What Is The Difference Between Huntingtons Disease And Parkinsons
Unfortunately, many people know someone who is affected by Huntingtons Disease or Parkinsons disease. The key difference between these two degenerative brain disorders is that while Huntingtons Disease causes emotional difficulties, cognitive abilities, and abnormal repetitive movements, Parkinsons causes a slowing of movements and affects mobility and muscle control due to rapid brain degeneration.;
Some of the other significant differences between the two are:
Stage of Life When Symptoms Appear: While Huntingtons Disease symptoms can begin to appear in early adulthood, Parkinsons Disease more commonly affects those who are 70 or older.;
Cause: Huntingtons Disease is caused by a defective gene, whereas Parkinsons is caused by the degeneration of neurons in the center of the brain.;
Life Expectancy Sadly, those affected by Huntingtons Disease are expected to live only 15-20 years after the first onset of symptoms. Conversely, Parkinsons has no effect on life expectancy but can dramatically reduce the quality of life for those affected.;
What Are The Symptoms Of Huntingtons Disease
This disease typically does not start to affect the body until well into adulthood. Symptoms usually begin to emerge at some point between ages 30 and 50 but have also appeared as early as 2 and as late as 80. Huntingtons Disease affects people in three areas, their physical abilities, cognitive abilities, and mood regulation.;
Physical The Hallmark symptom of this disease is the uncontrolled and involuntary movement of the arms, face, legs, head, and upper body.;
Cognitive Huntingtons Disease also dramatically affects thinking skills. More specifically, reasoning, memory, judgment, and concentration skills are affected. There may also be significant organizational and planning skill deficits.;
Mood Many people who are affected by Huntingtons Disease exhibit uncharacteristic irritability or anger. They may also develop anxiety and depression despite having very stable mental health previously. It has also been widely recorded that those suffering from Huntingtons disease are also likely to develop OCD ;
Electrical Neuromodulation Therapies For Pd And Hd
The cardinal motor symptoms of PD and chorea in HD are caused by the progressive degeneration of dopaminergic neurons in the SNpc and the loss of MSNs in the striatum , respectively. In both cases, the motor impairment is attributed to alteration of functional connectivity of the striatum, a principal input of the basal ganglia .
Hyperkinetic movement disorders are characterized by uncontrollable and excessive motor activity, as chorea in HD. Reports published between 1987 and 1989 showed that blocking the activity of the STN produces hyperkinetic motor symptoms. Similar results are observed when the GABAergic inputs from the striatum are blocked, favoring the inhibitory modulation of the GPe over the STN . On the other hand, hypokinetic disorders like akinesia and bradykinesia have been described in PD. In this case, the decrease in striatal DA levels, as a result of the decrease in its synthesis, release, and reuptake alter the corticostriatal balance causing an increase in the activity of the indirect pathway and reducing the activity of the direct pathway, that leads to a breakdown of the internal balance of the basal ganglia, and consequently the loss of movement control . These symptoms, unlike hyperkinetic movements, are treated with DA agonists as L-dopa . However, as stated in previous sections, the chronic use of this pharmacological therapy has a limited effect, which in the case of PD can induce a motor complication known as LID and on-off phenomenon .
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Living With Huntingtons Disease
Huntingtons disease is progressive. That means it gets worse over time. Living with the disorder means preparing for the symptoms to worsen. Eventually you will need help with everyday activities. These include getting around your home, hygiene, eating, and decision-making. A trusted advisor can help with important decisions and in monitoring changes in your behavior.
People with Huntingtons disease usually die within 15 to 20 years of their diagnosis. The most common causes of death are infections and injuries related to falls.
