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.
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Who Gets Parkinsons Disease
As stated previously, men are about 1.5 times more likely to develop Parkinsons disease than women however, although the majority of all patients that get the disease are over 60, the total chance of getting the disease is about 2% to 4% in this age group. Consequently, the disease is not rare but the chances of someone age 60 or over developing the disease is not high.
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Elimination Of Other Conditions
Although no test can diagnose Parkinson’s disease itself, your doctor may order blood tests or imaging studies to rule out other causes of your symptoms.
Your doctor will want to know about any medication or recreational drugs you take, since some drugs can cause symptoms similar to those of Parkinson’s.
Parkinson’s disease doesn’t show up on radiological studies like X-ray, MRI , or CT scans.
Doctors sometimes order dopamine transporter SPECT imaging to determine whether a person with suspected Parkinson’s has a different disorder called essential tremor.
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How Is Parkinson’s Disease Managed
Your doctors will tailor your treatment based on your individual circumstances. You will manage your condition best if you have the support of a team, which may include a general practitioner, neurologist, physiotherapist, occupational therapist, psychologist, specialist nurse and dietitian.
While there is no cure for Parkinson’s disease, symptoms can be treated with a combination of the following.
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.
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Parkinsons Disease: Patient Guide To Covid
Dealing with Parkinsons Disease poses its own challenges, but managing your disease while worrying about the current pandemic can be even more stressful. Here are some basic questions answered, about navigating the coronavirus pandemic with Parkinsons Disease.
The last few weeks have been challenging for everyone, and the challenges will most likely continue for several more weeks. All of our lives have been significantly interrupted by this pandemic. Many of us are experiencing anxiety, and there are more questions than answers. Your family at the Pacific Movement Disorders Center is here to help you navigate through this difficult time by answering some questions you may have regarding to COVID-19. Please note that our advice and answers may shift as new information comes in.
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How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease, but there are medications that can help control the symptoms that make day-to-day life difficult for patients, such as tremors and rigidity. Because every person experiences the disease differently, not every drug works for every patient. Some of these drugs can also have side effects, making it important to find the right mix of medication for each patient. These medications, which slow the progression of the disease, interact with the brains unique chemistry to help improve quality of life. There are also a range of therapies available to help patients manage their symptoms for as long as possible.
In some cases, doctors can use deep-brain stimulation to send electrical pulses to the brain to decrease symptoms. The surgery, which carries risks of its own , is typically reserved for those with advanced forms of the disease. And while the procedure has proven successful in reducing symptoms over sustained periods, it does not halt the advance of the disease.
Researchers have also identified three circuits in the brain that influence the development of the motor and non-motor symptoms of the disease . In a study that explored the manipulation of these circuits, the team was able to reverse the effects of the disease in mice. These circuits may prove to be effective targets for new therapies that help manage the disease in humans.
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What Are The Primary Motor Symptoms Of Parkinsons Disease
There are four primary motor symptoms of Parkinsons disease: tremor, rigidity, bradykinesia and postural instability . Observing two or more of these symptoms is the main way that physicians diagnose Parkinsons.
It is important to know that not all of these symptoms must be present for a diagnosis of Parkinsons disease to be considered. In fact, younger people may only notice one or two of these motor symptoms, especially in the early stages of the disease. Not everyone with Parkinsons disease has a tremor, nor is a tremor proof of Parkinsons. If you suspect Parkinsons, see a neurologist or movement disorders specialist.
Tremors
Rigidity
Bradykinesia
Postural Instability
Walking or Gait Difficulties
Dystonia
Vocal Symptoms
Less Common Premotor Symptoms
The CARD symptoms are the most common early symptoms of Parkinsons disease.
However, some patients may have other early symptoms as well.
They are important to know. These symptoms may be dismissed as vague or strange at first.
| 5 less common pre-motor symptoms |
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Causes Of Early Onset Parkinsons Disease
Its unclear exactly what causes Parkinsons at any age. Genetic factors, environmental factors, or some combination of the two may play a role. This condition occurs when cells are lost in the part of the brain that produces dopamine. Dopamine is responsible for sending brain signals that control movement.
