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How Does Parkinson’s Affect The Nervous System

So What Do We Know So Far

What is Parkinson’s disease? | Nervous system diseases | NCLEX-RN | Khan Academy

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.

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:

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

What Are The Treatments

Currently there is no cure for Parkinsons disease.

Symptoms can be mild in the early stages of the condition and people might not need immediate treatment. Your doctor and specialist will monitor your situation.

There are several different types of drugs used to treat Parkinsons disease. Drug treatments are tailored to each individuals needs and are likely to involve a combination of different drugs. Your medication should be reviewed regularly. It is likely that, over time, changes will be made to the types of drugs you take and the doses you take each day.

The main types of drug treatment for Parkinsons disease are:

  • drugs which replace dopamine
  • drugs which mimic the role of dopamine
  • drugs which inhibit the activity of acetylcholine
  • drugs which prevent the body breaking down dopamine
  • other drugs such as anti-sickness medication

Everybody is affected differently by medication. The possible side effects of Parkinsons disease drugs include nausea , vomiting , tiredness and dizziness. Some people might experience confusion, nightmares and hallucinations. For some people, dopamine agonists have been linked to compulsive behaviour such as addictive gambling or hypersexuality .

The effectiveness of the main drug treatment levodopa can wear off over time and its long-term use can cause some people to develop involuntary twisting or writhing movements of the arms, legs or face . To reduce the risk, doctors might delay the use of levodopa for younger people.

Recommended Reading: Life Expectancy Of Someone With Parkinson’s Disease

What Are The Different Stages Of Parkinsons Disease

Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms; others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.

In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:

Early stage

Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.

Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.

Mid stage

Mid-late stage

Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.

Advanced stage

Causes Of Parkinson’s Disease

Parkinson

Parkinson’s disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This;leads to a reduction;in a chemical called dopamine in the brain.

Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson’s disease.

Exactly what causes the loss of nerve cells is unclear. Most experts think that a combination of genetic and environmental factors is responsible.

Also Check: Parkinson Disease Dominant Or Recessive

A Long Term Mental Disorder

Definition of schizophrenia A long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation .Types of schizophreniaThere are several different types of schizophrenia including, Paranoid , Catatonic, Disorganized, Residual

Is Parkinson’s Diagnosed In The Brain

Parkinson’s disease is one of the most challenging neurological disorders to diagnose and treat. If your doctor suspects you have Parkinson’s disease, you will usually be referred to a neurologist for further tests. These tests will involve certain movements and exercises to check your symptoms.

A neurologist will look for motor symptoms such as:

  • A tremor that occurs at rest
  • Slowed movement
  • Muscle stiffness

If you have two or more of these symptoms and your doctor has taken blood tests to rule out other causes, it’s likely you will be diagnosed with Parkinson’s disease. Your symptoms will be closely monitored to see any progression of Parkinson’s disease, which can take years.

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Living With Parkinson’s Disease

As Parkinson’s develops, a person who has it may slow down and won’t be able to move or talk quickly. Sometimes, speech therapy and occupational therapy are needed. This may sound silly, but someone who has Parkinson’s disease may need to learn how to fall down safely.

If getting dressed is hard for a person with Parkinson’s, clothing with Velcro and elastic can be easier to use than buttons and zippers. The person also might need to have railings installed around the house to prevent falls.

If you know someone who has Parkinson’s disease, you can help by being a good friend.

Who Gets Parkinsons Disease

Managing Parkinson’s disease with medications | Nervous system diseases | NCLEX-RN | Khan Academy

Estimates vary, but about 1 million people are living with Parkinsons disease in the U.S. Doctors diagnose about 60,000 cases a year, most in people over age 60. Younger people can also get Parkinsons. About 5-10% of patients have young-onset Parkinsons disease, diagnosed before age 50.

About 15% of patients have Parkinsons-plus syndromes, also known as atypical Parkinsons. Medications may be less effective for these syndromes, which can lead to disability sooner.

Risk factors for Parkinsons disease include:

  • Age: Risk increases with age. Average age at diagnosis is 65.
  • Gender: Men are at higher risk.
  • Environmental exposure: Lifetime exposure to well water, which may contain pesticide runoff, can increase risk. So can exposure to air particles containing heavy metals, such as in industrial areas.
  • Family history: Having a close relative with the disease could increase your risk. Researchers have identified a dozen genes that may be linked to Parkinsons disease.
  • Sleep disorder: People who act out their dreams are up to 12 times more likely to develop Parkinsons disease. Its not clear whether this condition, called REM sleep behavior disorder or RBD, is a cause or symptom of Parkinsons disease.
  • Head trauma: Traumatic brain injury increases risk of Parkinsons, even years later.

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How Parkinsons Disease Affects The Autonomic Nervous System And The Heart

In PD, there are two major reasons why the automatic control of the cardiac system is impaired. First, areas of the brain that control this system often contain Lewy bodies and have undergone neurodegeneration. In addition, the autonomic nervous system itself is directly affected by Lewy body-like accumulations and neurodegeneration. This means, when the baroreceptors in the heart and carotid artery sense a drop in blood pressure and try to generate a signal to the heart and blood vessels to increase the blood pressure, the message may not get through. This results in neurogenic orthostatic hypotension , or drops in blood pressure upon standing due to autonomic nervous system dysfunction. There are no medications that can cure nOH by restoring the autonomic nervous system in PD. nOH however, can be treated. Read more about nOH and its treatmentshere.