How Is Chorea Diagnosed
Chorea is diagnosed clinically, meaning that it is based on the examination of an experienced physician. There is currently no objective test that differentiates chorea from other types of involuntary movements. The clinical evaluation includes a detailed history of other medical problems, prior surgeries, previous infections you may have had, exposures to medications and toxins , and a family history of diseases that occurred in your relatives. You should be ready to answer questions such as when the movements started, whether it was a quick or gradual onset, and any associated symptoms. It can be helpful to try to obtain a list of all the medications you have been prescribed within a year of onset of involuntary movements from your pharmacy. Once the clinical diagnosis of chorea is made, your physician will likely need to order additional tests to try to identify the underlying cause of the movements. This usually includes blood tests and imaging studies of the brain such as magnetic resonance imaging , and can sometimes include more specialized tests. Determining the cause of chorea can sometimes be challenging even for movement disorders specialists, and in some patients with chorea the cause cannot be identified.
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Cellular Replacement Therapies For Pd And Hd
In 1967, in an important breakthrough, Cotzias et al. demonstrated that the administration of a precursor of DA, L-dopa, improved motor function in PD patients, leading to the thought that the cure for PD was discovered. Also in the 1960s, tetrabenazine was introduced as an antipsychotic but also showed beneficial effects for the treatment of hyperkinetic motor symptoms, like chorea in HD patients . To date, it is known that these drugs do not reverse disease progression and in many cases do not have the desired effects. This has brought the idea that local production of DA and GABA, and therefore the replacement of the neurons that produce it, would be the ideal treatment for these diseases. The fact that the major symptoms present in PD and HD patients are due to the loss of dopaminergic and GABAergic neurons in specific brain regions, respectively, means that replacing these specific cell types could help relieve some of the symptoms present in patients. This has given rise to different branches of investigations seeking cellular replacement-based therapies, which have shown promising results in animal models for these diseases as well as in affected patients .
What Is The Most Common Cause Of Death In This Condition
The most common cause of death in Huntingtons disease is pneumonia and suffocation. Motor symptoms cause both problems.
When the condition is in its later stages, the person has poor muscle control, including those in the throat. This causes the main problem that leads to the patients death, which is not swallowing most foods adequately.
When the HD patient is being fed the food, whether it is liquid or not, it can go to the lungs. This small portion of food in the lungs carries anaerobic bacteria that cause pneumonia, which leads to the patients death.
Aspiration pneumonia can be more severe than common infections, especially if doctors do not identify quicky that its this type of infection, the one causing trouble and treat it as ordinary pneumonia. Suffocation happens when solid foods obstruct the upper airways in its totality because of the patients lack of muscle control.
Other causes of death are common such as:
- Heart disease: People with this disease suffer from nerve conduction in the heart that can cause low heart rate and arrhythmia. It also generates heart failure.
- Suicide: Usually in early or mid-stages of the disease because of the depression proper of the gene mutation that affects the brain.
- Cachexia: Is a state in which the body deteriorates through the loss of muscle mass and fat. It happens mostly in chronic diseases and is not because of less food ingestion.
Activation Pattern In Parkinson’s Disease And Huntington’s Disease Patients
The major finding emerging from our investigations in Parkinson’s disease and Huntington’s disease patients is that task-related differences in cortical and subcortical sensory-evoked activation exist by comparison with healthy control subjects and, like previous H215O-PET studies on motor processing, there was a considerable degree of congruency between activation patterns in Parkinson’s disease and Huntington’s disease . Among distributed areas with relative rCBF reductions, basal ganglia activation was reduced in both patient groups. This is in keeping with findings in cats rendered parkinsonian with MPTP, where marked decreases of neuronal responses to tactile stimuli have been demonstrated in globus pallidus . Similar reductions of striatal responsiveness to sensory stimulation have been reported in MPTP treated monkeys, and were reversible after apomorphine .
Will The Research Lead To A Breakthrough
Experts in these fields told Healthline this particular research does provide some encouragement.
James Hendrix, director of global science initiatives at the Alzheimers Association, said although the three diseases involve different proteins and have different effects on the brain, there is still some commonality.
He likened it to studying the motors of cars, airplanes, and boats. Although theyre different modes of transport, they still have similar engines.
