Today Is Parkinsons Disease Awareness Day 2022
In recognition to all of those living with Parkinsons, here are a few facts that you may not know
Have a read through and remember that those with Parkinsons may not show symptoms all the time.
Amphetamine And Trace Amines
Studies have shown that, in certain brain regions, amphetamine and trace amines increase the concentrations of dopamine in the synaptic cleft, thereby heightening the response of the post-synaptic neuron. The various mechanisms by which amphetamine and trace amines affect dopamine concentrations have been studied extensively, and are known to involve both DAT and VMAT2. Amphetamine is similar in structure to dopamine and trace amines as a consequence, it can enter the presynaptic neuron via DAT as well as by diffusing through the neural membrane directly. Upon entering the presynaptic neuron, amphetamine and trace amines activate TAAR1, which, through protein kinase signaling, induces dopamine efflux, phosphorylation-dependentDATinternalization, and non-competitive reuptake inhibition. Because of the similarity between amphetamine and trace amines, it is also a substrate for monoamine transporters as a consequence, it inhibits the reuptake of dopamine and other monoamines by competing with them for uptake, as well.
In addition, amphetamine and trace amines are substrates for the neuronal vesicular monoamine transporter, vesicular monoamine transporter 2 . When amphetamine is taken up by VMAT2, the vesicle releases dopamine molecules into the cytosol in exchange.
Types Of Parkinsons Pain
Most of the time, discomfort in muscles and joints is secondary to the motor features of Parkinsons lack of spontaneous movement, rigidity, and abnormalities of posture what is known as musculoskeletal pain. The most commonly painful sites are the back, legs, and shoulders and it is usually more predominant on the side more affected by parkinsonism.
But there are many other categories of pain associated with Parkinsons disease. Radicular or neuropathic pain is experienced as a sharp pain that can start in the neck or lower back with radiation to arm or leg respectively and is often associated with numbness or tingling, or a sensation of coolness in the affected limb. It is usually secondary to a pinched nerve due to something like a slipped disc.
Dystonia related pain occurs as its name suggests, at times of dystonia most often experienced in the foot, neck or face and arm at different points in the dosing schedule, particularly the off phase when there is not enough dopamine replacement but can uncommonly also occur at peak-dose times. It can be one of the most painful symptoms those with Parkinsons can face.
Akathisia pain is experienced as restlessness, a subjective inner urge to move, an inability to stay still and the inherent feelings of discomfort that it brings. It is primarily experienced in the lower limbs and can often be relieved by walking around.
Is It Possible To Have A Stroke And Not Know It
Yes. You can have a silent stroke, or one youre completely unaware of or cant remember.
When we think of strokes, we often think of symptoms like slurred speech, numbness, or loss of movement in the face or body. But silent strokes dont show symptoms like these. In fact, silent strokes usually display no symptoms at all.
Like ischemic strokes, silent strokes happen when blood supply to a part of your brain is suddenly cut off, depriving your brain of oxygen and damaging brain cells.
But a silent stroke is, by nature, hard to recognize. Thats because a silent stroke disrupts blood supply to a part of your brain that doesnt control any visible functions like speaking or moving, so you might never know a stroke occurred.
The way most people find out they had a silent stroke is when they have an MRI or CT scan for another condition and doctors notice that small areas of the brain have been damaged.
What Are The Causes
Drug-induced parkinsonism is caused by medications that reduce dopamine levels in the brain. Dopamine is a neurotransmitter that works to control bodily movements.
Dopamine is also part of the brains reward system. It helps you feel pleasure and enjoyment, and it supports your ability to learn and focus.
Medications that bind to and block dopamine receptors are called dopamine antagonists. These medications arent used to treat Parkinsons disease. Rather, theyre used to treat other conditions that might seriously impact your quality of life.
If your doctor has prescribed a medication that causes unwanted side effects, you may have options. You may also decide that the side effects are worth it if the medication effectively treats your condition.
Some medications that cause drug-induced parkinsonism include:
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Support For People With Parkinsons Disease
Early access to a multidisciplinary support team is important. These teams may include doctors, physiotherapists, occupational therapists, speech therapists, dietitians, social workers and specialist nurses.
Members of the team assess the person with Parkinsons disease and identify potential difficulties and possible solutions.
There are a limited number of multidisciplinary teams in Victoria that specialise in Parkinsons disease management. But generalist teams are becoming more aware of how to help people with Parkinsons disease.
Parkinsons Awareness Month: Why It Matters
April is Parkinsons Awareness Month, and its more important than ever to raise awareness for this challenging disease. Parkinsons affects 1 million people in the United States alone, and there is still no cure. So this month, lets learn more about Parkinsons and how we can support family, friends, care partners, and, of course, those living with Parkinsons disease during Parkinsons Awareness Month.
