How Does Parkinson’s Disease Affect Emotions

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Affect Modulated Startle Eyeblink Responses

Latency

To learn whether startle latency was modulated by valence, a Group × Valence repeated measures ANOVA was performed. Results revealed no significant main effects or interactions . Thus, latency to peak did not appear to vary as a function of group or valence category.

Amplitude

Startle eyeblink responses elicited during the picture task were converted to T-scores following the procedures of in order to minimize between-subject variability in the absolute size of startle responses. This was done by deriving an overall mean startle amplitude from the values of each subject’s individual trials. Then, for each participant, average startle responses were computed for the unpleasant, neutral and pleasant pictures and used as the dependent variable in the subsequent analyses.

Fig. 1

Peak amplitude of startle eyeblink responses during aversive, neutral, and pleasant pictures by Parkinson and control groups. Errors bars represent standard deviations. Asterisks refers to significance at P< 0.05 level ns = not significant .

Maintaining Your Normal Pd Medication Schedule

Maintaining your PD medication schedule is crucial for anyone with PD. The correct timing and dosage are essential to your comfort and well-being. However, oftentimes when undergoing surgery, there may be restrictions regarding when you can and cannot take medications. Here are a few tips to navigate this issue:

What Are The Warning Signs

There are several warning signs that an individual with Parkinsons and depression can display. However, it is important to remember that each individual will handle his or her emotions respectively and may display different warning signs. Some things to look out for are:

• Lack of motivation to carry out daily tasks such as cleaning the house, preparing meals, etc.
• Loss of interest in hobbies that once were a priority.
• Loss of interest in socialization.
• Lack of motivation to leave the house or get out of bed.
• Loss of interest in taking his or her medication or attending routine doctors appointments.

If you or your loved one is experiencing depression, anxiety or mood changes due to their Parkinsons Disease diagnosis, it is important to seek out resources to improve their overall wellbeing. It is imperative to seek out treatment through medical professionals, support groups from the community or support through family and friends. An in-home caregiver can also help the individual affected with his or her daily tasks such as light housekeeping, medication reminders, meal preparation or simple companionship. A caregiver can be the support system that a Parkinsons patient needs in order to continue with heir prescribed medical plan and avoid regression. With the proper medication, support and professional supervision, an individual with Parkinsons can improve his or her mental state and live a happy, healthy and prosperous life.

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One Of The Most Difficult Neurological Disorder Symptoms Of Parkinsons

Why might this be important to families challenged by PD? Because the biggest source of conflict in families occurs when loved ones fail to recognize that a person with brain changes is not the same person who existed at an earlier time in life. Human beings greatly value continuity in personality but by expecting the person to be the same as they once were, loved ones are unfair to the person with brain insult. This person could no more return to an earlier personality state than he or she can will away tremors or rigidity. Energy expended in any way other than coming to terms with this new person is fruitless. There is actually some fascinating research in this area and it is likely to be a topic for a great deal more discussion in future blogs.

Because of the greater likelihood for executive dysfunction and dementia, personality change is easier to see among individuals with more advanced PD. Motivation is frequently affected, resulting in apathy that diminishes how actively an individual interacts with other people and with the world . Thinking or cognition changes can cause the person to process information more slowly and with less focus and concentration . A previously methodical, consistent individual often becomes increasingly chaotic in their response to their environment . One easily becomes less interested and hopeful about the future .

Genetic Causes Of Parkinsons Disease

Although the genetic causes of PD can only account for a few percentage of patients with genes and genetic loci dysfunctions, early stress exposures usually predispose to depression, prompt or worsen motor symptoms in PD . The genetic origin of PD mostly includes mutations in -synuclein, parkin phosphatase and tensin homologue -induced putative kinase 1 , leucine-rich repeat kinase 2 and DJ-1 genes . Mutations of these genes can result in abnormal protein accumulation, -synuclein aggregates, protein phosphorylation, mitochondrial dysfunction and oxidative stress which is the most common pathway to cell death in PD pathogenesis . As exposure to stress early in life is known to alter both the behavior and physiology in certain brain areas, it is accepted that genetic changes associated with PD are in part the result of alterations in gene expression in these brain areas also affecting the stress response system .

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Shame Arising From The Increasing Physical Dependence And Need For Help

Shame is also associated with the progressive loss of independence. When asked to tell their stories, PwP describe feeling ashamed to have to hold on the arm of their companion to steady their walk, when getting assistance to sit down or getting up from a seat at a restaurant, or when a caregiver has to help tie shoelaces, dressing and undressing, or assisting with bodily functions. PwP may report feeling of shame towards their caregivers due to the increased request of special attention in the daily chores, such as in case of dysphagia for example which requires adaptation of the food consistency.

