether statins may even be able to slow the progression of Parkinson’s.
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How Do Symptoms Progress And What Is The Outlook
The symptoms of PD tend to become gradually worse over time. However, the speed of progression varies greatly from person to person. When symptoms first begin, you may not need treatment when symptoms are relatively mild.
Most people with PD can expect to have some time of relatively mild symptoms. Then, when the symptoms become worse, they can expect several years of good or reasonable control of the symptoms with medication. But everyone is different and it is difficult to predict for an individual how quickly the disease will progress. Some people may only be slightly disabled 20 years after PD first begins, whereas others may be very disabled after 10 years.
Research into PD is active. For example, one main aim of research is to find medicines that prevent the damage to the affected cells, rather than just treating the symptoms, which is the main value of treatment at present. Further research on these chemicals continues. Research is underway using stem cell therapy to help treat PD. Other researchers are looking at alpha synuclein, a protein that gathers around the junction between nerve cells and is thought to affect the way messages are conducted between the brain and the nerves controlling movement.
Further reading and references
What Does This Mean For People With Parkinson’s
Professor Donald Grosset, leader of the Tracking Parkinson’s study and one of the authors of the study, explains:
“It’s not surprising that many people living with Parkinson’s also have an increased risk of cardiovascular disease as both conditions get more common as we get older.
“But our study highlights the impact of living with both at the same time.
“People with poorer cardiovascular health had worse walking and memory even in the early stages of Parkinson’s, so improving cardiovascular health may help these aspects of the condition.
“We were slightly surprised that so few people in the high and medium risk groups were taking statins, since they are proven to reduce the risk of heart attacks and strokes.
“We hope our findings will help to start a conversation about vascular health in Parkinson’s, so that it can be assessed and, where appropriate, treated.”
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Ways To Decrease Risk Of Heart Disease
As in the general population, heart disease in people with PD can be decreased by managing traditional risk factors:
- Smoking cessation According to the American Heart Association, smoking is the most preventable cause of premature death in the U.S. Smoking increases the risk of developing many chronic disorders, including atherosclerosis that can lead to heart disease and stroke.3
- Treatment of high blood pressure Approximately 90% of all Americans will develop hypertension, or high blood pressure, over their lifetime. Hypertension puts more stress on arteries and can cause damage over time.3
- Treatment of high cholesterol High cholesterol is one of the major controllable risk factor for heart disease. When too much LDL cholesterol is in the blood, it can build up in the artery walls and narrow the vessels that feed the heart and brain.3
- Control of diabetes Diabetes can affect many major organs in the body, including the heart. Fortunately, diabetes is treatable and often preventable.3
Tips For Coping With Breathing Difficulties
- Work with your doctor to identify and treat any non-PD causes of shortness of breath, such as lung disease, heart disease or lack of physical conditioning and endurance.
- Exercise as much as possible. Shortness of breath may lead a person to move less. Less physical activity reduces the ability to take deep breaths. Staying active improves pulmonary function.
- Take steps to cope with anxiety. Talk with your doctor to figure out what sets off anxiety and find treatments and techniques that work for you.
- Speak to your doctor about getting an evaluation performed by a speech-language pathologist who can help you address issues related to swallowing.
- Give up smoking.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
How To Deal With Low Pressure In Parkinsons Disease
If you are a Parkinsons patient, it is very important to keep your eyes open on your blood pressure. Monitor and measure your blood pressure on regular bases, even if you dont feel any obvious signs. When taking blood pressure, do it in both seated and standing positions. It is good to take it 2-3 times a day. If you observed that your blood pressure is constantly low, talk to your caregiver immediately.
Here are some of the ways that can help you to maintain your blood pressure at a normal range.
- Drink a lot of water and avoid too much eating at once.
- If you have no issue with heart and kidney, increase the intake of salt in your food as it has been shown to elevate the blood pressure.
- Stop or reduce the consumption of alcohol and hot drinks. They widen the blood vessels and drop the blood pressure abruptly.
- Try to avoid excessive exercise as it can exacerbate the condition.
- Avoid changing your position suddenly. Take time to move from lying to sitting or from sitting to standing.
- Avoid standing for a long time.
- Consider the use of assistive devices like compression hose and an abdominal binder.
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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Hsn Deirmenci* Eftal Murat Bakirci And Hikmet Hamur
Cite this as
Parkinsons disease, which has symptoms and signs such as tremor, bradykinesia, rigidity and postural instability, is the most common neurodegenerative disease after Alzheimers disease. In Parkinsons disease, pathological mechanisms such as abnormal accumulation of protein aggregates, disruption of protein clearance pathways, oxidative stress, neuroinflammation, mitochondrial damage and genetic mutations lead to the formation of the clinic. Coronary artery disease, heart failure, cardiac autonomic dysfunction, heart failure, sudden death and hypertension can be seen in Parkinsons disease. Parkinsons disease leads to an increased risk of morbidity and mortality associated with these diseases. Dopaminergic drugs, non-dopaminergic drugs, growth factor support, stem cell therapy, gene therapy, exercise, diet and surgical treatment play an important role in the treatment of Parkinsons disease. This treatment helps to reduce cardiac effects.
Medicines For Parkinson’s Disease
Medicines prescribed for Parkinson’s include:
- Drugs that increase the level of dopamine in the brain
- Drugs that affect other brain chemicals in the body
- Drugs that help control nonmotor symptoms
The main therapy for Parkinson’s is levodopa, also called L-dopa. Nerve cells use levodopa to make dopamine to replenish the brain’s dwindling supply. Usually, people take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapysuch as nausea, vomiting, low blood pressure, and restlessnessand reduces the amount of levodopa needed to improve symptoms.
People with Parkinson’s should never stop taking levodopa without telling their doctor. Suddenly stopping the drug may have serious side effects, such as being unable to move or having difficulty breathing.
Other medicines used to treat Parkinsons symptoms include:
- Dopamine agonists to mimic the role of dopamine in the brain
- MAO-B inhibitors to slow down an enzyme that breaks down dopamine in the brain
- COMT inhibitors to help break down dopamine
- Amantadine, an old antiviral drug, to reduce involuntary movements
- Anticholinergic drugs to reduce tremors and muscle rigidity