Slice Title3 Things We Know About Parkinson’s
Parkinson’s develops when cells in the brain stop working properly and are lost over time. These brain cells produce a chemical called dopamine.
Symptoms start to appear when the brain cant make enough dopamine to control movement properly.
There are 3 main symptoms – tremor , slowness of movement and rigidity – but there are many other symptoms too.
Does Sporadic Parkinson’s Disease Begin In The Enteric Nervous System
Objective/Rationale: Although the cause of sporadic Parkinson’s disease are still unknown, recent studies indicate the disease-related destruction is highly specific and involves a few nerve cell types within the human nervous system. A retrospective cross-sectional post-mortem staging procedure published by the Frankfurt-based group in 2003 proposes the pathological process in the brain begins in the brainstem dorsal motor nucleus of the vagal nerve and not in the substantia nigra of the midbrain. From the brainstorm, the pathological process appears to progress in a predictable manner. The vulnerable neurons have long axons and the involved brain regions are, anatomically speaking, closely interconnected. Thus, physical contacts between susceptible nerve cell types may play a central pathogenic role. These initial findings prompted us to ask whether Parkinson’s disease begins outside of the central nervous system. Our project aims to test whether the enteric nervous system is hit first in sporadic PD.
Relevance to Diagnosis/Treatment of Parkinson’s Disease: If cases are found showing Parkinson’s disease-related lesions in the foregut in the absence of such pathology in the brain, this knowledge would be invaluable to clinicians in their search for all of the non-parkinsonian features of PD, particularly when they occur prior to parkinsonism.
Related Diagnosis: Lewy Body Dementia
Current research is helping to differentiate dementia related conditions in relationship to Parkinsonâs disease. Doctorâs use a 12-month arbitrary rule to aid in diagnosis. When dementia is present before or within 1 year of Parkinsonâs motor symptoms developing, an individual is diagnosed with DLB. Those who have an existing diagnosis of Parkinsonâs for more than a year, and later develop dementia, are diagnosed with PDD.
In the simplest terms, Lewy bodies are abnormal clumps of proteins that develop in nerve cells. Cholinesterase inhibitors, medications originally developed for Alzheimerâs disease, are the standard treatment today for cognitive DLB and PDD symptoms. Early diagnosis is important, as DLB patients may respond differently than Alzheimerâs disease patients to certain drug, behavioral, and dementia care treatments.
This challenging, multi-system disorder involving movement, cognition, behavior, sleep, and autonomic function requires a comprehensive treatment approach to maximize the quality of life for both the care recipient and their caregiver. It is very important to pay attention to symptoms of dementia and to search for an expert clinician who can diagnose the condition accurately.
When People Talk About Parkinsons They May Mention The Effects It Has On The Substantia Nigra But Did You Know That There Are Other Areas Of The Brain That Are Affected By The Condition
Parkinsons is a condition that causes the gradual loss of the dopamine-producing brain cells of the substantia nigra an area of the brain located just above where the spinal cord meets the midbrain. It is these cells that produce and release the neurotransmitter dopamine, which has a key role in turning thought about movement into action.
While this definition of the condition is useful to briefly explain Parkinsons, the whole story is somewhat more complex. Over the last 30 years, it has become accepted that Parkinsons also causes a number of non-motor symptoms, such as changes in sleep, smell and even the way we think, which likely involve other areas of the brain.
Now scientists are looking at the broader effects of the condition on the brain in an attempt to better understand why people experience different symptoms. The finding could lead us to new treatments that tackle more than just the motor symptoms of the condition.
Is There A Cure For Parkinsons
Theres currently no cure for Parkinsons, a disease that is chronic and worsens over time. More than 50,000 new cases are reported in the United States each year. But there may be even more, since Parkinsons is often misdiagnosed.
Its reported that Parkinsons complications was the
Complications from Parkinsons can greatly reduce quality of life and prognosis. For example, individuals with Parkinsons can experience dangerous falls, as well as blood clots in the lungs and legs. These complications can be fatal.
Proper treatment improves your prognosis, and it increases life expectancy.
It may not be possible to slow the progression of Parkinsons, but you can work to overcome the obstacles and complications to have a better quality of life for as long as possible.
Parkinsons disease is not fatal. However, Parkinsons-related complications can shorten the lifespan of people diagnosed with the disease.
Having Parkinsons increases a persons risk for potentially life threatening complications, like experiencing:
Parkinsons often causes problems with daily activities. But very simple exercises and stretches may help you move around and walk more safely.
Read Also: Parkinsons Disease Genetic
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.
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:
How Parkinsons Disease Affects The Body
Life with Parkinsons is challenging, to say the least. This progressive disease starts slowly, and because theres currently no cure, it gradually worsens how you think and feel.
Giving up may seem like the only solution, but it certainly isnt. Thanks to advanced treatments, many people are able to continue living healthy, productive lives with Parkinsons.
Take a glance at this infographic to get a visual picture of how Parkinsons can affect everything from your memory to your movement.