Planning For Future Care

PD is a neurodegenerative condition, which means that it progressively worsens over the years. You may need assistance with walking, such as a cane or a walker. While it is not common, some people with PD may need a wheelchair. Learning about your resources and the financial cost of these devices ahead of time can put you and your family at ease.

If you anticipate that you might not be able to drive or climb stairs, moving to a walkable neighborhood and to a home without stairs can help you enjoy your home and surroundings if your physical abilities become more limited.

And arranging for help around the house or help with transportation can provide you and your family with peace of mind as you navigate your illness through the years.

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Degraded Impairment Of Emotion Recognition In Parkinsons Disease Extends From Negative To Positive Emotions

Chon-Haw TsaiLi-Chuan Hsu

1Graduate Institute of Neural and Cognitive Sciences, China Medical University, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan

2Department of Psychology, Chung Shan Medical University, Taichung, Taiwan

3Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan

4School of Medicine, China Medical University, Taichung, Taiwan

Abstract

1. Introduction

Parkinsons disease is a neurodegenerative disorder characterized by a loss of dopaminergic neurons in the substantia nigra par compacta. Dysfunction of the nigrostriatal dopaminergic pathway impairs the function of basal ganglia-thalamocortical circuits, including those in the motor and prefrontal cortex . Patients with PD typically show not only motor symptoms but also cognitive deficits and a deficit in the processing of emotional stimuli . Clark et al. found that PD patients exhibited selective impairment in the recognition of angry and surprised facial expressions . Baggio et al. reported that PD patients showed reduced recognition of sad, angry, and disgusted facial expressions . A meta-analysis indicates that patients with PD were more impaired in recognizing negative emotion than relatively positive emotion .

2. Experiment1

2.1. Participants

2.2. Fast Emotion Discrimination Task

2.3. Statistical Analysis

2.4.1. Efficiency Scores of the PD Patients and HC Group

2.4.2. Disease Progression and Emotion Recognition

3. Experiment2

Medicines For Parkinsons Disease

Medicines prescribed for Parkinsons 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 Parkinsons is levodopa, also called L-dopa. Nerve cells use levodopa to make dopamine to replenish the brains 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 Parkinsons 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

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Shame Arising From Pd Motor And Non

Shame lurks when hand tremor occurs in public, or causes spilling food or drink all over oneself or somebody else, earning appraisals by others that one is gross, ill mannered, deviant or worse. Shame also emerges when PwP gait becomes unsteady or when the way to speak is modified, with a recurrent mislabeling by non-medical people as drunkard. Shame can erupt from akinesia, at the checkout counter of a grocery store for example, when PwP struggle pulling out money or credit cards from her/his wallet, and feeling that customers in line show signs of impatience, or when micrographia turns hand writing into chicken scratch that no one can read, or when turning takes ages because of the 10 steps needed to perform a turn. The facial mask induced by PD is also a sensitive topic for PwP. Facial expression is essential for communication and facial masking can be misinterpreted as unfriendliness or simply odd. Shame can also arise from PD-induced dysarthria and hypophonia when PwP have to repeat what they have to say.

Speech Difficulties Complicate Communication

Your loved one may also have difficulty speaking clearly as he or she loses control over the muscles in the throat and mouth. Make sure to be patient as your loved one speaks, and provide multiple options to communicate. For instance, your loved one may prefer to write things down or use electronic text-to-audio applications that turn typed words into speech.

Many seniors in the later stages of Parkinsons can continue to live at home, but they will likely need assistance from a family member or other caregiver to do so safely. For many seniors in Portland, live-in care is an essential component of aging in place safely and comfortably. However, its important for them to have caregivers they can trust and rely on. At Home Care Assistance, we extensively screen all of our live-in and 24-hour caregivers and only hire those who have experience in the senior home care industry. Our strict requirements ensure seniors can remain in the comfort of home with a reduced risk of injury or serious illness. Reach out to one of our Care Managers today at 835-4849 to schedule a free in-home consultation.

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Off Periods And Medication Effects

One of the complications of PD is that medication effects can wear off throughout the day, leading to a re-emergence of PD symptoms, often described as off periods.