Its valuable to have this cross talk. You dont want to work in a silo, Hendrix told Healthline. A discovery in one area can revolutionize another field.
George Yohrling, PhD, the senior director of mission and scientific affairs at the Huntingtons Disease Society of America, agrees.
Theyre looking at whats going on at the cellular level. What cellular machinery is being disrupted, he told Healthline.
It gets down to the cellular level, added Hendrix. If you can understand whats going wrong, you might be able to prevent that mechanism from happening.
A breakthrough is sorely needed for all these diseases.
Late last month, the Centers for Disease Control and Prevention announced that the death rate from Alzheimers in the United States increased 55 percent between 1999 and 2014.
In addition, about 50,000 people in the United States are diagnosed with Parkinsons every year. An estimated 500,000 Americans are living with the disease.
That would be wonderful, said Yohrling.
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Gene Therapies For Pd And Hd
For the development of new therapies for PD and HD, it is important to include, especially for HD and genetic forms of PD, genetic correction/editing of the mutated gene. Nowadays, there are several gene silencing/editing technologies, including RNA interference , antisense oligonucleotides , and clustered interspaced short palindromic repeats , which can be used as therapies for the treatment of PD and HD. For a more in-depth knowledge of gene therapy delivery systems and other cellular targets, reviews are published elsewhere .
As previously stated, PD is characterized by the selective degeneration of dopaminergic neurons in the SN, thus approaches aiming to revert this loss based on the delivery of genes encoding for enzymes required for DA synthesis could be useful. The first enzyme for DA synthesis is TH, which requires the enzyme GTP-cyclohydrolase-1 to synthesize a cofactor for DA biosynthesis . TH converts tyrosine into L-dopa, which finally is converted into DA by the aromatic L-amino acid decarboxylase . Therapies to deliver enzymes involved in DA synthesis have been proved in preclinical and clinical studies showing its benefits.
Symptoms Of Huntington Disease
Symptoms of Huntington disease usually develop subtly, typically beginning between the ages of 35 and 40 but sometimes before adulthood.
During the early stages of Huntington disease, the face, trunk, and limbs may move involuntarily and rapidly. At first, people can blend these abnormal involuntary movements into purposeful ones so that the abnormal movements are barely noticeable. However, with time, the movements become more obvious.
Muscles may contract briefly and rapidly, causing the arms or another body part to suddenly jerk, sometimes several times in a row.
People may walk in a lilting or exaggeratedly jaunty way, like a puppet. They may grimace, flick the limbs, and blink more often. Movements become uncoordinated and slow. Eventually, the entire body is affected, making walking, sitting still, eating, speaking, swallowing, and dressing extremely difficult.
Mental changes frequently occur before or as the abnormal movements develop. These changes are subtle at first. People may gradually become irritable, excitable, and agitated. They may lose interest in their usual activities. They may be unable to control their impulses, losing their temper, having fits of despondency, or becoming promiscuous.
As Huntington disease progresses, people may behave irresponsibly and often wander aimlessly. Over years, they lose their memory and their ability to think rationally. They may become severely depressed and attempt suicide.
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What Causes Huntingtons Disease
Huntingtons disease is caused by a mutation in the HTT gene. The HTT gene is responsible for making the huntingtin protein, which is thought to play an important role in nerve cells of the brain.
In Huntingtons disease, a DNA segment within this gene, called the CAG trinucleotide repeat, is repeated more often than is normal.
Who Does Chorea Affect
Since many different types of diseases and disorders can cause chorea, it can affect almost anyone from infants and children to the elderly, and it can occur in both males and females. The number of people affected with specific diseases that cause chorea is known and the number of people who have chorea or develop it every year is difficult to study.
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How Does One Get Parkinsons Disease
A patient gets Parkinsons disease due to degeneration or destruction of the nerve cells which produce dopamine. Absence of the neurotransmitter called dopamine makes it difficult for the brain to control and coordinate muscle movements which in turn produces symptoms of tremors. It must be remembered that Parkinsons disease is a progressive neurological disorder.