Structural problems of the heart such as coronary artery disease or cardiomyopathy are not thought to be part of the pathology of PD, although of course, could co-exist with PD.

Study Finds Widespread Sympathetic Nerve Damage In Parkinsons Disease

The NINDS is a component of the National Institutes of Health in Bethesda, Maryland, and is the nations primary supporter of biomedical research on the brain and nervous system.

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The Heart Of The Matter: Cardiovascular Effects Of Parkinsons Disease

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Treatment For The Motor Symptoms Of Parkinsons Disease

There are many ways to deal with Parkinsons disease motor symptoms, including medications, occupational therapy and lifestyle adjustments. You may find that tremors make you more susceptible to accidents such as tripping, falling or spilling hot liquids so you must take care and ask for the help and support you need.

Unlike other Parkinsons motor symptoms, tremors can be hard to treat with medication. However, medicines can be helpful for treating symptoms such as Parkinsons disease gait impairments, which can have a major impact on your life. The gait of Parkinsons disease presents slightly differently in each patient. Some experience the Parkinsons disease shuffling gate, which can make movement markedly slower and make it look like you are dragging your feet. You may also experience reduced arm movement while walking.

In Parkinsons disease, freezing of gait is characterized by hesitation before stepping forward, or a feeling like your feet have frozen to the floor. Frozen gait usually only lasts for a step or two, but you will need to be careful when crossing busy streets and try to minimize your risk of falling wherever possible.

You can talk to your doctor about medications to try, as well your surgical and homeopathic options. However, there is no cure for Parkinsons disease and no way to stop the symptoms entirely, but scientists are working to change that.

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Vagus Nerve Branch Competition And Contradiction

  • The concept of competition between Sympathetic and Para-Sympathetic Nervous Systems is well known, as is the VN’s ability to inhibit Sympathetic influences, allowing us to discharge from excited or stressed states.

  • However, there may also be a different type of competition, in which the two Vagal branches convey contradictory information to the target organs. Both branches of the VN are capable of regulating heart beat rate, for example, via signals they send to specialized muscle tissue in the heart.

  • This competition between the two branches readily explains many medical issues when the Smart VN becomes very weak . Its regulation of the heart may then be easily inhibited, resulting in sudden loss of control. If there is a surge of Vegetative VN activity in response to this withdrawal of the Smart VN, the consequence is a rapid slowing of the heart rate, from which it might not be able to recover, and the heart and brain being starved of oxygen. Examples of this occurring include massive bradycardia in hypoxic babies and sudden death of athletes following exercise.

  • Similarly, the breathing rate in people with a weak Smart VN system may be overly prone to the influences of the Vegetative VN, and sudden changes from Smart to Vegetative VN control can cause asthma attacks.

  • Is There A Parkinson’s Disease Brain Scan

    Parkinson

    MRI brain scans and single photon emission computed tomography scans are often performed to rule out other causes of your symptoms, including strokes or a brain tumor.; However, neither of these scans are diagnostic of Lewy bodies. There is no Parkinson’s disease brain scan, and no tests can conclusively show that you have Parkinson’s disease.

    APA ReferenceSmith, E. . How Parkinsons Disease Affects the Brain, HealthyPlace. Retrieved on 2021, August 27 from https://www.healthyplace.com/parkinsons-disease/effects/how-parkinsons-disease-affects-the-brain

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    What Are The Causes

    The cause of Parkinson’s 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 .

    The Role Of Other Cranial Nerve

  • In humans, the Vagal NS is also inter-linked with other Cranial Nerves, including the trigeminal, facial, accessory and glossopharyngeal nerves. These nerves control muscles and sensation in the face, biting, chewing, the tongue, tilting and rotation of the head, shoulder movements, ear membranes, sucking in air, and muscles in the throat for vocalization and swallowing.

  • The Smart VN systems in humans therefore integrates functions such as head rotation to orient the senses toward the source of stimulation, mastication to ingest food, salivation to initiate digestive processes, facial expression and creating noises for purposes of social communication.

  • Furthermore, in evolutionary terms, the voluntary muscles supplied by these five Cranial Nerves evolved from regions in the body which were gills in early stages of life, and hence were, and remain, strongly associated with oxygen supply and chemically sensing oxygen and carbon dioxide levels in the body. They influence the rate of rhythmic movements such as heart beat, impacting on states of stress or relaxation, via the voluntary control of breathing, and are also responsible for voluntary control of the volume and tone of vocalizations .

  • Hence the overall Smart VN System is also strongly associated with movement, emotion, and communication, contributing to the unique social and survival behaviors observed in mammals.

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    Term / Parkinsons Disease

    Parkinsons Disease belongs to a group of conditions called motor system disorders which result from the loss of dopamine-producing brain cells.

    In the brain, dopamine functions as a neurotransmitter a chemical released by nerve cells to send signals to other nerve cells. Several important diseases of the nervous system are associated with dysfunctions of the dopamine system, including Parkinsons disease.

    Dopamine is available as an intravenous medication that acts on the sympathetic nervous system , but because dopamine cannot cross the bloodbrain barrier, dopamine given as a drug does not directly affect the central nervous system. To increase the amount of dopamine in the brains of patients with diseases such as Parkinsons, L-DOPA is often given because it crosses the blood-brain barrier relatively easily.

    The four primary symptoms of PD are:

    • Tremor, or trembling in hands, arms, legs, jaw and face
    • Rigidity, or stiffness of the limbs and trunk
    • Bradykinesia, or slowness of movement
    • Postural instability, or impaired balance and coordination

    How Is Tremor Classified

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    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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