Deep Brain Stimulation For Parkinsons: Am I A Candidate
Deep brain stimulation is not a cure, but it can relieve your symptoms from Parkinsons disease when medications are not an option. Only you and your doctor can decide if this surgical procedure is right for you. You may be a candidate for deep brain stimulation if:
- You have idiopathic Parkinsons disease. Patients with atypical parkinsonism are not candidates.
- You have good motor function and independence during your best on state when taking the drug Sinemet.
In The Loop: Staying Ahead Of Parkinsons Disease One Ping Pong Game At A Time
Since being diagnosed with Parkinsons disease, Steve Grinnell has worked hard to stay active, stepping up his table tennis game and, thanks to co-workers, testing his skills outside his home.
Four years ago, Steve Grinnells life was forever changed when doctors at Mayo Clinic in Rochester diagnosed him with early-onset Parkinsons disease. Since that time, the progressive nervous system disorder has begun to take a toll on Steve and his family, just as it does on the millions of other Americans living with the disease. It has greatly diminished his quality of life, leaving him with tremors, physical exhaustion, impaired balance, troubled grasping things with his right hand, slow right-arm movement and problems sleeping, the Rochester Post-Bulletin recently reported. Thats to name just a few of his symptoms.
Reading that, one might assume the disorder is winning. And to Steve, sometimes it feels like it is. But much of the time, he tells us he also feels like hes staying one step ahead of the disease by staying as physically active as possible. Parkinsons presents such a conundrum because it wears you down physically, and yet exercise is so valuable, Steve says. My legs, feet and right arm are always cramping, so it takes mental effort to get moving.
Changes In Cognition And Parkinsons Disease
Some people with Parkinsons may experience changes in their cognitive function, including problems with memory, attention, and the ability to plan and accomplish tasks. Stress, depression, and some medications may also contribute to these changes in cognition.
Over time, as the disease progresses, some people may develop dementia and be diagnosed with Parkinsons dementia, a type of Lewy body dementia. People with Parkinsons dementia may have severe memory and thinking problems that affect daily living.
Talk with your doctor if you or a loved one is diagnosed with Parkinsons disease and is experiencing problems with thinking or memory.
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And Speaking Of Timely Parkinsons Disease Diagnosis
Turns out its not just selfies and videos that can help with diagnosing Parkinsons disease.
More and more, people are using speech-activated smart devices, such as Alexa, Apple Watch, and Google Voice Assistant, to accomplish everyday tasks. Could these devices analyze our speech and voices to alert us if we show early warning signs of Parkinsons disease?
Recent work by Rochester researchers suggests its entirely possible. Wasifur Rahman, Sangwu Lee, Md. Saiful Islam, and other students in Hoques lab published findings in the Journal of Medical Internet Research that show how an online tool can be used to help screen almost anyone anywhere for Parkinsons disease remotely using video- or audio-enabled speech tasks.
Taken together, the Rochester researchers efforts are contributing to a future in which equity and access to neurological care is as ubiquitous as owning a smart phone or other internet-enabled device.
What You Can Do
As of 2021, there is no definite cure for Parkinsons disease. There is also no definite known cause. Its likely due to a combination of an individuals susceptibility and environmental factors. Most cases of Parkinsons disease happen without a genetic link.
According to research published in 2012, only report having a family member with the disease. Many toxins are suspected and have been studied, but no single substance can be reliably linked to Parkinsons.
However, research is ongoing. Its estimated that
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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.
Treatment For Early Stage Parkinsons
Several recent research developments have brought new hope for treating symptoms of Parkinsons disease and developing therapies to potentially slow disease process.
Medications such as dopamine replacement therapy and dopamine-inhibitors, which mimic the effect of dopamine on the brain, are among the main medication treatments for primary symptoms of PD.
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Deep Brain Stimulation For Parkinson’s: Am I A Candidate
Deep brain stimulation is not a cure, but it can relieve your symptoms from Parkinson’s disease when medications are not an option. Only you and your doctor can decide if this surgical procedure is right for you. You may be a candidate for deep brain stimulation if:
- You have idiopathic Parkinson’s disease. Patients with atypical parkinsonism are not candidates.
- You have good motor function and independence during your best “on” state when taking the drug Sinemet.
Managing Depression In Parkinsons Disease
People with Parkinsons, family members and caregivers may not always recognize the signs of depression and anxiety. If you are experiencing depression as a symptom of Parkinsons, it is important to know it can be treated.
Here are some suggestions:
- For information and support on living well with Parkinsons disease, contact our Information and Referral line.
- As much as possible, remain socially engaged and physically active. Resist the urge to isolate yourself.