Recommended Reading: Parkinsons Life Expectancy
The Nervous System & Dopamine
To understand Parkinson’s, it is helpful to understand how neurons work and how PD affects the brain .
Nerve cells, or neurons, are responsible for sending and receiving nerve impulses or messages between the body and the brain. Try to picture electrical wiring in your home. An electrical circuit is made up of numerous wires connected in such a way that when a light switch is turned on, a light bulb will beam. Similarly, a neuron that is excited will transmit its energy to neurons that are next to it.
Neurons have a cell body with branching arms, called dendrites, which act like antennae and pick up messages. Axons carry messages away from the cell body. Impulses travel from neuron to neuron, from the axon of one cell to the dendrites of another, by crossing over a tiny gap between the two nerve cells called a synapse. Chemical messengers called neurotransmitters allow the electrical impulse to cross the gap.
Neurons talk to each other in the following manner :
What Are The Symptoms Of Parkinson Disease
Parkinson disease symptoms usually start out mild, and then progressively get much worse. The first signs are often so subtle that many people don’t seek medical attention at first. These are common symptoms of Parkinson disease:
- Tremors that affect the face and jaw, legs, arms, and hands
- Slow, stiff walking
Also Check: Can Essential Tremor Turn Into Parkinson’s
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 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.
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.
Parkinsons & The Substantia Nigra
The substantia nigra is a part of the midbrain just above the spinal cord. Itâs also part of the basal ganglia, an area of the brain that scientists believe controls movement. Healthy brains contain an abundance of dopamine-producing cells in this part of the brain. The natural chemical dopamine is essential for regulating both movement and mood.
A dramatic 80% drop in these dopamine cells is what causes the symptoms of Parkinsonâs disease. Doctors and researchers are unsure why this process occurs. In addition to the effects previously mentioned, this dopamine loss may cause patients to experience slowness of movement, an inability to concentrate, and speech difficulties.
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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.
- Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
- Pain, lack of interest , fatigue, change in weight, vision changes.
- Low blood pressure.
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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The Complete Explanation For Parkinson’s Disease
Notwithstanding the types of sudden onset PD caused by blows to the head or acute chemical poisoning, we now have a complete, simple and elegant framework of understanding of “Ideopathic” Parkinson’s Disease, which is readily explained as follows.
With the weakening of the Smart VN and associated Cranial Nerves, go all their functions outlined previously, leading, precisely, to all the well known major non-motor symptoms of Parkinson’s Disease. Facial expressiveness is lost and the face becomes a blank mask. Use of the larynx and muscles in the throat are lost, causing the problems with speech and vocalizations, swallowing, chewing and saliva control. The ability to rotate and tilt the head is lost and the neck becomes extremely stiff and painful. The ability to raise the arms is lost and shoulders become painful and frozen. The sense of balance provided by the ear is lost, causing falls. The ability to experience positive emotional states, and to read these in the faces of others, is lost and anti-socialness increases, leading to feelings of isolation.
As the Freeze response of the Vegetative VN becomes more easily excited, its other role in regulating rest and digest function is inhibited, resulting in the appearance of the gastric problems associated with PD , together with imbalances in the gut microbiome.
If these negative feedback cycles are not interrupted, these vicious circles lead to the apparently degenerative nature of Parkinson’s Disease.
Symptoms Of Peripheral Neuropathy
The symptoms of PN can be non-specific, and a person therefore may not be able to distinguish on their own whether his/her symptoms are due to PN or another condition. PN, however, often results in specific findings on a neurologic exam, such as decreased sensation to pin prick or vibration or the lack of ability to discern which way a toe is being pointed without looking. Other tests such as Electromyogram and Nerve conduction studies may be necessary to confirm the diagnosis. Small fiber neuropathy which typically causes pain, burning, tingling and/or numbness in the feet, may have normal EMG and NCS and a skin biopsy may be necessary to confirm the diagnosis. With the appropriate examination and supportive tests however, a neurologist should be able to distinguish the symptoms of peripheral neuropathy from other conditions, including PD, that may cause similar symptoms.
There are many known causes of PN including diabetes, vitamin deficiencies, certain infections, and autoimmune diseases. Many of these causes can be treated, so it is important to know if you do have PN and what the cause is. There are those people however, who have the signs and symptoms of PN, but no known cause can be identified.
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.
Read Also: What Causes Slow Brain Waves
What Are Lewy Bodies
Alpha-Synuclein is a protein found exclusively in neurons. In PD, a-Synuclein is found in globs known as Lewy bodies that are found in neurons.
Lewy bodies are found in dopaminergic neurons in the substantia nigra pars compacta and likely contribute to the death of these neurons. Lewy bodies can be found in other brain areas such as the amygdala, locus coeruleus, and raphe nucleus.
These brain areas play a role in anxiety and depression. A brain area called the cortex is responsible for cognition, and executive function, i.e. the ability to plan for the future. Lewy bodies in this area of the brain are thought to cause dementia.
Recommended Reading: Can Parkinson\’s Stay Mild
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.