Certain genes are associated with early onset Parkinsons.
According to the National Parkinson Foundation, studies show that 65 percent of people with Parkinsons who experience onset before age 20 may do so because of a genetic mutation. This organization also suggests this mutation affects 32 percent of people who experience onset between age 20 and 30.
Environmental causes of the condition may include exposure to chemical toxins such as certain insecticides, fungicides, and herbicides.
The U.S. Department of Veterans Affairs recognizes Parkinsons as a disease caused by exposure to Agent Orange. Agent Orange is a synthetic chemical herbicide that was used to spray vegetation and trees during the Vietnam War.
You may have a higher risk of developing Parkinsons if you:
- are a man
Five Early Signs Of Parkinson’s Disease
In order to help people reach an appropriate diagnosis and receive suitable Parkinson’s care, the National Parkinson Foundation shared some of the most common early warning signs of Parkinson’s disease. Paying attention to the following signs could help you consider talking with a health care professional about the possibility of your having Parkinson’s disease.
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Treatment Of Parkinsons Disease
There is currently no cure for Parkinsons, and this disease is degenerative. Therefore, at this time, the only thing doctors can do for the patient is alleviate the symptoms and try to slow the progression of the disease. There are two leading medical therapies used to treat and control the symptoms of Parkinsons disease: levodopa, which stimulates the brain to produce more dopamine, and carbidopa. Carbidopa is used in conjunction with levodopa to help manage some of the unpleasant side effects of levodopa, which include nausea, vomiting and restlessness. Levodopa can sometimes be reduced when both medications are taken.
Another form of treatment known as deep brain stimulation can help patients who cannot take medication. Deep brain stimulation requires surgical implantation of an electrode within the brain as well as an electrical device in the chest. A painless electrical charge helps to control tremors, slowness and stiffness by stimulating areas of the brain that control movement.
How Long Can Mild Parkinsons Last
Individuals with PD may have a slightly shorter life span compared to healthy individuals of the same age group. According to the Michael J. Fox Foundation for Parkinsons Research, patients usually begin developing Parkinsons symptoms around age 60 and many live between 10 and 20 years after being diagnosed.
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Cognitive And Psychiatric Symptoms
- depression and anxiety
- mild cognitive impairment slight memory problems and problems with activities that require planning and organisation
- dementia a group of symptoms, including more severe memory problems, personality changes, seeing things that are not there and believing things that are not true
Common Symptoms Of Parkinsons Disease
Parkinsons is mostly known for its movement-related symptoms . Everyone with Parkinsons has the first symptom, bradykinesia. The term literally means slowness of movement. Researchers believe that this is due to changes in the motor areas of the brain . These changes interfere with the brains ability to execute the commands to move.
Experiencing bradykinesia alone does not result in a diagnosis of Parkinsons disease. The patient must also exhibit at least one of the following movement symptoms:
- Postural instability
- Rigidity
- Tremor
Of the three, tremor is the most common and most commonly associated with the condition. It presents as a slight shaking in the hand or chin. Rigidity is when the patient experiences stiffness in the arms or legs that is not caused by arthritis. Finally, postural instability simply means that the patient has issues with balance or is prone to falling.
Other movement symptoms include:
- Insomnia, excessive daytime sleepiness, restless legs syndrome, vivid dreams, and other sleep disorders
- Losing sense of taste or smell
- Mood disorders such as anxiety, depression, and apathy
Some non-movement symptoms do not become apparent until a patient has had PD for many years.
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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 systems 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.
Early Signs And Symptoms Of Parkinsons
Parkinsons disease often comes on gradually with early signs and symptoms. Physical and mental changes in the early stages of PD may go relatively unnoticed, but the condition generally becomes more noticeable over time.
Many MyParkinsonsTeam members have described their early experiences with the condition and the time it took to get a diagnosis. My falls existed long before my diagnosis, a member wrote. Another member said, Im pretty new to a PD diagnosis. I can trace symptoms back to 2005.