- You may want to consult a psychologist and there are medications that help relieve depression in people with Parkinsons, including nortriptyline and citalopram .
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What Medications And Treatments Are Used
Medication treatments for Parkinsons disease fall into two categories: Direct treatments and symptom treatments. Direct treatments target Parkinsons itself. Symptom treatments only treat certain effects of the disease.
Medications that treat Parkinsons disease do so in multiple ways. Because of that, drugs that do one or more of the following are most likely:
Several medications treat specific symptoms of Parkinson’s disease. Symptoms treated often include the following:
- Erectile and sexual dysfunction.
- Hallucinations and other psychosis symptoms.
Deep brain stimulation
In years past, surgery was an option to intentionally damage and scar a part of your brain that was malfunctioning because of Parkinsons disease. Today, that same effect is possible using deep-brain stimulation, which uses an implanted device to deliver a mild electrical current to those same areas.
The major advantage is that deep-brain stimulation is reversible, while intentional scarring damage is not. This treatment approach is almost always an option in later stages of Parkinson’s disease when levodopa therapy becomes less effective, and in people who have tremor that doesnt seem to respond to the usual medications.
Researchers are exploring other possible treatments that could help with Parkinsons disease. While these arent widely available, they do offer hope to people with this condition. Some of the experimental treatment approaches include:
Stooping Or Hunching Over
Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson’s disease .
What is normal?If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.
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More Than 6000 Pwr Trainers And Virtual Classes Make The Program Accessible Around The United States
In addition to individual and group exercise options, PWR also offers rehabilitation services and interventions that address other aspects of wellness, such as nutrition and stress management.
Part of our vision statement is that we want everyone with Parkinsons to have access to this type of cutting-edge and integrated care thats what were trying to do as an organization, says Farley.
Toward that goal, the organization offers PWR training to physical therapists, as well as other fitness and exercise professionals, about how to target specific exercises to address individual PD symptoms, which can be customized for each persons needs and skill level.
We make the exercise and rehabilitation Parkinsons-specific, based upon the clients motor, cognitive, and emotional symptoms. It is comprehensive we want to address all of those pieces, because all of those things contribute to their functional decline and motor deterioration, says Farley.
So far, more than 6,000 therapists and exercise specialists around the United States have completed PWR training. The organizations website offers a searchable directory by ZIP code to help people locate the closest PWR-trained professional.
Theres also a that offers people with Parkinsons an opportunity to try out classes virtually and learn about the program, she says.
How Soon After Treatment Will I Feel Better And How Long Will It Take To Recover
The time it takes to recover and see the effects of Parkinson’s disease treatments depends strongly on the type of treatments, the severity of the condition and other factors. Your healthcare provider is the best person to offer more information about what you can expect from treatment. The information they give you can consider any unique factors that might affect what you experience.
Diagnosing Early Onset Parkinsons Disease
There is no single test to detect Parkinsons. A diagnosis may be difficult and take a while. The condition is usually diagnosed by a neurologist based on a review of your symptoms and a physical exam.
A DaTscan to visualize your brains dopamine system may help confirm diagnosis. Blood tests and other imaging tests, such as an MRI scan, dont diagnose Parkinsons. However, they may be used to rule out other conditions.
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If You Have Parkinsons Disease
If you have been diagnosed with Parkinsons, call your doctor if:
- You notice any significant change in your symptoms, such as severe episodes of freezingâa sudden loss of mobilityâwhich may affect walking.
- Your response to your medicine changes.
- Any other symptoms occur, such as constipation, sexual problems, or incontinence.
- You have symptoms of depression, such as feeling sad or hopeless and losing interest in daily activities.
- You or your family notice that you have problems with memory and thinking ability.
Parkinsons disease has four main symptoms:
- Tremor in hands, arms, legs, jaw, or head
- Stiffness of the limbs and trunk
- Slowness of movement
- Impaired balance and coordination, sometimes leading to falls
Symptoms of Parkinsons and the rate of progression differ among individuals. Sometimes people dismiss early symptoms of Parkinsons as the effects of normal aging. In most cases, there are no medical tests to definitively detect the disease, so it can be difficult to diagnose accurately.
People with Parkinsons often develop a parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward, and reduced swinging of the arms. They also may have trouble initiating or continuing movement.
How Do I Take Care Of Myself
If you have Parkinsons disease, the best thing you can do is follow the guidance of your healthcare provider on how to take care of yourself.
- Take your medication as prescribed. Taking your medications can make a huge difference in the symptoms of Parkinson’s disease. You should take your medications as prescribed and talk to your provider if you notice side effects or start to feel like your medications aren’t as effective.