The key to managing the off periods often lies in timing. Many people who have PD can observe trends in physical function throughout the day. You can keep track of your symptomatic changes throughout the day with a diary, and work with your doctor to adjust your medication schedule for optimal function during the times when you need it most.

The medications that are used to treat PD can produce physical side effects as well. You might begin to experience writhing movements and other involuntary movements that are often described as dyskinesias. Often, medication adjustments can help reduce dyskinesias.

Many people who have PD find that getting regular exercise can help in regaining some physical control. Exercises such as dancing, , swimming, and other challenging skill-based physical activity can help build better motor controleven if you start in your 70s or later.

How Can I Maintain Emotional Wellbeing

The most important thing is to try to stay positive and there are lots of things you can do to help with this:

• Educate yourself about Parkinsons, its cause and treatment. Being informed generally helps you to feel more in control.
• Take an active role in managing your condition.
• Keep doing the activities you enjoy if possible. Research has shown that keeping active can improve mood.
• Exercise regularly as this too improves mood. Swimming, walking and cycling are low-impact sports that can be done alone or with a friend.
• Try to ensure you get enough sleep for tips on good sleep hygiene see Sleep.
• Pace yourself know and accept your limitations and accept that these may change over time.
• Try to stay relaxed. Complementary therapies such as yoga, Tai Chi or meditation may help.
• Learn to recognise triggers that negatively impact your mood alcohol and caffeine are often culprits
• Accept help when you need it.
• Contact your local Parkinsons organisation or other support groups.

There are also many techniques and treatments available to support emotional wellbeing. Each person will respond to these in different ways so talk with your doctor if you think you need help and he or she will be able to advise.

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What The Research Says

A person may experience depression before any of the physical symptoms of Parkinsons disease.

A 2013 study found that people diagnosed with depression were 3.24 times more likely to go on to develop Parkinsons disease.

A further study in 2015 determined that depression might be an early symptom of Parkinsons disease or a factor that increases the risk of developing the condition.

Scientists at The Michael J. Fox Foundation believe that decreased levels of serotonin in the brains of people diagnosed with Parkinsons disease cause depression. The research to prove this link is ongoing.

Physical Issues Of Your Sex Drive

Parkinsons affects ones autonomic nervous system, which controls sexual response and functioning. Parkinsons acts upon neurons in the brains substantia nigra, causing dopamine-producing nerve cells to die. Since dopamine is a chemical that transmits signals between parts of the brain that usually coordinate smooth muscle movement, this is critical to sexual function on two fronts.

Introducing an easier way to track your symptoms and manage your care.

Dont want to download the app? Use the non-mobile version here.

First, this dopamine drop may result in a decreased sex drive and sexual interest. Second, the lower levels of dopamine that result are believed to cause ones loss of balance, changes in walking pattern and posture, muscle rigidity, Bradykinesia , and tremors when resting. The symptoms of Parkinsons can also be seen in:

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Are Persons With Pd More Prone To Experience Shame Compared With Patients With Other Chronic Neurological Diseases

Whether shame is experienced more frequently in PD relative to other chronic conditions is understudied. Numerous factors influence the degree to which a condition is considered to be stigmatizing, such as whether the individual is viewed as responsible for the condition, the impact of the illness on others, and the outward appearance or competence changes associated with the condition.

In summary, PD does not seem to induce more embarrassment or stigmatization than other chronic neurological conditions. However, studies are scarce and this assumption needs to be confirmed.

Facial Masking Makes Expressing Emotions Difficult

The same muscle stiffness and lack of responsiveness that occurs in the limbs can also happen to the facial muscles. Facial masking can cause your loved one to look angry or sad when he or she feels the exact opposite. Since this symptom is often difficult for people who are unfamiliar with Parkinsons to understand, it could cause them to respond negatively or avoid your loved one. Your loved one may also avoid seeing others if he or she picks up on the awkwardness of the expressions. Let your loved one know how to explain to others why he or she may appear to feel one way when he or she actually feels another. Most people understand facial masking once its explained to them.

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Are There Treatment Options

Vivid dreams are generally normal and not concerning.2 However, some people find vivid dreams disturbing or find that they make it difficult to sleep. Many report that sleep troubles affect their day-to-day life. Sleep disturbance is also linked to depression and poor quality of life. Improving sleep could go a long way towards improving these issues.3

Melatonin is a molecule that your brain naturally makes. It helps regulate your sleep-wake cycle. It can be found as an over-the-counter drug in most pharmacies and stores. Some people have found that taking melatonin nightly reduces their dreams and helps them sleep.2

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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 .