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Other Causes Of Parkinsonism
“Parkinsonism” is the umbrella term used to describe the symptoms of tremors, muscle rigidity and slowness of movement.
Parkinson’s disease is the most common type of parkinsonism, but there are also some rarer types where a specific cause can be identified.
These include parkinsonism caused by:
- medication where symptoms develop after taking certain medications, such as some types of antipsychotic medication, and usually improve once the medication is stopped
- other progressive brain conditions such as progressive supranuclear palsy, multiple system atrophy and corticobasal degeneration
- cerebrovascular disease where a series of small strokes cause several parts of the brain to die
You can read more about parkinsonism on the Parkinson’s UK website.
Page last reviewed: 03 November 2022 Next review due: 03 November 2025
Parkinsonism Falls And Fracture Risk
All forms of parkinsonism, both PD and DIP, have implications for bone health. A 2014 meta-analysis on PD and fracture risk concludes that PD increases the risk of fracture.4
Given that the symptoms of parkinsonism affect balance, motor skills, gait, and the bodys ability to control movement, it is no surprise that people with PD are more likely to experience a fall than people without PD. Here is an excerpt from a 2016 study comparing the incidence of falls and fracture in PD patients:
It is estimated that 60.5% of patients with PD experience at least one fall and 39% have recurrent falls. The high frequency of falls consequently contributes to the increased risk for fractures in PD patients, which has been estimated to be approximately two times the risk in healthy controls. It has been estimated that 76% of falls in PD patients require health care services and 33% result in fractures. Falls and fractures may result in a series of unfavorable outcomes, such as disabilities and death. Furthermore, among PD patients with fractures, the mortality rate is approximately 10.6%.5
All too often, doctors prescribe these drugs without appropriate consideration of this risk. This excerpt from a study on DIP clarifies the danger of accepting a prescription of an unnecessary or inappropriate prescription drug:
Shockingly, the drugs that cause DIP are still being prescribed. This yet one more example further proving that the FDAs drug approval process is useless.
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What Were The Basic Results
Exposing wild Drosophila flies to low dose 1-octen-3-ol caused movement problems within the first 24 hours and 50% to die by 16.9 days. The control group all survived for at least 27 days, by which time the entire 1-octen-3-ol group had died.
In the second part of the study, exposure to 1-octen-3-ol reduced the number of all types of dopamine nerves except for one. This caused a reduction in dopamine levels of 28% compared to flies that were not exposed. It also increased the level of the waste product of dopamine, 3,4-dihydroxyphenylacetic acid by 40%.
In the human embryonic kidney cells, very low levels of 1-octen-3-ol did not have an effect, whereas low and higher levels caused a difficulty in transporting dopamine into the cells.
They found that overexpression of a different genetic neurotransporter cell in flies brains was protective against the effects of 1-octen-3-ol.
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How Can We Support The Sleep/wake Cycle Of Pdd
For people with PDD who are confused about the day-night cycle, some daily strategies can be helpful. At night, starting a lights out routine that happens at the same hour every day, where all curtains are closed and lights are turned off, can help the person understand that it is sleep time. During the day, opening the curtains, allowing the person with PDD to spend as much time in the daylight as possible, avoiding naps, and organizing stimulating activities, can be helpful. Having lots of calendars and clocks in every room might also help a person with PDD be less confused about the time of day.
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Peripheral Neuropathy And Parkinsons Disease
A number of studies have tried to determine if PN is more common among people with PD as opposed to people without PD. PN is a relatively common condition in the general population, which makes it difficult to ascertain whether or not it is even more common among people with PD.
The available studies have varying results and are difficult to compare with each other as they:
- Include different types of populations of people with PD
- Assess peripheral neuropathy differently
- Assess for causes of peripheral neuropathy differently
A recent review looked at all the available data and determined that large fiber neuropathy was present in 16% of patients with PD, about double the prevalence of this condition in the general population. Skin biopsy-proven small fiber neuropathy was present in over 50% of people with PD, although this result was based on a small sample of patients.
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Diffuse Lewy Body Disease
Diffuse Lewy body disease is a spectrum of diseases involving dementia and motor symptoms, and the second most common cause of dementia. Because the dementia is similar to that of Alzheimers, and other symptoms imitate Parkinsons disease, the disease can be difficult to diagnose. However, patients with DLBD have hallucinations and are very sensitive to antipsychotic medications. DLBD is more common in men than women.
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How To Talk To Someone With Hallucinations Or Delusions
- It is usually not helpful to argue with someone who is experiencing a hallucination or delusion. Avoid trying to reason. Keep calm and be reassuring.