- See your provider as recommended. Your healthcare provider will set up a schedule for you to see them. These visits are especially important to help with managing your conditions and finding the right medications and dosages.
- Dont ignore or avoid symptoms. Parkinsons disease can cause a wide range of symptoms, many of which are treatable by treating the condition or the symptoms themselves. Treatment can make a major difference in keeping symptoms from having worse effects.
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Some Parkinsons Treatment Options
Parkinsons disease has no cure, but there are treatment options to control your symptoms and improve your quality of life which include:
- Medication. Levodopa and other medications, which are trying to boost dopamine . There are number of those medications which can be used alone or in combination. Although many of those medications can help you significantly control your motor symptoms , you might also experience side effects and diminished efficacy over time.
- Physical, occupational, and speech therapy are usually part of your treatment plan and can improve your balance, mobility, ability to do daily tasks, and speech.
- Deep brain stimulation is a surgery performed by a neurosurgeon, and in indicated patients can help with motor symptoms, though non-motor symptoms, such as falls, constipation, low blood pressure and incontinence do not improve.
- Tai Chi is a Chinese martial art that may help sufferers regain some of their balance and strength, as well as decrease the risk of falling. Dance, such as a Zumba, may also help, as can using a stationary bicycle and rock steady boxing.
Many treatment options for Parkinsons are most effective when used in conjunction with others such as taking medication and doing physical therapy.
Software Analyzes Facial Expressions Hand Movements
Smiles are not the only behaviors that Hoque and his lab can analyze for early symptoms of Parkinsons disease or related disorders.
In collaboration with Ray Dorseya leading expert in Parkinsons disease and the David M. Levy Professor of Neurology at Rochesterand the Universitys Morris K. Udall Parkinson Disease Research Center, the researchers have developed a five-pronged test that neurologists could administer to patients sitting in front of their computer webcams hundreds of miles away.
This could be transformative for patients who are quarantined, immobile, or living in underdeveloped areas where access to a neurologist is limited, Hoque says.
In addition to making the biggest smile, and alternating it with a neutral expression three times, patients taking the test are also asked to:
- Read aloud a complex written sentence
- Touch their index finger to their thumb 10 times as quickly as possible
- Make the most disgusted look possible, alternating with a neutral expression, three times
- Raise their eyebrows as high as possible, then lower them as far as they can, three times slowly
Using machine learning algorithms, the computer program showswithin minutesa percentage likelihood from each of the tests whether the patient is showing symptoms of Parkinsons disease or related disorders.
Hence the importance of testing other expressions and movements, according to Ali, a former postdoctoral associate in Hoques lab who now is an associate data scientist at Sysco.
Acting Out What Youre Dreaming
- People with REM sleep behavior disorder might talk in their sleep and flail their arms and legs during dreams, accidentally hitting or kicking a person in the same bed.
When people learn about the sleep disorder, they often say, Ive been doing that for years. Theyre sometimes astonished to learn its an early symptom of Parkinsons, Dr. Joseph says.
Is There A Way To Slow The Progress Of Parkinsons
Parkinsons disease is a progressive disorder, which means its symptoms worsen slowly over time. There is no cure for Parkinsons disease yet and no known way to slow its progress.
But there are treatments and medications that can control or reduce the symptoms and help people live productive lives. Some research suggests that regular exercise may slow the progress of Parkinsons. Physical activity can also alleviate stiffness and other symptoms.
There are other things a person can do to feel better after a diagnosis of Parkinsons, such as joining social support groups and learning as much as possible about the disease. Its also important to make the home safer and less cluttered, since a person with Parkinsons is more likely to fall.
While its not always easy, neurologists say a positive mindset can also help.
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Exercise And Parkinsons Disease
Research conducted by the Parkinsons Foundation reveals that exercising at least 2.5 hours per week improves symptoms and slows disease progression. The group also found that the earlier patients began exercising, the more pronounced the benefits were.
To help with balance and mobility, the Foundation recommends aerobics, strength-training, and flexibility exercises. Popular options include:
- Weight lifting
The real secret to the best exercise program, though, is doing what you enjoy. For some ideas, please see our previous articles on strength-building exercise and how to begin an exercise program. And remember, never begin a new exercise regimen without talking to your doctor.
How Is It Diagnosed
Diagnosing Parkinson’s disease is mostly a clinical process, meaning it relies heavily on a healthcare provider examining your symptoms, asking you questions and reviewing your medical history. Some diagnostic and lab tests are possible, but these are usually needed to rule out other conditions or certain causes. However, most lab tests aren’t necessary unless you don’t respond to treatment for Parkinson’s disease, which can indicate you have another condition.
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