PD is a disorder in the central nervous system. It is caused by low levels of dopamine due to the degeneration of nerve cells in a part of the brain called the substantia nigra. Dopamine is a neurotransmitter that controls movement, mood, learning, and functions in other parts of the body.
PD can cause motor symptoms that create movement disorders and problems with mobility, as well as nonmotor symptoms such as depression, sensory disorders, and cognitive problems. Parkinsons is a chronic disease and there is no cure. Treatment is aimed at managing symptoms, slowing disease progression, and improving quality of life.
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Stooping Or Hunched Posture
People who have Parkinsons disease may notice changes in their posture due to other symptoms of the disease, such as muscle rigidity.
People naturally stand so that their weight is evenly distributed over their feet. However, people who have Parkinsons disease may start bending forward, making them appear hunched or stooped over.
What Are The Signs And Symptoms Of Parkinsons Disease
Although individuals may experience symptoms differently, the four common signs of Parkinsons disease are:
- Muscle rigidity or stiffness when the arm, leg, or neck is moved back and forth.
- Tremorsinvoluntary movement from contracting musclesespecially when at rest.
- Slowness in initiating movement.
- Poor posture and balance that may cause falls or problems with walking.
Get more information about Parkinsons disease from UR Medicine Neurosurgery.
Every day, millions of people take selfies with their smartphones or webcams to share online. And they almost invariably smile when they do so.
To Ehsan Hoque and his collaborators at the University of Rochester, those pictures are worth far more than the proverbial thousand words. Computer vision softwarebased on algorithms that the computer scientist and his lab have developedcan analyze the brief videos, including the short clips created while taking selfies, detecting subtle movements of facial muscles that are invisible to the naked eye.
The software can then predict with remarkable accuracy whether a person who takes a selfie is likely to develop Parkinsons diseaseas reliably as expensive, wearable digital biomarkers that monitor motor symptoms. The researchers technology is described in Nature Digital Medicine.
Though ethical and technological considerations still need to be addressed, the Gordon and Betty Moore Foundation has agreed to fund this novel research through a $500,000 grant, effective November of 2021.
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What Are The Five Stages Of Parkinson’s Disease
Researchers may disagree on the number of stages of Parkinsons disease . However, they all agree the disease is a progressive disease with symptoms that usually occur in one stage may overlap or occur in another stage. The stage increase in number value for all stage naming systems reflect the increasing severity of the disease. The five stages used by the Parkinsons Foundation are:
- Stage 1: mild symptoms do not interfere with daily activities and occur on one side of the body.
- Stage 2: Symptoms worsen with walking problems and both sides of the body affected.
- Stage 3: Main symptoms worsen with loss of balance and slowness of movement.
- Stage 4: Severity of symptoms require help usually person cannot live alone.
- Stage 5:Caregiver needed for all activities patient may not be able to stand or walk and may be bedridden and may also experience hallucinations and delusions.
A neurologist who specializes in movement disorders will be able to make the most accurate diagnosis. An initial assessment is made based on medical history, a neurological exam, and the symptoms present. For the medical history, it is important to know whether other family members have Parkinson’s disease, what types of medication have been or are being taken, and whether there was exposure to toxins or repeated head trauma previously. A neurological exam may include an evaluation of coordination, walking, and fine motor tasks involving the hands.
The diagnosis of Parkinson’s disease is more likely if:
Diagnosis Of Parkinsons Disease
A number of disorders can cause symptoms similar to those of Parkinson’s disease. People with Parkinson’s-like symptoms that result from other causes are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinson’s, certain medical tests, as well as response to drug treatment, may help to distinguish them from Parkinson’s. Since many other diseases have similar features but require different treatments, it is important to make an exact diagnosis as soon as possible.
There are currently no blood or laboratory tests to diagnose nongenetic cases of Parkinson’s disease. Diagnosis is based on a person’s medical history and a neurological examination. Improvement after initiating medication is another important hallmark of Parkinson’s disease.
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