Differences Between Alzheimers And Parkinsons
Were going to group the differences between both illnesses into different blocks and explain what each of them consists of. All of them have been extracted from two reference psychopathology manuals: Belloch, Sandín, and Ramos and the DSM-5 .
The first block of differences between Alzheimers and Parkinsons refers to their type of symptoms. Lets see what they are.
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Possible Link To Alzheimers
Though Alzheimers, Huntingtons, and Parkinsons are distinctly different diseases, some evidence has emerged that shows a common link between the three.
All three diseases have proteins within the cells that do not assemble properly. Though the molecular and cellular changes that occur in each disease vary greatly, this protein degradation has been shown to precede early clinical signs in each disease. This is promising news, as more studies are being done to determine whether this can either predict or prevent these neurodegenerative diseases.
How Does Huntingtons Disease Affect Speech
In many cases, Huntingtons Disease affects ones ability to speak clearly and effectively, as this disease can cause a loss of coordination within the throat and mouth muscles that facilitate speaking and breathing. Some of the most common changes in speech due to Huntingtons Disease are slurred words, loss of control of the volume of speech, hoarseness of the voice, or improper pauses when speaking. In these cases, speech therapy can be an incredibly valuable resource for supporting someone affected by Huntingtons disease.;;
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My Doctor Mentioned Athetosis Is Athetosis The Same Thing As Chorea What Is Choreoathetosis
Athetosis is a form of chorea that is slow and writhing in quality. Most movement disorders neurologists consider it a form of chorea, and often athetosis can change over time into chorea and vice versa. When both chorea and athetosis occur at the same time, it is sometimes referred to as choreoathetosis. Athetosis and choreoathetosis can sometimes be mistaken for another involuntary movement called dystonia.
How Is Huntingtons Disease Treated
At this point in time, there is no cure for Huntingtons Disease. There is also no known way to slow or prevent the disease from progressing. For now, treatment focuses on the management of symptoms and optimizing the quality of life for those affected. Each person affected by Huntingtons Disease will experience their symptoms uniquely. Meaning no two patients are the same, and no two patients exhibit identical symptoms.;
There are a wide variety of medications and therapies that are available to help people with Huntingtons Disease. It is important to practice patience and perseverance when beginning a new medication as it takes time to figure out how these medications interact with your body and with each other. It may take weeks or months to figure out the correct combination and dosage of medications.;
Speech therapy is also a very important part of a treatment plan for Huntingtons Disease. One of our highly specialized virtual speech therapists can offer support and guidance on the road to managing symptoms. Connect with one of our speech therapists by scheduling your free introductory calltoday!
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Whats The Difference Between Parkinsons And Huntingtons
Although Parkinsons and Huntingtons disease are very similar, they also have some marked differences that can help in the diagnosis.
First of all, the diseases onset is quite different since Parkinsons patients do not suffer from chorea. Instead, they begin with small tremors in their fingers that look as if they were rubbing coins.
It continues as rigidity and very slow movements, small steps as they walk and not balancing their arms. Their facial expression also disappears, giving them a ¨permanent poker face¨.
In this disease, there is a direct link to the loss of neurons that produce dopamine, which causes these particular symptoms. It isnt well known the precise cause of this disease, although its most likely genetics, some patients dont show precise mutations.
What is certain is the presence of Lewy Bodies in the brain cells, which this disease affects. Lewy bodies are inclusions in brain cells with a-synuclein; protein cells cannot get rid of, causing their death.
Parkinsons patients also suffer from psychiatric symptoms such as dementia and depression, making it even more similar to Huntingtons.
What differentiates both diseases without a doubt is the presence of mutant huntingtin in Huntingtons patients. A gene test confirms its existence and excludes Parkinsons diseases from being a potential diagnosis.