- You can say you do not see what your loved one is seeing, but some people find it more calming to acknowledge what the person is seeing to reduce stress. For example, if the person sees a cat in the room, it may be best to say, I will take the cat out rather than argue that there is no cat.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
How Is Parkinson’s Disease Diagnosed
Diagnosis is difficult at every stage of the disease, but particularly in the early stages. No single test can provide a diagnosis. A diagnosis will likely involve physical and neurological examinations, conducted over time to assess changes in reflexes, coordination, muscle strength, and mental function. Your doctor might also see how you respond to medicine.
You may need to have brain imaging tests to rule out other conditions that might be causing your symptoms. Such tests could include MRI and CT scans and possibly some other types of scans. Blood tests may also be done to exclude other illnesses.
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Causes Of Parkinson’s Disease
Parkinson’s disease is caused by a loss of nerve cells in the part of the brain called the substantia nigra.
Nerve cells in this part of the brain are responsible for producing a chemical called dopamine. Dopamine acts as a messenger between the parts of the brain and nervous system that help control and co-ordinate body movements.
If these nerve cells die or become damaged, the amount of dopamine in the brain is reduced. This means the part of the brain controlling movement can’t work as well as normal, causing movements to become slow and abnormal.
The loss of nerve cells is a slow process. The symptoms of Parkinson’s disease usually only start to develop when around 80% of the nerve cells in the substantia nigra have been lost.
What Are Parkinsons Delusions
Delusions are thoughts that arent grounded in reality. Theyre not as common as hallucinations, affecting only about 8 percent of people with Parkinsons disease. But they are harder to treat.
The most common delusions involve paranoia for example, the feeling that people are out to get you, or that your partner is cheating on you. Having these thoughts can lead to aggressive or even dangerous behavior.
Youll start with a visit to your doctor for an evaluation. Your doctor may diagnose you with this condition if you:
- have had symptoms like hallucinations and delusions for at least 1 month
- dont have another condition that could be causing these symptoms, like dementia, delirium, major depression, or schizophrenia
Not everyone with Parkinsons disease will develop psychosis. Youre more likely to have this if you:
There are two possible causes of Parkinsons psychosis:
- changes in levels of brain chemicals like serotonin and dopamine from the disease itself
- changes in levels of these chemicals from medications that treat Parkinsons disease
Dopamine is a chemical that helps your body move smoothly. People with Parkinsons disease have lower than normal levels of dopamine, which causes their body to move stiffly.
Drugs that treat Parkinsons improve movement by increasing dopamine levels. Yet they can sometimes cause psychosis as a side effect.
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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.
Locating The Basal Ganglia
The basal ganglia are collections of nerve cells located deep within the brain. They include the following:
The basal ganglia help initiate and smooth out muscle movements, suppress involuntary movements, and coordinate changes in posture.
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Who Gets Parkinson’s Disease
About 1 million people in the United States have Parkinson’s disease, and both men and women can get it. Symptoms usually appear when someone is older than 50 and it becomes more common as people get older.
Many people wonder if you’re more likely to get Parkinson’s disease if you have a relative who has it. Although the role that heredity plays isn’t completely understood, we do know that if a close relative like a parent, brother, or sister has Parkinson’s, there is a greater chance of developing the disease. But Parkinson’s disease is not contagious. You can’t get it by simply being around someone who has it.
No One Definitive Cause Of Parkinsons
There are no biomarkers or objective screening tests that indicate one has Parkinsons. That said, medical experts have shown that a constellation of factors are linked to it.
Parkinsons causes are likely a blend of genetics and environmental or other unknown factors. About 10 to 20 percent of Parkinsons disease cases are linked to a genetic cause, says Ted Dawson, M.D., Ph.D., director of the Institute for Cell Engineering at Johns Hopkins. The types are either autosomal dominant or autosomal recessive .
But that leaves the majority of Parkinsons cases as idiopathic, which means unknown. We think its probably a combination of environmental exposure to toxins or pesticides and your genetic makeup, says Dawson.
Age. The biggest risk factor for developing Parkinsons is advancing age. The average age of onset is 60.
Gender. Men are more likely to develop Parkinsons disease than women.
Genetics. Individuals with a parent or sibling who is affected have approximately two times the chance of developing Parkinsons. Theres been an enormous amount of new information about genetics and new genes identified over the past 10 or 15 years that have opened up a greater understanding of the disease, says Dawson.
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What Is Parkinsons Disease
Parkinsons disease is a condition where a part of your brain deteriorates, causing more severe symptoms over time. While this condition is best known for how it affects muscle control, balance and movement, it can also cause a wide range of other effects on your senses, thinking ability, mental health and more.